"Stem cell
research: Hope or hype?"
by Ulrika G. Gerth
A year and a half after Toni Redmond was diagnosed
with ALS, or Lou Gehrig’s disease, she died an excruciating
death. Tonia Zampieri of Manchester watched the neuromuscular
disease break down her once-so-active mother.
When Redmond, 56, passed away earlier this year,
she was constrained to her bed, only left with the blink of her
eyes to communicate.
The cause of the disease that ruthlessly takes
away patients’ ability to walk, talk, swallow and eventually
breathe yet leaves them painfully aware of their body’s
degeneration, is a mystery to the medical community.
Redmond thought the answer could be found in
stem cell research and so do a world of scientists.
"My mom was always very hopeful," said
Zampieri, now in charge of the development of public awareness
for the New England Chapter of the ALS Association.
But how to find cures for the nearly 150 million
Americans who suffer from diseases and handicaps like multiple
sclerosis, Parkinson’s disease, diabetes and spinal cord
injury is surrounded by a cloud of controversy in which politics
and big business play as large a role as science.
There is the research on human embryonic stem
cells promoted by Hollywood stars like Michael J. Fox and the
late Christopher Reeve, but opposed by pro-life advocates, since
it requires the destruction of a living embryo.
Human embryonic stem cells are considered unique
as they are the only cells proven to have the potential to give
rise to any of the body’s 200 cell types, leading scientists
to believe the cells could replace or repair organs and tissues
damaged by some of today’s most devastating diseases and
disabilities.
There are also adult stem cells, which despite
their name, are found in both adults and children. They were once
thought to only generate cells identical to the tissue in which
they were harvested, but are now known to be much more versatile.
Brain stem cells can, for example, develop into
blood and skeletal material whereas bone marrow stem cells can
differentiate into cardiac muscle cells, fat, bone and cartilage.
Adult stem cells have for years been used to
treat diseases like leukemia, lymphoma and immune deficiencies,
and have recently shown clinical potential in the treatment of
Parkinson’s, diabetes, advanced kidney cancer and spinal
cord injury.
Six years after Dr. James Thomson at the University
of Wisconsin-Madison developed the first human embryonic stem
cell line in 1998, research has yet to produce results in humans.
But, said Lulu Pickering, president of the New
Hampshire Biotechnology Council, "This is not hype. We’ve
infinite potential to do something good. The industry is abuzz
to use this technology and the potential is tremendous. The problem
is the restriction on research."
Political football
Months after Redmond’s death, the issue
of human embryonic stem cell research rose to the fore of Sen.
John Kerry’s presidential campaign.
Hammering away at what Kerry often labeled Bush’s
"ban" on the research, the Democratic candidate pledged
to lift all restrictions.
In April of 2001, Bush made — for the first
time — federal funds available for human embryonic stem
cell research but limited the research to embryonic stem cell
lines derived before the law was signed into effect. There are
no such limits on research done with private funding.
In a rally in Newton, Iowa, Sen. John Edwards
told the crowd that with Kerry in the White House "people
like Christopher Reeve are going to walk, get up out of that wheelchair
and walk again."
His statement provoked both outrage and support,
showing how polarized the issue had become.
"It’s not a good thing to make a political
football out of it," said Charles Carson, president of the
Spinal Cord Society. "There is so much potential in both
adult and embryonic stem cells, it should be free from all politicians
monkeying around with it."
To James Kelly, a paraplegic since an auto accident
in 1997, Edwards’ claim was "as cruel as cruel can
get."
"I was upset over that. He was misleading
and using millions of desperate humans for political gain. Embryonic
stem cells offer nothing for spinal cord injury."
Kelly, who began researching the issue five years
ago and is about to start a foundation called Cures First has
testified before the U.S. Senate and around the country. But unlike
the people who usually testify alongside him, pleading for more
money in human embryonic stem cell research, Kelly takes the opposite
position.
"Although I sympathize with them, they’re
in my opinion cutting their own throat. There’s so much
money and so much hype involved. We’re diverting massive
resources away from research that could help people in the forseeable
future."
Proposition 71 in California, that over the next
10 years will pour $3 billion in state bonds into mainly human
embryonic stem cell research, represents to Kelly a misguided
diversion.
The media focus and Hollywood’s hailing
of the potential wonders of embryonic stem cells has left the
progress of adult stem cell research out of the limelight even
though, he said, it is saving lives right now.
"We’ve been told we need embryonic
stem cell research and therapeutic cloning to find a cure, but
the bottom line is that it’s science for the sake of science,"
said Kelly, who emphasized he is not religious as many other opponents
of human embryonic stem cell research.
Progress
In July 2004, Dennis Turner who has suffered
from Parkinson’s for 14 years testified before a Senate
subcommittee about his improved condition after being treated
with adult neural stem cells taken from a small tissue sample
in his brain.
Extreme shaking of the right side of his body
disappeared, and for four years following the treatment he was
symptom-free.
At the same hearing, 19-year-old Laura Dominguez
told the senators how doctors had given her no chance to ever
walk again after she was left paralyzed from the neck down in
a car accident three years ago.
But research and consultations with medical experts
led her to Portugal, where she became the first American to have
tissue removed from her olfactory sinus area and transplanted
into her spinal cord, the site of injury.
Now, she said in her statement, she can contract
her quadriceps and hamstring muscles, move her feet, feel down
to her hip level, and with assistance and the use of braces, walk
1,400 feet.
Zampieri said one of her mother’s friends
who also suffered from ALS went for a new treatment in Atlanta.
Desperate for a cure, she was one of 43 patients
who paid $25,000 each to have umbilical cord blood infused. The
blood is rich in adult stem cells, and in animal studies the treatment
has proved to slow the progress of the disease and relieve some
of the symptoms, according to Dr. Mitchell Ghen who performed
the treatment.
Seventeen of the patients had their symptoms
reversed although Redmond’s friend was not one of them.
But to the patients’ disappointment, the
Federal Drug Administration put a stop to the treatments because
Ghen had not filed an investigational new drug application that
the agency had initially said he did not need. Sen. Joe Lieberman
questioned the decision in a letter to the FDA.
Although there are still deficiencies in diabetes
treatment with adult stems cells, 80 percent of 250 patients who
received adult pancreatic stem cells from adult cadavers have
been free from insulin shots or pumps for more than a year and
adult stem cells have reversed diabetes in animals, according
to studies cited by The Center for Bioethics and Human Dignity.
"There’re extremely interesting developments
and I wouldn’t be surprised if adult stem cells turn out
to be more valuable than embryonic stem cells," said Alan
Cherrington, president of the American Diabetes Foundation. "But
it’d be silly to restrict research to only one of them."
Dead end
Alzheimer’s disease is contrary to conventional
thought one of the least-likely diseases to benefit from embryonic
stem cell treatments, experts on the subject conceded to the Washington
Post in June this year. Ronald Reagan’s death from the disease
triggered an outpouring of support that had little to do with
scientific evidence.
"To start with, people need a fairy tale,"
Ronald D.G. McKay, a stem cell researcher at the National Institute
of Neurological Disorders and Stroke, told The Post. "Maybe
that’s unfair, but they need a story line that’s relatively
easy to understand."
Charles Jennings, the executive director of the
Harvard Stem Cell Institute, dismissed as "absurd criticism"
claims that the growth of human embryonic stem cells are too difficult
to control and that they are likely to be rejected by a patient’s
immune system as they — unlike adult stem cells —
are not matched genetically with the patient.
"This is a field in its infancy. There is
clear evidence of the potential in mouse research," Jennings
said. "We have to careful not to raise false hope, but the
sooner we start, the sooner we’ll see results."
First he would like to see federal funding extended
to research of new human embryonic stem cell lines. The 22 lines
that are available for research with federal funds from the National
Institutes of Health registry are not adequate, he said, as they
only represent a healthy, white middle class.
Harvard scientists recently announced they had
developed 17 new human embryonic stem cell lines but the effort
had to be privately funded.
In 2002, 30 firms spent $208 million experimenting
on embryonic and adult stem cells, according to the NIH, the federal
government’s leading biomedical research organization. Last
year, the NIH funded $383 million in adult stem cell research
and $24 million in human embryonic stem cell research.
But with California about to pump nearly $300
million a year into the industry and with its eye set on top researchers
worldwide, Jennings recognizes the institute is likely to lose
a few of its scientists to the West Coast. Still, he hopes Harvard
is attractive enough to retain most of them.
If scientists can figure out how human embryonic
stem cells differentiate into specialized cells in the body, they
may be able to reverse processes that today result in devastating
diagnoses for millions of Americans, said Pickering at the Biotechnology
Council.
"It’s a glorious thing," she
said. "But it’s hard work."
Until a real cure materializes, the ALS Association
in Manchester will keep getting calls from people willing to travel
the world for the slightest chance of a miracle.
"People are desperate," said Zampieri.
"This is a disease I’d never wish on my worst enemy.
There’s so much possibility out there that everything must
be explored."
Links:
http://www.isscr.org/
http://stemcells.nih.gov/index.asp
http://www.stemcellresearch.org/
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