Thursday, December 3, 2009

Final Posting - Stem Cell Research is the Way of the Future

There has been much controversy in the press recently about the ethics and viability of stem cell research. To understand this ongoing debate, it is useful to understand the history of this field. Scientists first became interested in stem cells in the 1800s, when the ability of some cells to generate different types of cells was first discovered. The 1980s and 1990s saw the discovery of new techniques for targeting and altering genetic material and methods for growing human cells in the laboratory. In 1998, James Thomson removed cells from spare embryos at fertility clinics and established the world’s first human embryonic stem cell line. Today, stem cells are being used in treatments for over 100 conditions including leukemia, heart disease, and Hunter’s syndrome.


But what exactly is a stem cell, you ask? Stem cells are distinguished from other cell types by two important characteristics. First, they are unspecialized cells capable of renewing themselves through cell division, sometimes after long periods of inactivity. Second, under certain physiologic or experimental conditions, they can be induced to become tissue- or organ-specific cells with special functions. The specific factors and conditions that allow stem cells to remain unspecialized are of great interest to scientists. Addressing questions about cell differentiation may lead scientists to find new ways to control stem cell differentiation in the laboratory, thereby growing cells or tissues that can be used for cell-based therapies.


So why hasn’t more been done in this exciting field of research? Unfortunately, the major restrictions on stem cell research in the US are not limitations of scientific technology or knowledge. Rather, politicians have imposed laws limiting embryonic stem cell research. This entire field is fraught with controversy. Many religious individuals are morally bothered by the idea of destroying the lives of embryos for the sake of scientific research. Others view the subject from a Utilitarian perspective, stating that the anticipated benefits of the research outweigh the costs of conducting it. Still others argue that this research is ethically sound because blastocysts are not human – a reflection of the imperative bioethical question of when an embryo becomes a life with a right to personhood. Politicians are routinely guided by their personal religious and moral views, and the field of stem cell research is not exempt from this. Church and state are not always as separate as they should be.


In 2001, President George W. Bush signed an executive order banning the National Institutes of Health from providing federal funding of embryonic stem cell research beyond using the sixty or so cell lines that already existed. This past March, President Barack Obama reversed Bush’s decision. He promised to make it easier for federally funded researchers to acquire new stem cell lines. Yet not much has happened since. Obama has done little to back up his previous promises. What a shame: stem cell research has the potential to cure or treat hundreds of different diseases – and save billions of dollars in the process.


The United States’ strict restrictions on embryonic stem cell research have caused the US to fall by the wayside as other countries (with fewer restrictions) take the lead. Great Britain, Israel, and China are some of the technological leaders in this field. All have adequate funding and government support. Also, the cultural climate in each of these countries is amenable to stem cell research. Perhaps the United States should model its stem cell policies after the successful strategies employed by Great Britain, Israel and China. Brilliant scientists are leaving America in droves, heading to countries where their research is not as restricted. If America does not soon make efforts to catch up to the world leaders in stem cell research, it may be too late.


Exciting advances in stem cell therapies are currently being made all across the world. French scientists have used the HIV virus as a vector to transplant the stem cells present in bone marrow into patients with adrenoleukodystrophy (ALD), a disease that destroys the myelin coating on nerve fibers in the brain. They have successfully halted the progression of brain damage caused by ALD with this technology. The FDA is overseeing Phase I clinical trials in which embryonic stem cells are being used to treat spinal cord injuries. The United States is also using banked umbilical cord blood to treat cerebral palsy. Stem cell research is steadily gaining momentum – even in the United States.


But will stem cell therapy be affordable to potential patients? Without affordability, the therapies will never take off. In California, there was a measure taken to help ensure cheaper medicines for state residents. California’s Proposition 71 created the California Institute for Regenerative Medicine (CIRM) in 2004, which authorized it to issue $3 billion in grants over ten years for embryonic stem cell and other biomedical research. CIRM aims to support collaboration between scientists and drive down the costs of stem cell research and medicine. If CIRM is successful, it can lead the way for much more innovation in the biomedical world and shed light on stem cell therapy’s financial viability.


As the number of applications for the use of stem cell therapies increases, it seems that the field has a big future in the realm of biotechnology. We have collected articles arguing that embryonic stem cell research does not always have to be applied toward specific diseases – rather there is potential for universal cancer vaccines and treatment therapies for neurodegenerative disorders, for example. By being able to use these cells to treat both specific and non-specific conditions that affect large populations, it seems that the research has the potential to be more viable. In fact, as underlying cellular mechanisms of embryonic stem cells are understood more clearly, scientists will have even more reason to encourage federal funding.


In order to advance stem cell exploration and further the fascinating research that has been mounting in the last two or three years, policy changes must accompany research strides. Economically, stem cell research makes sense. The therapy has so much promise; many diseases and injuries could potentially be cured using stem cell therapy, including Alzheimer’s disease and spinal-cord injuries. Millions, if not billions, of dollars in hospitalizations and healthcare-related expenditures could be saved every year. With the ability to quickly and permanently cure so many diseases, hospital admissions would drastically drop, and the length of hospital stays would decrease. This would save insurers, taxpayers, and the government millions of dollars. There would be more money available to spend on the fight to make universal healthcare a reality. If that’s not an incentive for Obama to focus more effort on improving opportunities for stem cell research, what is?


Though deeply rooted in politics, ethics, religion and global perspective, the controversy over stem cell research is always going to exist. The best way to address this? Scientists must continue to advocate for the technology and prove that it does have critical applications for patients of this generation. The more evidence supplied in support of the cells’ efficacy, the increased likelihood that the research will become more sustainable. Our group firmly believes that stem cell research is the way of the future. While some will always be morally opposed to embryonic stem cell research, we feel that the potential benefits for millions of patients outweigh the negatives. We support stem cell research – including embryonic stem cell research.