Scientific Demagoguery in the Stem Cell Wars
Analyzing the status and ethics of current stem cell research
by David Stevens, MD, MA (Ethics)
Today's Christian Doctor - Fall 2013
The "Stem Cell Wars," as they were called on the cover of Newsweek on July 9, 2001, are over, and we won!
I remember that magazine issue because it hangs framed in our CMDA offices in Bristol, Tennessee as a remembrance of one of CMDA’s early forays into representing you on a contentious bioethical issue. My half hour interview with the reporter got dehydrated to one sentence in the cover article called, "Battle for Bush’s Soul," where it was introduced by saying I was part of the "religious right." The entire article was full of hyperbole, scientific demagoguery and anti-religious bigotry. The first sentence asserted that if then- President George W. Bush didn’t allow federal funds for human embryonic stem cell research (hESCR), the name of the GOP should be changed to "POG – the Party of God." It went on to assert that this was a life and death issue and those opposing funding were sentencing people to death.
That was just the warm-up for those claiming that the faction opposed to sacrificing human beings on the altar of research was playing "politics with science." Demagoguery is appealing to the emotions, prejudices and ignorance of the population to gain power, influence or money. It usually involves politicians, but in this battle, scientists led the way. Science and society both paid the price as researchers ridiculously claimed that Parkinson’s, diabetes, Alzheimer’s and a host of other diseases could be cured within the next five to 10 years if the federal coffers would just be opened to fund "lifesaving" research.
Researchers occupied the scientific high ground and took shots at everyone who opposed them, asserting that the ends justified the means, even if it involved destroying nascent human life. Gone were the claims of "my body, my right," "a woman’s choice" or "reproductive rights" commonly heard in the abortion debate. Instead, it was about wasting "unused embryos" and the nobility of parents donating them to science.
It was a horrific battle. I know; I still have some "scars." I remember being called a "Luddite" in one interview. I didn’t know how to respond because I didn’t know what a Luddite was! My later research revealed that unbeknownst to me, I was "against all new technology." In a CNN interview after a video montage of stem cell scientists manipulating cells to save lives, the host turned to me and said, "Dr. Stevens, you’re a physician and you have children. Why would you be opposed to something that could save so many people’s lives?"
I answered, "I believe stem cells will usher in a new era of regenerative medicine that will rival the development of antibiotics in the 1930s in saving lives. The question is not whether we should do stem cell research but where do we get the stem cells?" I then stated that hESCR was immoral, impractical and unnecessary. I even pointed out that the main scientific "authorities" advocating funding had completed more than 200 radio and TV interviews in the last few months and not once had they revealed the fact that they were shareholders, patent holders or officers in for-profit companies and stood to benefit from the government’s largesse.
Where are we now?
The scientists, the commanding officers in the stem cell wars, have largely surrendered on the last two points of conflict in the last 12 years. They admit that hESCR is impractical and unnecessary. Not only have there been stunning developments using umbilical cord, amniotic and adult stem cells, but by inducing the forced expression of specific genes, somatic cells were turned into embryonic stem cell-like induced pluripotent cells (iPSCs). While many scientists were marching in lock step down the dead-end path of embryonic stem cells, Shinya Yamanaka in Japan and John Gurdon in England made this scientific breakthrough, earning them a Nobel prize in just six years.
The cells they developed avoid the need for harvesting women’s eggs and sacrificing embryos. The iPSCs can be made from any somatic cell from a patient and the cells developed will immunologically match that patient. Using these and other sources of non-embryonic stem cells, significant progress is being made achieving in four out of the five main scientific goals of regenerative medicine.
The first goal is functional cellular genomics so that scientists can understand the complex events of cellular development. They want to know the factors involved in the cellular decision-making process resulting in cell specialization. What genes are involved and what modifies their expression so that a stem cell turns into heart muscle rather than nervous tissue? Many of our most serious medical conditions, such as cancer, are due to abnormal cell specialization and division.
Recent research reveals that declining levels of protein BubR1 occurring in stem cells causes cellular senescence, leading to weight loss, muscle wasting, cataracts and other symptoms of aging. Dr. Michael Rudnicki’s research in Canada found the trigger to cause adult muscle stem cells to develop in brown fat instead of muscle fibers when cellular microRNA-133 is reduced. This could play a critical role in the fight against obesity. Scientists at Yale, using sophisticated gene sequencing and analysis techniques, found a regulatory link in stem cell factor Lin28 that affects the microenvironment in ovarian carcinogenesis that could lead to effective treatments for this deadly disease.
The second focus of stem cell research is to develop disease-specific cell culture mediums to use in new drug testing. Stem cells could allow scientists to test new drugs using human cell lines which could hasten new drug development and make it much cheaper. Only drugs found to be safe and beneficial in cell line testing would then graduate to animal and human testing.
Last May, researchers at UCLA successfully developed a "disease-in-a-dish" model from iPSCs developed from patients with ataxia telangiectasia skin cells. This will speed drug trials for treatment of this neurodegenerative disease. The same has been done for Alzheimer’s and other diseases. This technology will have profound economic effects. The present cost of developing, testing and getting approval for a new drug can approach a billion dollars and it is having a chilling effect on development.
The third goal of regenerative medicine is to develop specific cell therapies to replace damaged or destroyed tissues, and many are already in use. Pau Gasol, a 12-year veteran of the Los Angeles Lakers, had autologous stem cell injections to stimulate cartilage regeneration in his knees during the off-season. Scientists are growing and implanting bone grown from iPSCs made from the patient’s skin cells and repairing bone defects. Bone stem cells have been successfully turned into brain cells, opening the door to new treatments for central nervous system diseases. Scientists recently isolated adult stem cells from human intestinal tissue which will allow the exploration of new tactics to treat inflammatory bowel diseases. There has been only limited success in growing new heart muscle in patients after heart attacks using stem cells. One of the problems has been tracking the stem cells going to the damaged areas. In March, scientists announced they have successfully injected silca nanoparticles into stem cells which enables them to be tracked real time by ultrasound. The Mayo clinic is now conducting clinical trials of an adult stem cell treatment for ALS. In New Jersey, trials of stem cell and physical therapy combinations in chronic spinal cord injury patients have reported increases in bladder control, sensation and muscle function. Progress is being made on numerous fronts at an ever increasing pace.
Lastly, regenerative medicine will enable the creation and transplantation of organs. Building tissues have four levels of complexity. The easiest is creating flat structures, such as skin because they are made up of just one type of cell. Tubes, such as urethras or blood vessels, serve as conduits and have two types of cells so they must be made in layers. Hollow non-tubular organs like the bladder and stomach have more complex structures and function. Solid organs, like the kidney, heart and liver are the most complex to engineer.
Tissues of the first three levels of complexity have been created and implanted in humans already, including growing a trachea and implanting it in a two and a half-year-old girl born without one. One of the challenges is creating the "scaffolds" to grow the stem cells, but progress has been made using cellulose, silk and even sugars as the matrix for stem cells to cling to and grow.
Recently, U.S. scientists made news when they successfully cloned human embryos using fewer eggs and then successfully developed ESC cultures from them. The scientific community yawned. Though, sadly, they still don’t see the immorality of sacrificing nascent human beings for their biological parts, they are pragmatic. The train has long left the station of ESC research.
The good news for Christian healthcare professionals is that ethical sources of stem cells are transforming medicine as we move further in the era of regenerative medicine. Neither patients nor their physicians will have to abuse their consciences to access real cures for real people for the diseases that beset our culture.
The stem cell wars are over. We won!