Thursday, June 07, 2007

A Question of Priorities... Issues in Stem Cell Research

Our friend and colleague, Art Caplan, does a keen job in his MSNBC column of dissecting the issues surrounding the latest breakthrough in stem cell research, which has been a leading news story everywhere, including the New York Times, Washington Post, and Nature. He advises that doctors and funders shouldn't put all their embryos in one basket, so to speak. He makes several good points, encouraging the Congress to pass the Stem Cell Research Enhancement Act of 2007. I think it is important to note that Congress and the Administration, if they are serious, should be pouring money into all aspects of stem cell research -- adult, umbilical, and embryonic. Each type of cell has its advantages and disadvantages, from what my research colleagues tell me -- adult stem cells, which are not as pluripotent, communicate well and integrate fairly well with surrounding cells. Embryonic stem cells, while very pluripotent, tend to act as 'wild cards', and we are still learning how keep them from growing out of control. And umbilical cord stem cells are somewhere in-between, but you don't hear much about them in the media, possibly because there doesn't seem to be funding or encouragement for research using umbilical cord stem cells. Could that be because the private biobanking business has cornered the market on these, encouraging parents to freeze and store their babies' cords for a mere $3000? (not to mention to yearly storage fee). While the Institute of Medicine recommended setting up public banking of cord blood last year, little has been done to implement that recommendation.

If this Administration sincerely wanted to help individuals with debilitating diseases, and further research in the interest of public health and welfare, and make significant progress, it would have sanctioned and funded public biobanking and research on umbilical cord stem cells a long time ago. But it is easier it seems, to deflect the issue, cloaking it in simplistic sound bites. Or to distract us to seemingly more pressing issues like the war on terror, although the debilitating chronic diseases we battle everyday as health care providers are a greater threat to our lives (and our quality of life) than terrorism. What really what it boils down to is a question of priorities.
[Image courtesy the ALS Association]

Addendum 06/08/2007: The House has voted to pass the Stem Cell Research Enhancement Act of 2007 with a vote of 247/176/10, not enough votes to override a presidential veto.


thomas said...

I agree with you that "it is important to note that Congress and the Administration, if they are serious, should be pouring money into all aspects of stem cell research- adult, umbilical, and embryonic."

I would be careful about your reasoning for supporting all three, though. Umbilical cord blood cells (and amniotic stem cells) are really very much like certain adult bone marrow stem cells. I think the biobanking industry hopes that the discoveries rolling out every few months in adult stem cells will translate into new customers. I have yet to encounter reports of viable treatments.

Back to the skin/stem cell story that broke today, my opinion is that the media is handling this issue as an either/or story; either you support embryonic or you support adult stem cell research. I made a post detailing this position, if you are interested in another view.

Linda MacDonald Glenn said...

I read your post on your blog about this and you are so right -- this should not be presented as an either/or choice.

btw, I was using the International Society for Stem Cell Research primer as my source about umbilical cord stem cells (UCSCs) :
"These hematopoietic stem cells are usually referred to as neonatal stem cells and are less mature than the hematopoietic stem cells found in the bone marrow of adults." -- but you are right in pointing out that there are other drawbacks in using UCSCs -- for example, there are a limited number of stem cells in any given cord which prevents its generalized use for the treatment of blood disorders in adults.

thomas said...

Thanks for your reply to my reply : )

I agree that the cord blood cells have wider potency than hematopoietic stem cells (HSCs), but I think many would agree that the excitement over adult stem cells are not for HSCs*, but the other stem cells in the bone marrow - mesenchymal stem cells (MSCs). Recent (and not so recent) findings suggest that the cord blood stem cells' characteristics very much resemble MSCs.

*By the way, the great majority of the successful therapies already derived from adult stem cells (the number 70 is often used by the anti-ESC folks) are 'bone marrow transplants' of HSCs. So while everyone is excited about these other less differentiated cells, HSC transplants continue to save thousands of lives (many of whom are children) every year. And why do we have so many HSC treatments? 25 years of Federally funded stem cell research. said...

Texas has two separate public umbilical cord blood banks. One is at MD Anderson and the other is State funded and a subsidiary of the South Texas Blood Bank.

We were successful in obtaining funding through our State budget this year as well as passing a bill instructing the State Health Services to publish a brochure explaining the options for expectant mothers.

Currently, there are only about 6 hospitals participating in collection, but we hope for more.

This is personal for me - my grand daughter was born with Kostman's, unable to make white blood cells, and eventually developed aplastic anemia. She had a transplant from cord blood donated by an anonymous, unrelated little boy back in December, 2001.

Linda MacDonald Glenn said...

Bev, I'm glad to hear your granddaughter benefited from this -- I hope she is doing well -- said...

She's perfect! She'll be 7 in September and is healthier than my kids were. We watch, but so far, no bad effects that we can see from the original disease or the transplant.