Scientists looking in the wrong place

Australasian Bioethics Information
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Scientists looking in the wrong place for their stem cell supplies
by Amin Abboud
first published in the Sydney Morning Herald, 4 March 2002

Adult stem cell research is the best place to invest our medical research resources, writes Amin Abboud.

There has been a lack of clear logic in the debate about stem cell research. All agree governments should pursue this kind of research enthusiastically and energetically. The argument is not over the usefulness of stem cells, but over their source.

Silviu Itescu, an Australian scientist researching at Columbia University, will begin a trial on treating heart conditions from adult stem cells in the next few months.

He began investigating bone-marrow-related stem cells and has, in less than three years, laid the groundwork for what he hopes will be the first clinical trial with cardiac patients using the patients' own stem cells. No need for spare embryos in this great research.

Those who argue for embryonic stem cell research ask that we destroy the surplus embryos from IVF or propose the creation of embryos to destroy them (the misnomer of therapeutic cloning).

To many in the community this goes against the dignity of the human embryo, the dignity of the point in life where we all began. Why destroy when we all have an abundant supply of adult cells?

To date, the main spokespeople in the stem cell debate have been those which have most to gain from embryonic stem cell research, especially financially - institutions such as the Monash Institute, Sydney IVF and BresaGen, which have engaged in a well-orchestrated public relations exercise. They are also those who can draw on an abundant supply of embryos, from clinics which they manage, which raises enormous ethical concerns.

How free are those who would donate embryos, what emotional and psychological issues can impact on their decision? Can they give away an embryo in that way?

These are all serious issues that are easily dismissed.

Stem cells are those primary cells which have the capacity to develop into many different cell types (muscle, skin, brain, etc). Because of this capacity, they may prove useful for treating some conditions.

Embryonic stem cells come from embryos by destroying them. Adult stem cells, despite their name, can come from children or adults without harming the person. Another rich source is the blood that remains in the umbilical cord after birth.

Every day, scientists are publishing one striking finding after another in adult stem cell research. In Taiwan adult stem cells have been used to treat blindness in one patient. A team at Harvard believes it can use adult stem cells from diabetics to try to cure their diabetes and are about to begin experiments. The list goes on.

Advocates of embryonic stem cell research, such as ethicist Julian Savulescu, writing in the Herald last week, have overlooked the evidence that states it doesn't work. In fact the few trials have been disastrous in Parkinson's patients and one woman in China who was treated with embryonic stem cells for a brain condition developed a teratoma, a type of tumour, from them.

A criticism of adult stem cells has been that they are not as versatile as embryonic stem cells. However, everyday research disproves this theory. In the MIT magazine Technology Review, Stephen Hall noted that, "Recent animal studies emerging from academic labs have underscored the major take-home lesson about adult stem cells in the past year or so: these cells are much more biologically versatile, and capable of adopting many more cellular fates, than anyone previously thought."

There is something holistic and natural about adult stem treatment. It involves harnessing our own cells to treat ourselves. No foreign bodies, no problems of rejection as is likely to occur with embryonic stem cells.

All studies to date reinforce the notion that the adult body maintains a reserve of stem cells, certainly in the bone marrow and probably in other tissues as well, although the supplies seem to dwindle with age. "They seem to be part of a natural repair system, so that when you damage a tissue, they come from the marrow in large numbers," says Darwin J. Prockop, director of Tulane University's centre for gene therapy in New Orleans.

In other words, adult stem cells appear to act as the body's on-call, 24-hour-a-day microscopic medical dispensary for wound repair.

It sounds like the best place to be investing our limited health care budget.

Dr Amin Abboud is an assistant lecturer in medical ethics and health law at the University of NSW, and is the co-ordinator of Australasian Bioethics Information.