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In stem cell debate, truth lies between the slogans

Published August 24, 2004

WASHINGTON - For Republicans trying to hold the White House four more years, it didn't look good: The son of the late President Ronald Reagan, the party's modern savior, addressing the Democratic National Convention, telling a prime-time TV audience that President Bush was wrong to restrict embryonic stem cell research, that the religious objections of a few were blocking medical miracles for many.

As the Republican Party will show next week, two can play at that game. Among the speakers at the GOP convention will be Reagan's other son, Michael, who has called embryonic stem cell research "junk science."

Stem cell research has eclipsed gay marriage as the leading social issue of the presidential campaign. Creative politicking by Democrats and Republicans alike has obscured the truth of what the president's policy does and, just as importantly, what effect it's having on research into treatments for diseases from Alzheimer's to diabetes.

As with so much in emerging science, the answer is not nearly so neat as either campaign would have you believe.

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Stem cells are the building blocks of life. They are master cells, or blank slates, potentially capable of becoming any cell in the body. Scientists believe stem cells eventually will be used to replace dead or damaged cells as treatments for Parkinson's disease, spinal cord injury, heart disease and other ills.

Embryonic stem cells are taken from an embryo in the earliest stage, just after conception. Adult stem cells are found in organs, in bone marrow and in the umbilical cord blood of newborn babies.

Scientists believe both types hold potential, but embryonic stem cells are widely assumed to be most promising because they are wholly undifferentiated. Unlike adult stem cells, they have not already been given a job to do.

But these cells carry ethical baggage. Taking stem cells destroys the embryo, which some people equate to taking a human life, akin to abortion. Advocates counter that embryos used in stem cell research are essentially leftovers, created for infertile couples to use for in vitro fertilization. Those not used are typically destroyed anyway.

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Despite what Democrat John Kerry's campaign would have you believe, Bush has not banned embryonic stem cell research.

Despite what the Bush campaign would have you believe, the president's restrictions do hamper research, according to independent experts and some Republican policymakers. It is difficult to say exactly how much.

Campaigning in 2000, Bush promised to ban funding for embryonic stem cell research. In August 2001, the president announced a compromise: Scientists could apply for federal funding only for research into 78 existing stem cell lines owned by labs around the world. The policy was designed to aid research while preventing the destruction of embryos with public money.

Kerry pledges that he would remove Bush's restrictions, potentially opening the door to hundreds of millions of dollars in federal funding for embryonic stem cell research.

This year, the government will award $24.8-million in grants for embryonic stem cell research - about one-tenth of what the National Institutes of Health spends on adult stem cell research. Many scientists can't reconcile that discrepancy, considering the promise of embryonic stem cells.

"The president's stance was not an absolute ban on human embryonic stem cell research, but rather a very, very severe constraint, and should be viewed in that light," said Dr. Ira Black, founding director of the new Stem Cell Institute of New Jersey, which uses state and private money for embryonic stem cell research.

There were nowhere near 78 stem cell lines available for study; the NIH says the real number is 22, and they were developed with what now amounts to ancient technology. Researchers say more lines are needed. Some lines are better than others, or have different genetic qualities.

"Embryonic stem cell lines behave close to the same, but not the same. They grow a little differently," said Dr. Dennis Steindler, a researcher at the McKnight Brain Institute at the University of Florida who works with adult stem cells and stem cells harvested from mouse embryos. His work is not affected by Bush's policy.

"It's kind of like comparing a souffle from Julia Childs to one from me. They both look like a souffle, they both taste like a souffle, but they're going to be different."

More than 120 stem cell lines around the world have been created with new technology since the president's announcement. Some have built-in genetic characteristics that allow scientists to study how specific diseases develop. These are off-limits to researchers working with federal dollars.

In a column titled "Missed Opportunities," published this month in the New England Journal of Medicine, Dr. George Q. Daley of Children's Hospital and Harvard Medical School in Boston noted that many of these newest lines have not been contaminated with animal products that have been used to keep stem cells alive.

The stem cell lines available under the Bush edict are sufficient for exploring "generic questions," such as how stem cells can be coaxed into into blood cells or neurons, but their limited diversity and animal contamination likely limits their use for treatments or advanced experimentation, he wrote.

"As research struggles forward in the absence of federal funding, the number of embryonic stem cell lines will continue to grow, creating ever more valuable tools that are out of reach for U.S. scientists," Daley wrote. "The science of human embryonic stem cells is in its infancy, and the current policies threaten to starve the field at a critical stage."

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Politically, this is hard science for the Bush campaign. Polls consistently show broad support for embryonic stem cell research, support that extends to former first lady Nancy Reagan, whose husband died of Alzheimer's.

In a letter to the president this summer, 206 members of the U.S. House, including 37 Republicans, urged Bush to expand the number of stem cell lines eligible for federal funding; 58 U.S. senators, including 15 Republicans, sent a similar letter.

The White House asked NIH director Elias Zerhouni to respond. Zerhouni defended the policy while acknowledging the number of cell lines it allows may be inadequate. "Although is fair to say that from a purely scientific perspective more cell lines may well speed some areas of human embryonic stem cell research," he wrote, "the president's position is still predicated on his belief that taxpayer funds should not "sanction or encourage further destruction of human embryos that have at least the potential for life."'

Increasingly, researchers are seeking other ways to finance embryonic stem cell research. The New Jersey Legislature allocated $10-million for Black's institute. Californians will vote in November whether to spend $3-billion over 10 years on embryonic stem cell research. Harvard is using private donations to launch a embryonic stem cell program that's developed 17 new cell lines. It is making them available for free.

Bush officials say - correctly - that Ron Reagan's speech at the Democratic convention exaggerated the state of the science when he suggested treatments for juvenile diabetes, Alzheimer's and other diseases were imminent.

"There's an awful lot of hype going on with the promise of stem cell research," said Jay Lefkowitz, a former senior adviser to President Bush who helped craft his stem cell policy. "We still don't know whether embryonic stem cell research is going to pan out."

That uncertainty is part of what's driving scientists' dissatisfaction with Bush's policy. Adult stem cells may prove as effective as embryonic ones, but the restrictions make it difficult to find out.

"Without access to a representative range of human embryonic stem cells, those questions cannot be addressed," Black said. "And consequently, we cannot determine which cells are best for which disorders for which patients under which circumstances."

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