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MEDICAL ADVANCES: Research using federal money will begin slowly so cures aren't just around the corner.
By WES ALLISON
© St. Petersburg Times, published August 10, 2001
Don't expect any miracle cures soon.
President Bush's decision Thursday to allow taxpayer funding of limited embryonic stem cell research likely will accelerate the search for potential cures for a variety of debilitating diseases, from Alzheimer's to Parkinson's to diabetes to stroke.
But the initial effects of Bush's decision will be more subtle, as this previously unfunded arm of stem cell science gears up, and scientists digest the restrictions Bush attached.
The National Institutes of Health has never paid for embryonic stem cell research, despite approval for it during the Clinton administration, and most scientists who are studying stem cells from other sources aren't likely to switch suddenly to embryos.
Plus, only 20 to 30 people boast the credentials and experience to qualify for the NIH funds, experts estimate.
"People who do have that expertise and who are working on other issues . . . are not all of a sudden going to drop what they're doing," said Dr. Dennis A. Steindler, professor of neuroscience at the University of Florida's McKnight Brain Institute, who works with stem cells found in the brain.
But allowing NIH funding will ensure public access and scrutiny of research into cells taken from human embryos. This research is now dominated by private companies and a scant handful of university medical centers, such as Johns Hopkins, that have secured private grants.
"You don't want to see this kind of research remain in private hands, because these companies don't always behave ethically," said Dr. Glenn McGee, editor-in-chief of the American Journal of Bioethics and a professor of bioethics at the University of Pennsylvania.
Bush's decision will allow federal funding only for embryonic stem cells that have already been propagated by private research. They can be manipulated to produce new generations of cells. McGee said much of the available federal funding -- perhaps as much as 50 percent -- will have to be used to buy the rights to those cell lines and other patents companies hold on them.
Dr. Juan Sanchez-Ramos, a professor of neurology at the University of South Florida who experiments with stem cells from bone marrow and umbilical cord blood, said allowing NIH funding for embryonic research is key to learning what works best and may draw more scientists into the field.
"This is the very beginning of this research. We don't know how useful (embryonic cells) will be, we don't even know if they'll be the best," he said. "The only way we're going to find out is to allow regulated research to go on, and to make the research public."
The promise of stem cells is dizzying: In experiments, the cells have become new neurons to replace cells damaged by stroke, Parkinson's and Alzheimer's. New insulin-producing cells to cure diabetes. New heart cells to cure cardiovascular disease.
The key to these treatments is a delicate process called transdifferentiation, by which a stem cell -- essentially a blank slate -- is chemically coaxed into becoming a specific type of cell. One reason embryonic stem cells are so important is because they appear more willing to be transformed than stem cells from other sources. They also appear more plentiful and more hardy.
Last month, the NIH issued a report saying that while all stem cells were promising, embryonic cells appeared especially so. Clearly, technology to convert one cell type into another to repair damage would be the ultimate human tool kit.
Although Clinton cleared the way for federal funding for embryonic research, the process of developing guidelines outlasted his term. Bush put the funding on hold before the March 15 deadline for funding applications. The NIH received just two.
Most stem cell research in the United States involves so-called adult stem cells found in the umbilical cord blood of newborn babies, the bone marrow, the brain, liver and other organs. NIH support of that research amounted to $256-million last year.
The problem is "you can't know whether or not the alternative sources are better until after you have basic knowledge from embryos," Pennsylvania's McGee said. "You have to do embryo research."
Alternative stem cell research is safely ensconced at dozens of American medical centers, including USF and UF, which haven't worked with embryos.
But with federal funding, Sanchez-Ramos said he might. He said he would like to be able to compare other stem cells directly with embryonic stem cells.
Regardless how promising the prospect of stem cell therapies, researchers say the public doesn't always realize how untested the work is. That's partly because the media have over-hyped it and partly because people want to believe miracle cures are close at hand.
Dr. Paul Sanberg, director of the Center for Aging and Brain Repair at USF, said he has heard from hundreds of people demanding cord-blood transplants after he announced that cord-blood stem cells successfully replaced damaged brain cells in mice.
In his experiments, most of the stroke-impaired mice regained mental ability after receiving stem cell transplants. But he figures safety trials in humans are at least two years away.
"I still get (calls), and that was February. I got two this weekend. Their stories are sad. We have a whole file," Sanberg said. "But it shows the need out there for people, and the more people are needy, the more they put hope into things, and the more they need to be educated on where the science stands."
Approved federal funding for limited medical research on stem cells extracted from human embryos.
Federal funds will only be used for research on existing stem cell lines that were derived with the informed consent of the donors, from excess embryos created solely for reproductive purposes, and without any financial inducements to the donors.
No federal funds will be used for the derivation or use of stem cell lines derived from newly destroyed embryos, the creation of any human embryos for research purposes or the cloning of human embryos for any purpose.
Created a President's Council on Bioethics, led by Dr. Leon Kass, expert in biomedical ethics and professor at the University of Chicago.