Heart disease, cancer, stroke, chronic lung and liver disease, diabetes, Alzheimer's, multiple sclerosis, lupus, rheumatoid arthritis, scleroderma, Parkinson's — just a small sampling of the diseases that could potentially be cured by stem cell technology. So how can this medical miracle, this panacea, be so politically controversial?
On July 18, the U.S. Senate approved a bill that would make federal funds available for research conducted with embryonic stem cells. The Bush administration had banned federal funding for this research in 2001 except for a small number of preexisting embryonic stem cell lines. Keeping a promise, the president exercised his first-ever veto to squash the Senate bill.
Lawmakers were acting in response to growing public support of stem cell research and treatment. After the 2004 election, a Harris poll found that 73 percent of Americans supported medical research using embryonic stem cells. A very vehement and vocal minority oppose stem cell research on the grounds that it, as South Carolina Senator Jim DeMint (R) says, "kills human life and crosses an important moral line we have always respected."
"Politicians are pandering. They don't really care about life, just controlling lives," says state Sen. Phil Leventis (D-Lee/Sumter), a proponent of stem cell research. "Politics is more important, despite what they say. Anybody that has diabetes, spinal chord injuries, Alzheimer's — or any of their relatives — they should be incensed that their president doesn't see fit to come to a resolution that allows the scientific community to receive access to stem cells, not as a commodity, but as a potentially life-saving material that is currently being wasted."
As evidence of this pandering, S.C. Sens. Lindsey Graham and Jim DeMint, despite strong moral and ethical convictions, weren't ready to throw out all the stem cells with the bath water. On July 18 — after voting against embryonic stem cell research — senators Graham and DeMint voted "yea" to a bill which would award federal funds for research involving adult stem cells and other stem cells not derived from embryos. Does this distinction amount to anything other than political hairsplitting?
There is a variety of differences between embryonic and adult stem cells, the biggest policy distinctions being that research of adult stem cells is not subject to the ban on federal research funding. This makes the S.C. senators' "yea" votes little more than reaffirmations of the status quo.
Most of the back-and-forth surrounds distinctions that create moral and ethical concerns about stem cells. Embryonic stem cells are available only when harvested from early human embryos that do not reach maturity, while adult stem cells appear during fetal development and persist through adulthood.
The distinctions between adult and embryonic stem cells that Scott and other scientists are interested in are the behavioral differences that impact the research and potential medical uses of stem cells.
"Embryonic cells have the ability to make any cell in the body," says Dr. Makio Ogawa, a professor of medicine and the director of the Division of Experimental Hematology at the Medical University of South Carolina (MUSC).
There are 200 different kinds of cells in the body. The clever embryonic stem cell can morph into any one of them. But just like us, the older a stem cell gets, the less flexible it becomes. Adult stem cells are more set in their ways.
The other advantage the nubile embryonic stem cell has is "self-replication," which allows them to divide and replicate over and over again — creating a limitless supply to be used for research and medical use.
Scientists are as yet unsure about the effectiveness of embryonic stem cells. "We don't know what works better, embryonic or adult stem cells," says MUSC provost Dr. John Raymond. It is possible that adult stem cells — which can be harvested directly from the patient, or from a genetically similar healthy patient — may be more compatible with adults. What scientists are sure of is that learning about embryonic stem cells will increase their knowledge of adult stems cells. Liz Blackburn, a member of the president's commission for bioethics, explains the idea by saying that one can't find answers to questions about apples by doing research on oranges, but you can learn a whole lot about fruit in general.
A number of local medical organizations, including MUSC, have chosen to use what knowledge currently exists about adult stem cells to begin treating patients.
The Hollings Cancer Center has been on the cutting-edge of bone marrow stem cell transplants since 1987, treating patients with leukemia and lymphoma. They have just celebrated their 700th transplant. MUSC's Dr. Ogawa is considered an international authority on adult stem cells, his colleague Dr. Vladimir Mirinov is developing a "bio-print" technique that will employ a dot matrix-type printing system to assist in placing stem cells into the body, and Dr. Roger Markwald has a dream to build an artificial heart created from stem cells.
"The veto will have a minimal effect on what MUSC is doing now," says provost Dr. Raymond. "But if there were more funding for the general area of research, it might move things along faster."
CureSource and Definitive Tech are local businesses working with adult stem cells. CureSource stores stem cells from fetal umbilical cord blood that is collected at the time of birth. They use a scientific process to separate the stem cells from the blood and then store them in liquid nitrogen. If the need should arise, and the scientific knowledge be available, the stem cells are ready for use. Definitive Tech collects donations of tissue and other blood products to use in stem cell research by biotech companies.
"This is the face of medicine for the future," says CureSource and Definitive Tech chairman Don DeLuca. "It is unfortunate that controversy arises, because there is a big difference between staving off disease and curing disease. Stem cells have the potential to cure disease."
Currently, DeLuca claims there are over 70 diseases being treated or that are under research for potential treatments using stem cells.
"We lag the world in the use of research of cord blood stem cells," says DeLuca. Singapore, England, Australia, and Israel lead the way in stem cell research and technology.
Some states are attempting to make up the lost ground without federal support. California passed a $3 billion initiative to fund stem cell research of all types. A day after Bush's veto, Governor Schwarzenegger awarded another $150 million. Wisconsin, Connecticut, Missouri, and Maryland are following suit.
State Sen. Phil Leventis proposed legislation last year in the South Carolina General Assembly that would have increased statewide regulation of stem cell research and businesses like DeLuca's CureSource. With increased regulation, Leventis believes the industry could become a statewide economic force.
Despite increasing state support for research, the scientific community feels that support from the federal government is necessary to truly propel advances.
In 2002, leaders from the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Research Council convened at a conference to discuss the issue of embryonic stem cell research. Their conference concluded unequivocally that, in order for progress to be made against autoimmune and degenerative diseases, the Bush administration's ban on funding and research must be lifted.
"The quality of people's lives and deaths," says senator Leventis, "can be traced to the fact that we are not doing cutting edge research."
The enormous potential of stem cell use is not a matter up for debate, and research will continue to progress despite a lack of government funding. But for the millions of Americans who live with Alzheimer's, Parkinson's, and diabetes, and the millions more who know them, slow and steady will not win the race.
"We are involved in something," says CureSource's Don DeLuca, "that will save lives."
Perhaps our federal and state governments should have an interest in that.