Huge news in the stem cell field. The first clinical trial using embryonic stem cells has been halted. Go visit Mary Meets Dolly for the lowdown:
First, Id like to warn everyone that this post will be typed entirely without the use of apostrophes since Im unable to find that particular character in this carazy Italian keyboard. If thats the kind of thing that bothers you greatly, please stop reading immediately.
Ok now that thats (note no apostrophe) over with… THIS CONFERENCE IS AMAZING! The content may be a little thick to update daily here, and given the short amount of time I want to spend sitting in front of a comptuer while in Italy, I think Ill save all of the content for later posts and just show you what all weve been doing while here.
For those who dont know, when I first learned that I was invited to this conference, I started a novena to St. Josemaria Escriva in order to raise the funds to come to Rome for this conference. Through his intercession, I was able to raise sufficient funds so my first stop was to go to his tomb at the Opus Dei prelature and pray at his tomb. While the outside of the building is very nondescript, the church they built within it is absolutely beautiful.
I’m off to the Vatican on Monday, so I figured I could take some time for an extremely brief introduction (EBI… perhaps this will be a series here – any opinions?) to adult vs. embryonic stem cells (ESCs) as a precursor to the information that will be presented at the conference. I’m intentionally excluding a recent stem cell discovery, namely induced pluripotent stem cells (iPSCs), because they blur some of the distinctions I’ll make between adult and embryonic stem cells. Suffice it to say that iPSCs have (generally) the same properties as ESCs without the moral conundrums since they are derived from adult tissues.
Here’s the 10,000 foot view:
- ESCs are pluripotent while adult stem cells are lineage restricted. This means that ESCs can become any cell type in the body if pushed properly in the right direction, while adult stem cells have a limited number of cell types that they can become. This is also known as “differentiation capacity” – stem cells that can become many different cells have a high differentiation capacity. Since embryonic stem cells are taken from a very early stage embryo, these are the same cells which would have gone on to divide and make every single cell in the fully developed human body – thus the “pluripotent” capacity of these cells.
- ESCs are “immortal” while adult stem cells undergo “senescence.” What this means is that ESCs are capable of growing forever in a plastic dish. They do not ever stop dividing and producing more ESCs. This is very desirable because the cells are relatively easy to culture and because the therapies that these cells would be used for generally require a large number of cells. Adult stem cells, on the other hand, undergo senescence, which is to say that they simply stop growing in a culture dish after a certain number of divisions. This immortal capacity of ESCs leads us to…
- Teratoma formation! The major practical hurdle (as opposed to the moral hurdles) with using ESCs is their uncanny ability to form cancers when injected into living animals. They form very specific kinds of tumors called teratomas. During embryonic development, all the cells in the organism divide into one of three “germ layers” that will go on to develop into certain parts of the body. For example, the “endoderm” layer will make things like your digestive tract, the “mesoderm” will make things like your muscles and bones, and the “ectoderm” layer will make things like your skin and nerves. These tissues under normal development, of course, are well organized and make a functional organism. When you inject ESCs into an organism, however, they differentiate into various cells of all three germ layers in a very disorganized fashion and you end up with a chaotic mass of teeth, hair, skin, and even at times primitively developed organs like eyes or even limbs. Because of the adult stem cells’ limited differentiation capacity and because they are not immortal, this does not happen when they are injected into animals.
- The other major practical obstacle with stem cell therapies is immune rejection. When someone receives an organ transplant (like a heart for example) you must have a “matched” donor. This means that certain proteins known as human leukocyte antigens (HLA) must be the same or at least similar between the donor and the recipient, otherwise the recipient’s immune system will recognize the new heart as foreign and attack it, leading to rejection. Embryonic stem cells express HLA antigens and are therefore susceptible to immune rejection. Because of this, the cells would have to be from an HLA matched cell line in order to prevent immune rejection, but even with matching, the patient would likely have to be on immunosuppressive drugs for the rest of their lives. In order to circumvent this problem, many scientists have been attempting “therapeutic cloning” (which in reality is exactly the same thing as regular cloning) in order to harvest ESCs from an embryo that has exactly the same genetic makeup of the person the cells will be used in. With this approach, there would not be any immune rejection. Adult stem cells, on the other hand, generally don’t express HLA antigens so there is no chance of immune rejection! These cells have been used in thousands of patients already without any donor/recipient matching and there is not immune rejection! Even if immune rejection were to be a problem with adult stem cells, you can isolate the cells from your own body, expand them, and then give them back to yourself thereby circumventing immune rejection.
- Finally, ESC production involves the destruction of human persons in order to harvest the stem cells. Some would say that the embryo is not really a “person,” but there is no scientific reason to conclude otherwise – the topic of a future post. Adult stem cells, on the other hand, are isolated from adult patients and do not involve their death or destruction. So long as the patient has given informed consent, there are no moral quandaries with the isolation of adult stem cells.
In May 2010 (yeah I know, I lag behind a little), New York based adult stem cell company Neostem announced a ground-breaking collaboration with the Vatican’s Pontifical Council for Culture. From the press release:
NeoStem’s Stem for Life Foundation, formed to create awareness about the promise of adult stem cells to treat disease, and the Pontifical Council’s Foundation, called STOQ International (Science Theology and the Ontological Quest), will work on a variety of collaborative activities with the goal of advancing scientific research on adult stem cells, exploring their clinical application in the field of regenerative medicine and the cultural relevance of such a fundamental shift in medical treatment options, particularly with regard to the impact on theological and ethical issues.
The Pontifical council has thrown it’s weight behind the initiative with a hefty $1 million donation to the Stem for Life Foundation. This is not, contrary to some rumors that have been spread around recently, a purchase of stock in the company for profit. The money will go toward funding educational programs that promote the use of adult stem cell therapies which, unlike embryonic stem cell therapies, have been used clinically for years in hundreds of patients to treat debilitating diseases.
As part of the collaboration, NeoStem and the Pontifical Council will pursue the development of educational programs, publications and academic courses with an interdisciplinary approach for theological and philosophical faculties, including those of bioethics, around the world.
As described in a recent LA Times article, Neostem has a strong interest in the moral and ethical implications of stem cell research; this, among other reasons, attracted the attention of the Pontifical Council:
The partnership is rare, perhaps unprecedented. “It is unusual, ” said Father Tomasz Trafny, the Vatican’s point man on the deal. “Never in history [have] we entered into such [a] collaboration.”
Trafny, a Polish-born priest who heads a science and theology unit within the Pontifical Council for Culture, said the church decided to collaborate with NeoStem for two reasons.
“First, they have a strong interest in … searching for the cultural impact of their own work, which is very unusual,” he said. “Many companies will look at the profit and only at the profit.
“And the second, of course, is that they share the same moral, ethical sensitivity…. Because of that ethical position, we entered into this unique collaboration.”
Perhaps the most exciting program to develop from the collaboration is a three day conference being held November 9-11, 2011 in the Vatican. The mission of the conference is “To foster the highest levels of scientific research on Adult Stem Cells and to explore the cultural, ethical and human implications of their use.” It is great to see the Church stepping up to the challenges of modern science and offering a voice of conscience and morality to help guide the discussion!
The conference is by invite only and yours truly has been given the honor of being one of those invited to attend. In just two short weeks, I’ll be flying to Rome to take part. I’ll be blogging throughout in an effort to bring the conference to as many as possible, so if you’re interested in getting updates, subscribe! I’m also doing some last minute fundraising in order to help pay for travel expenses involved with the conference, so if you’re feeling generous you can send me an email at jcreneau [at] gmail(dot)com.