Monday, June 25, 2012

Better Late Than Never


Like CIRM, others are rethinking all the hype for hESCR and coming to realize that the real promise of stem cell research in all probability lies elsewhere, in adult and other non-embryonic avenues.

For more than a decade, Michael J. Fox has been a leading celebrity advocate for human embryonic stem cell research.  As the New Scientist recently put it, Fox “was on the front line of the US's ‘stem cell wars’, arguing that embryonic stem cells could cure conditions like his own – Parkinson's disease.”

In testimony before a Senate subcommittee in 2000, Fox referred to the “miraculous potential” of human embryonic stem cells and claimed that the “consistent and inescapable conclusion is that this research offers a potential to eliminate diseases -- literally save millions of lives.”[1]

Fox also was a vigorous advocate for passage of California’s Proposition 71, which established CIRM.  In a commercial he taped Fox declared “[Prop] 71 will support research to find cures for diseases that affect millions of people ... including cancer, diabetes, Alzheimer's and Parkinson's.  Please support the effort to find cures by voting Yes on 71.  It could save the life of someone you love."

But in a recent interview with ABC News’ Diane Sawyer, Fox’s take on the ability of hESCR to deliver cures was far different, as he expressed an outright skepticism that such research will ever live up to its hype– hype that he had a very prominent role in promoting.

Sawyer broached the topic with Fox by characterizing hESCR as “this is the promise, this is the future” (had she been a lawyer and this was a courtroom, that would clearly be called “leading the witness”).

Ten years ago, Fox doubtless would have enthusiastically agreed.  But now, his response was highly qualified and cautious:  “The other avenues of research have grown and multiplied and have become as much or more promising,” Fox replied.  “So an answer may come from stem cell research but it’s more likely to come from another area.”

Those other areas, according to the New Scientist “are speeding towards clinical trials. These include neurotrophic factors – proteins that promote the survival of nerve cells – as well as antibodies that target the alpha-synuclein protein, which may be a cause of the brain damage seen in Parkinson's.”

Proponents of hESCR should have displayed such realism and caution over the last decade in the public policy debate on stem cell research, rather than the hype and exaggeration they resorted to instead.

“It's time to act on what we've learned,” said Mr. Fox in 2000.  “Further delay would come at a high price.”  Treatments from adult and other non-embryonic stem cell research were indeed almost certainly delayed, as public attention and resources were diverted for years toward the largely disappointing avenue of research based on embryo destruction.  Advocates who called for such diversion may now be realizing that it is their agenda that slowed authentic progress.

But as the saying goes, better late than never.


[1]Testimony before the Senate Committee on Appropriations, Subcommittee on Health, 9/14/00

Tuesday, June 19, 2012

A Trend Continues...


With its recent round of grants, the California Institute for Regenerative Medicine (CIRM) continues a trend begun several years ago now – increasing support for non-embryonic stem cell research and reducing support for destructive human embryonic stem cell research (hESCR) and research aimed at human cloning.  This trend by CIRM away from embryonic stem cell research is not driven by any ethical concerns—CIRM continues to issue grants for hESCR, only on a far smaller scale than originally envisaged.  CIRM was founded, after all, on the premise that it would give funding priority to hESCR and cloning for research as those were considered the most promising avenues for producing cures.

But since 2004, when California voters approved a referendum establishing CIRM, the evidence for the efficacy of adult stem cells to provide therapeutic benefits for patients has continually increased, while the evidence for human embryonic stem cells to do the same has decreased.  CIRM, for instance, approved a $25 million loan[1] to Geron for that company’s now infamous clinical trial using hESCs to treat spinal cord injury, only to see Geron cancel the trial just over one year after the first patient was treated -- with no evidence of therapeutic benefits to the five patients who received the hESCs (see previous blog, “An Era EndsBefore It Even Begins”).

According to a report in Nature, since October 2011 CIRM has been considering a new 5 year strategic plan that gives funding priority to stem cell research with the best chance of leading to clinical trials.  The new plan, adopted in late May, envisions at least 10 early stage clinical trials within the next 5 years.

Commenting on the shift of emphasis from basic research to preparing for clinical trails,
Deepak Srivastava, a cardiovascular researcher at the Gladstone Institute in San Francisco, told Nature “With their stated goals of getting cures into people, it’s appropriate to shift the balance.”

The latest round of CIRM grants, announced the same day the new strategic plan was adopted, reflects this funding priority of “getting cures to people.”  Of the 21 grants  –totaling $69.3 million – only 6 involve research using hESCs[2]  None of the grants go to human cloning for research.

The remaining 15 grants all go to research using adult stem cells, iPSCs and direct reprogramming of adult cells.  Obviously this funding emphasis -- a lion’s share of $50.9 million --on non-embryonic research reflects a belief that these avenues hold the most promise for producing actual therapies.


[1] Of the$25 million approved, Geron actually received $6.42 million before cancelling the trial.  The company has repaid the loan in full, with interest.  
[2] One of those six uses [non-embryonic] induced pluripotent stem cells (iPSCs) in addition to hESCs.

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