Tuesday, January 20, 2009

Obama and Stem Cell Research

There is speculation on the Hill about whether President Obama (love those words) will immediately reverse the ban on stem cell research by executive order, or wait until Congress submits a bill to him that he would sign. I think it is about 50/50.

Either way, these are significant steps in the right direction after 8 years of "anti-science" and suppression of expert research under the Bush administration. Former Surgeon-General under Bush, Dr. Richard Carmona complained he was muzzled in attempts to speak out on stem cell science and other issues.

The fact that Obama is likely to be lifting the restrictions on US federal funding of human embryonic stem cell research speaks volumes about how he will govern.

Stem cell research from public funding will potentially ensure open access to research results and allow easier transition from research to development of new therapies and cures for patients with a wide range of illnesses.

In 2007, Senator Obama co-sponsored the Stem Cell Research Enhancement Act and said the study of stem cells held enormous promise for the treatment of debilitating and life-threatening diseases, like Alzheimer's, diabetes and spinal cord injury. "Instead of creating roadblocks, we must all work together to expand federal funding of stem cell research and continue moving forward in our fight against disease by advancing our knowledge through science and medicine", then Senator Obama said.

It will be interesting to see what first Executive decisions, President Obama (there it is again!) will make after he recovers from the partying night of the inauguration. He has pledged to start work on Wednesday and get a stimulus recovery bill passed ASAP. Many are hoping he makes good on reversing the Embryonic Stem Cell ban also.


Anonymous said...

A neurologist I used to work for said stem cell could also help Parkinson's patients.

I thought I read some where that it might help stroke patients or is that the paralyzed effect they leave? Do you know anything about if stem cells could help with strokes?

Also I remember reading Christopher Reeves saying if he could have lived long enough he thought it would have helped him.

It is exciting to think of the improvments and quality of life this can now open up, as well as what Presidient Obama will do for more help for ovarian cancer that his mother died from.

ERP said...

Bush back in Tx:
Mission Accomplished.

Toni Brayer MD said...

ERP: hahaha

Quiact said...

Over 100 years ago, a Russian histologist suggested stem cells be applied for scientific research.

They are the human body’s equivalent of a generator, as they can renew, regenerate, and replicate under the right conditions.

The apex of cellular therapy and regenerative/reparative medicine has been reborn after an 8 year moratorium that basically halted federal funding for stem cell research with most states in the U.S.

Now the NIH can award grants to scientists involved with biomedical research involving stem cell therapy through the CMS to each state in the U.S.

While never banned, stem cell research had limited funding during this time. And this was unfortunate, because there are several likely uses of stem cells.

These uses include the replacement of tissues in the human body, as well as repairing cell types that are defective.

Also, stem cells can deliver genetic therapies that are needed in certain patients.

ESCs are totiplotent if obtained from the morula which is a pre-blastocyst stage. Normally, the stem cells are acquired from the blastocyst itself.

From this source, the stem cells can be any cell in the human body except for the placenta, and are pluripotent.

Embryonic stem cells are obtained from a 4 day old embryo called a blastocyst, and are pluripotent from this source.

The blastocyst contains about 100 cells, and is not suitable at this stage for implantation into the uterine wall.

The inner core of the blastocyst has about 20 cells, and this is where stem cells are obtained.

These cells are unspecialized cells that can be developed or morphed into the over 200 cells available in the human body through differentiation, as ESCs are undifferentiated by nature.

As such, they can become any human cell, as long as they are prevented from clumping or crowding together when explanted into cultures as they are propagated. After stem cells are cultured, they are moved to what are called stem lines.

Until recently, ESCs were believed to be most beneficial instead of the adult stem cell alternative (ASC), as these stem cells are limited to application to the tissue the stem cells were obtained from only.

However ASCs (somatic stem cells) now can be coerced into differentiation through plasticity (trans-differentiation).

This likely will reduce if not eliminate those opposed to stem cell therapy because of moral and ethical reasons related to the utilization of ESCs.

Thanks to molecular biology, four transcription factors control the transfer of genetic information from DNA to RNAS to regulate gene expression. So ASCs can have the same beneficial qualities as ESCs.

In the past, viral vectors and exotic genes interfered with the purity of ASCs. Now ASCs are re-programmed using plasmids instead of viruses and oncogenes that can become detrimental for the patient treated.

So now, ASCs can safely become induced pluripotent cells with the same potential as ESCs. As a result, the ASCs are free of genetic artifacts that potentially can interfere with transgene sequences.

They are capable of, and are able to renew and reproduce with minimal effort, stem cells, under the right laboratory conditions.

Human blood can be reproduced with stem cells under the right conditions, it has been shown by researchers.

SCT can also be used to investigate disease states for better treatment options.

Disease-specific stem cell lines, which are those cells that are pluripotent and are created with the same genetic errors of certain diseases, are studied for this reason.

So there clearly is a huge potential for stem cell-based therapies. The first FDA approved clinical trial occurred early in 2009.

This human trial will involve evaluating primarily the safety of ESCs designed to be used as treatment for spinal cord injury patients. The trial was submitted by Geron Corp.

Pfizer, the largest drug company, has implemented stem cell research, as they are an asset to drug discovery by creating within the organization a regenerative medicine unit.

Other large pharma companies are implemented similar research protocols for the same reasons.

Geron Corp. in California is the world’s leading esc developer, and financed researchers at Univ. of Wisconsin, who isolated the first human esc in 1998.

Stem cell therapy potentially can cure multiple sclerosis, among other disases and those with damaged human tissue.

The therapy prevents the advancement of disease, as well as reverses the neurological dysfunctions associated with MS. Patients are injected with their own stem cells obtained from their bone marrow, which are called haemopoietic stem cells.

These particular stem cells are the origin of all blood cells. Further large clinical trials are needed to support these results. Studies have shown between 70 and 80 percent of MS patients who received stem cell therapy did not relapse afterwards.

Allogenic, or donor transplants, have a risk of graft versus host disease. Autologous, which is the patient’s own stem cells, are preferable and most beneficial.

Similar results from this autologous bone marrow transplant cellular therapy are seen with Chron’s disease as well.

During the procedure, the immune system is reset so it is not in an autoimmune state where it attacks the human body. The process lasts about 2 months, and consists of 6phases:

1. Initial chemo
2. Release of stem cells
3. Acquisition of stem cells
4. Cells are then frozen until ready for transplant
5. Second chemo to reduce leukocytes
6. Autologous stem-cell transplant. Immune system is reset.

Positive results from stem cell therapy are seen usually within a month, and patients can request another treatment about 6 months after the first treatment presently.

This stem cell paradigm of therapy addresses the etiology of a disease state, instead of focusing on the symptoms only. As such, this is the practice of regenerative medicine with the implementation of SCT.

Some believe ethical restraints are needed regarding the use of ESCs for therapeutic reasons. Yet they improve the quality of life of those with devastating diseases which involves suffering without any relief.

So stem cell therapy and research may be the most right and ethical thing to do for such patients. Not only is the tremedous suffering relieved with those possessed with devistating diseases, their functional ability is restored for those who receive stem cell therapy.

Embryos are acquired from fertility clinics (IVFs) that have thousands routinely stored and are abnormally fertilized. This means that they could never go on to become a human, and would be destroyed otherwise.

Ironically, one could argue it is inappropriate to discard what may be valuable and ethical for others, potentially.

Most couples with frozen embryos would gladly give them to such research, surveys have concluded.

These embryos are believed by many to not be morally equivalent to human life, but only have the potential for life. And they are used for therapeutic cloning, known as somatic cell nuclear transfer, and not reproductive cloning.

Ten states have banned this cloning out of ignorance, it seems. Bioethic principles, which are beneficience, or physician-centered decisions, as well as non-maleficence, which is first do no harm, are not corrupted.

Furthermore, autonomy, which is the patient’s right to determine their health, and justice or fairness remain intact.

Stem cells should be utilized for those terminally ill as well, many believe. Many are seeking stem cell therapy overseas due to restrictions that exist in the U.S. presently. The United Kingdom is believed to be the leader in stem cell research presently.

Dan Abshear

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Anonymous said...

On the third floor of UCSF's newest research building, at the far end of a lab devoted to growing pancreatic cells to treat diabetes and using stem cells to study cancer, sits a vacant set of work stations.

Dr. Arnold Kriegstein, director of stem cell research, is hoping it will be filled in a month or two, if he can manage to recruit a top scientist and a team of researchers to the Bay Area. At the moment, the main competition for the recruitment effort is a certain school back east.

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