Subject: Hard Cell: Science Does Better With Adult Stem Cells
Source: Wall St. Journal; July 23, 2001

Hard Cell -- Science Does Better With Adult Stem Cells
by Richard Miniter

[Pro-Life Infonet Note: Mr. Miniter is an editorial page writer for The
Wall Street Journal Europe. His column appears Fridays.]

When President Bush meets the pope today, one of the issues they're sure
to discuss is the controversy over embryonic stem-cell research. Mr. Bush
is reportedly struggling with the decision of whether to accept a
last-minute Clinton decision that would effectively lift the ban on
federal funding of such research. During his campaign, Mr. Bush promised
to uphold the ban.

Proponents of such research, and the media, frame the issue as one of
religion vs. science, arguing that if the president keeps his promise, he
will set back new medical advances and sacrifice potential cures for
diseases like Parkinson's.

But science isn't on their side, and Mr. Bush doesn't have to choose
between convictions and cures. While federal funding for embryo research
is banned, the research itself is not. The private sector lavishly funds
research on stem cells drawn from both embryos and adults. Yet research on
embryonic stem cells is no more developed than the embryos themselves --
while research on adult stem cells is close to delivering miraculous
treatments.

Consider these recent advances:

* Surgeons in Taiwan restored vision to patients with severe eye damage by
using stem cells from the patients' own eyes. Their vision improved from
20/112 to 20/45, according to results published in the New England Journal
of Medicine.

* British scientists found that adult stem cells in bone marrow can turn
into liver tissue, a first step toward developing new treatments for liver
damage. Their work was reported in the journal Nature.

* Two recent studies show that adult stem cells in bone marrow
transplanted into the brain of mice can develop into neurons and have been
reprogrammed into healthy brain cells in lab rats. Previous research had
shown this transformation was possible in cultured cells, but these
studies, one of which was published in the journal Science, show it can
happen in living animals.

* Scientists found that adult stem cells in bone marrow injected into a
damaged mouse heart could become functional heart muscle cells, and that
these new cells partially restored the heart's pumping ability. One of the
scientists predicted that after successful follow-up studies, human
clinical trials could start in three years. The results were published in
Nature.

These findings were all reported within the past year. And they are only a
few examples of the breathtaking medical breakthroughs occurring after
years of research on adult stem cells -- stroke victims' brains repaired
with adult stem cells becoming fully functional neurons connecting with
existing brain cells, new cartilage grown to repair damaged knees.

We are on the verge of astounding human applications using adult stem
cells. Embryonic stem cells, by contrast, have yet to save a single life.

Stem cells are unspecialized cells that have the ability to transform
themselves, in varying degrees, into many other types of cells. Thus a
single stem cell could become a skin cell, a hair cell, a liver cell and
so on. All of us were once stem cells, and our bodies still hold many
forms of these cells.

It appears that every organ and tissue in the body has undifferentiated
stem cells. These cells may exist to repair organs when they are
traumatized or damaged, but scientists are still puzzled by how they work
and what exactly they are supposed to do. If scientists can improve this
natural repair process with adult stem cells, people may be able to grow
new livers from stem cells extracted from their own liver. Another source
of adult stem cells is body fat. And umbilical cords provide a large
supply of stem cells -- without political or moral controversy.

A National Institutes of Health report, released just in time for last
week's congressional hearings, argues that stem cells from embryos are
better. But on closer examination, the evidence is shaky and speculative,
while the unique drawbacks of embryo stem cells are becoming clearer.

The case for the superiority of embryo stem cells rests on three pillars:
They are easier to harvest, there are more stem cells in embryos than in
adults, and they can be more easily changed into every organ and tissue in
the body.

The first two claims are misleading. Harvesting is a nonproblem.
Scientists have been extracting some types of human adult stem cells for
almost a decade, while human embryo stem cells weren't successfully
isolated until 1998. Several biotech companies have developed proprietary
methods to make adult-cell isolation and extraction even easier. "We've
been here in the background while all the noise was going on, and there's
been a pressure on us to provide a solution," John Wong, CEO of MorphoGen
Pharmaceuticals, told BioWorld Today last August. "We believe we've
provided that solution. The technology has just moved beyond stem cells
from embryonic tissue."

While it's true that embryos have a higher ratio of stem to nonstem cells,
that doesn't mean much. Scientists have discovered stem cells in adults in
virtually every major organ, including the brain and body, and researchers
last year identified conditions that would allow for the multiplication of
adult stem cells in culture by a billion-fold in a few weeks.

The real argument for using stem cells from embryos is they are more
"plastic" -- that is, they are easier to change into other types of cells.
This is a hard claim to evaluate because, as last week's NIH report notes,
"the field of stem-cell biology is advancing at an incredible pace with
new discoveries being reported in the scientific literature on a weekly
basis." Any distinguishing advantage from using embryo stem cells today
may already have been overtaken by a lab that is waiting for its results
to be published.

Indeed, scientists have already proved adept at turning adult stem cells
into a variety of seemingly unrelated cells. Jonas Frisen, a scientist
working at NeuroNova AB, a Stockholm-based biotech firm, published some
exciting work in one of the world's leading scientific journals, Science,
in June 2000. "We have demonstrated that the potency of these [adult stem]
cells was far greater than expected and what seemed to be a fairly
restricted cell type can give rise to many different types of cells. These
recent findings may turn some previous concepts upside down," Dr. Frisen
said in a press release. Already, human adult stem cells have been
transformed into cartilage, muscle, bone, cardiac tissues, neural cells,
liver tissues and blood vessels. Research with animal adult stem cells
indicate the ability to transform them into kidney, heart, lung, intestine
and nervous-system tissues.

While adult stem cells may never be as completely "plastic" as embryo stem
cells they will almost certainly be plastic enough for all practical
applications. "These adult tissues don't appear to be as restricted in
their fate as we thought they were," Dennis Steindler, a professor of
neuroscience and neurosurgery at the University of Tennessee-Memphis, told
Blood Weekly magazine in May. "In some ways they may not have the same
potential as embryonic cells, but once we figure out their molecular
genetics, we should be able to coax them into becoming almost anything we
want them to be."

Diane Krause of the Yale School of Medicine -- a supporter of embryonic
stem-cell research -- says she was "surprised" by her own research on
adult stem cells. "It went against our dogma," Dr. Krause says. Stem cells
found in the liver were believed to be limited to making liver tissue,
stem cells in the skin more skin and so on. "But at least for stem cells
found in bone marrow, that is not true." Scientists, who previously
underestimated the potential of adult stem cells, are "searching for a new
paradigm," she adds.

What's more, new research suggests that embryonic stem cells may be a
little too plastic. "The emerging truth in the lab is that pluripotent
[embryonic] stem cells are hard to rein in," University of Pennsylvania
bioethicist Glenn McGee told MIT's Technology Review. "The potential that
they would explode into a cancerous mass after a stem-cell transplant
might turn out to be the Pandora's box of stem-cell research." In a recent
Weekly Standard article, author Wesley J. Smith, who opposes embryonic
stem-cell research on moral grounds, cites a chilling report from China in
a study in the May 1996 edition of Neurology, the official journal of the
American Academy of Neurology, in which implanted embryonic and fetal stem
cells became bone, skin and hair cells -- inside a test subject's brain.
He died.

Then there is the problem of rejection. Transplant patients know that they
must take antirejection drugs for years and, in some cases, for life. New
tissues developed from embryonic stem cells may require a long-term
regimen of drugs to suppress the body's immune system. These drugs have
side effects, and a suppressed immune systems can increase the risk of
infection. This is not a problem of adult stem cells because they can be
drawn from the patient's own body.

Adult stem cells appear to be easier to control than embryonic cells, are
closer to commercial application, and have a history of proven benefits --
including bone-marrow applications. It's easier to transform, say, a
pancreatic adult stem cell into pancreatic tissue than to turn an
embryonic stem cell into pancreatic tissue. "It is inherently a shorter
biological step to make a beta cell from a duct [adult stem] cell than it
is from other possible cells, such as embryonic stem cells," according to
the British Medical Journal. Human adult pancreatic stem cells have
already been grown in culture and differentiated into insulin-producing
cells.

Adult stem cells are also being used in human clinical trials and
applications to treat multiple sclerosis, leukemia, liver disease, cardiac
damage, brain tumors, ovarian cancer, breast cancer, arthritis, lupus and
other conditions. French physicians used a patient's own adult muscle stem
cells to treat heart disease, with promising results.

Little wonder, then, that the private sector is focusing almost
exclusively on adult stem-cell research. Of the 15 U.S. biotech companies
solely devoted to developing cures using stem cells, only two focus on
embryos. "While the embryonic cells are rumored to have broad potential,
so far only adult stem cells have demonstrated wide uses," writes Scott
Gottlieb, a physician and staff writer for the British Medical Journal, in
The American Spectator.

In the race to cure Parkinson's disease, cancer and other age-old
scourges, the private sector is more than a few laps ahead. And perhaps a
dozen private-sector projects are within a few years of human trials.
StemCells Inc. is using adult stem-cell research to develop methods for
regenerating damaged central nervous systems and restoring function to
kidneys and livers. Baltimore-based Osiris Therapeutic Inc. has already
developed technology for isolating adult stem cells, found adult stem
cells in the body's connective tissues and conducted a clinical trial of
adult stem-cell infusion for breast cancer patients who'd had
chemotherapy. "The practical use of adult stem cells is not 10- to 15
years away but well along in the commercialization process," Osiris
president James Burns told Transplant News in March 1999. "We believe that
adult stem cells will become a routine treatment for cancer, immune
disorders, orthopedic injuries, transplant medicine, congestive heart
failure and degenerative diseases."

By contrast embryo stem-cell research is at the drawing-board stage -- not
for lack of funds but for lack of promising research to finance. Venture
capitalists have no agenda beyond making money; if they see embryo
projects that are likely to bear fruit over the next five to seven years
-- the usual VC time horizon -- they will fund them.

That the market is speaking so loudly against embryo stem-cell research
probably explains why embryo researchers are so eager to reverse the ban
on government funding. But medical science will continue to advance even
if Mr. Bush keeps his word.

Whatever the president decides, though, the NIH should put more funds into
adult stem-cell research. That would give the most promising research a
big push -- and isn't that what's most important_