Stem cell concern: Public patience amid all the hype

When I listen to some politicians that support stem cell research, especially embryonic stem cell research, I understand why stem cell research pioneers like Dr. James Thomson try to be realistic when talking about its potential benefits, and the timetable on which these benefits will reach us.

It is the political season, and in the coming weeks we'll hear a lot about the potential cures and treatments that stem cell research could produce. Be prepared, however, for snake oil salesmen (and women) that trot out families whose members suffer from debilitating conditions and make it sound as though stem cell research will produce cures that are just around the corner.

It's the latest version of “vote for me, and I'll set you free.” They may be able to hoodwink some members of the public into believing this, but in the long run their baloney may be doing this promising research a great disservice in terms of public expectations and eventual disillusionment.

I thought about this recently during the World Stem Cell Summit in Madison, where Thomson once again acknowledged how much work there still is to do, and following a recent chat with Alta Charo, a University of Wisconsin-Madison professor of law and bioethics. As people who are fully immersed in advancing stem cell research, they understand that the science is unpredictable and could benefit people in ways we don't expect.

They also understand that the most immediate applications may not be cures for the most debilitating human diseases or regenerative applications like transplants, but in gradual improvements in the fundamental areas of public health. It's not that they believe the most remarkable breakthroughs are impossible, but they will take some time. Stem cell apps

“The most likely applications are not the kind people have in mind, not transplanting a pancreas in a diabetic, or the spinal cord of a paralyzed veteran,” Charo said. “Some of the applications will be things like creating test tube models of diseases so we can screen possible new drugs more quickly, more cheaply, and more safely than we currently do.”

Another important application, Charo said, is going to be the development of a safe human blood supply. At the moment, we rely on donations from individuals, but in the future we might be able to grow real human blood from embryonic stem cells or other kinds of cell lines, she noted. This could produce a blood supply that is manageable, abundant, and free of contaminants or viruses.

Another important application could come in the study of genetic disease. Someday, we could be able to take cells from people who have genetic disorders and generate stem cell lines, whether through cloning or induced pluripotent stem cell work, and then grow those cell lines in laboratories so that researchers can see how a genetic mutation affects the normal growth of tissue. In this application, stem cells could help researchers understand how genetic mutations cause illness.

“That may give us some insights into new ways that we can try and ameliorate or even cure these diseases,” Charo said.

"A lot of those research applications don't have the wow factor that a human transplant does, but the public needs to appreciate that the most important developments may take place in less obviously dramatic areas of research, which are nonetheless hugely important in improving public health.”

Regarding human transplant work, Charo said the public soon might hear more about experiments in human stem cell lines that have been placed into animals. This will be done in order to test whether those stem cell lines can reliably be directed “to make the kind of tissue you want it to make, and make sure that that tissue then integrates itself into the body where you want it to integrate, and begin to function as that tissue needs to function,” she explained.

The idea of putting human tissue into an animal can be very alarming, Charo cautioned. “It's even generated some Congressional interest, and it is something that can sound science fiction-like,” she said. “It can sound dangerous. It can sound creepy even, but in fact it's a perfectly normal part of research.”

The harm of hype

These applications provide more than enough justification to support human embryonic stem cell research and ramp up federal funding beyond existing lines. (I've predicted that rescinding the Bush restrictions might be Barack Obama's first official act as president, but I'm getting ahead of myself). Investing in stem cell research is both a short and long-term commitment, but it's an investment that should be tempered with some truth about expectations.

During the World Stem Cell Summit, I engaged in some small talk with a couple of attendees about the cautious tone of Thomson, who serves as the director of regenerative biology at the Morgridge Institute for Research. One man seated in front of me, somewhat annoyed by Thomson's stance, actually wondered whether he believes in regenerative medicine.

Imagine that. The man who first isolated and cultured embryonic stem cells, and who was instrumental in developing induced pluripotent stem cells, was having his commitment questioned.

Perhaps the hype already has gone too far.