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Cord blood claims questioned

Expectations for umbilical-cord stem cells may be too high.

5 February 2003

HELEN PEARSON

Parents paying to freeze their child's umbilical-cord blood in the
hope of fighting future disease, may be over-optimistic, suggests new
research. The banked cells appear unlikely to repair the brain.

A growing number of parents are attempting to insure their child's
future health by storing a vial of blood drained from its umbilical
cord at birth. According to the medical companies offering the
service, the stem cells this contains could cure conditions from
leukaemia to dementia.

Some of these claims are overblown, warns Evan Snyder of Harvard
Medical School in Boston. He has preliminary evidence that cord blood
cells cannot generate new brain cells easily - which would be needed
to treat a stroke, or Parkinson's or Alzheimer's disease. "I object
to [the practice of] giving false hope," he says.

Snyder's group examined the autopsied brain of a deceased 20-month-
old girl who, at nine months of age, had received an experimental
transfusion of a male's cord blood to treat her rare brain disease.
They looked for nerve cells derived from the blood - and found none.

Other scientists echo Snyder's concerns. "[Blood] cells banked as
they are will not be very useful except for a bone-marrow
transplant," argues Juan Sanchez-Ramos of the University of South
Florida in Tampa.

Sanchez-Ramos carried out some of the first promising studies that
suggest that, in the lab at least, stem cells from cord blood can
generate nerve-like cells spontaneously. Two years down the line, he
now believes that perhaps only one in a million cells can do this. "I
wouldn't want the public to be misled," he says.

Drawing blood

For banking, blood left in the umbilical cord and placenta is
syringed out minutes after a baby's birth and the cord has been cut.
Vials are shipped to the storage lab, where the valuable blood cells
and stem cells are filtered out and kept in liquid nitrogen.

These stockpiled cells can save lives. But so far, doctors have
mainly used stores in public banks to treat unrelated people with
rare blood cancers or genetic diseases. The young cells are often
better tolerated than are adult bone- marrow transplants.

Parents who use private banks hope that the cells could save their
child if they develop such a disease. This likelihood is very slim,
warns Joanne Kurtzberg, director of the paediatric stem-cell
transplant programme at Duke University in Durham, North Carolina. "I
think [banks] are playing on people's fears," she says.

According to the website of the Cord Blood Registry, the biggest
private US bank, "many doctors and scientists believe that in the
future, stem cells may be used to repair brain or spinal cord
damage". For $1,385 - plus $95 a year for storage - the bank freezes
a vial of cord blood.

David Harris, scientific director of the Cord Blood Registry, argues
that his company's information is not misleading because it portrays
the science as work in progress. "We try to present it even-
handedly," he says.

In the United States private cord-blood banks voluntarily submit to
inspection by the US Food and Drug Administration. In the majority of
European countries (including UK, Netherlands, Belgium, Austria)
there is no regulation; in France it is banned.

Despite their concerns, scientists admit that future research on cord
blood cells could reveal new medical uses. For example, Sanchez-Ramos
has found (but not published) evidence that a few special stem cells
can be isolated from cord blood in the laboratory. Treating them with
specific growth factors seems to help them produce new nerve cells,
he says.

"In 20-50 years these cells might be a life-saver," he says, "but I'd
be reluctant to give a guarantee."

SOURCE:  Nature News Service
http://www.nature.com/nsu/030203/030203-4.html

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