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Rao: There are two extreme viewpoints here. The most promising is providing
cells for replacement therapy. There's been a lot of activity and companies
have filed INDs (investigational new drug applications with the FDA). For
example, Geron (is planning to file) an IND for spinal cord injury -- they
have a cell derivation to repair damaged spinal cords. Other groups have
focused on Parkinson's disease. Other groups have said that they can replace
damaged heart cells. So diseases for which there's no other cure for, we can
provide cells that were simply not available before.
At least two other important pieces have been a boon for the developmental
biologists or people who want to understand human development. It's been a
black box between fertilization and early stages of embryonic development
before you get to a fully formed fetus. We've never had a way to approach
this, and now we do. We can study questions that have been of fundamental
importance for which we simply had no tools. X chromosome inactivation,
methylation and regulation of the genome, cancer regulation, how aging
senescence and these properties of cells is regulating.... That's already
yielded fruit, but it's not the excitement (the public is) looking for,
they're looking for cures for disease.
WN: If scientists recognize the public doesn't really understand more
complicated uses for stem cells, they often emphasize the potential disease
cures. Do you think that's dangerous and creates hype that might never be
lived up to in the minds of the public?
Rao: Yes, and I think it's not just the public that's to blame -- it's the
scientists as well. The public understands these things, provided somebody
takes the time to explain, but nobody has told the public how long it takes
to bring a drug to market. Let's say we really had a breakthrough today --
it takes eight years to 10 years to go through an approval process before
they can provide that product to the public. The FDA has said cells as
therapy are also a drug and (need) the same sort of regulatory process as
drugs, and we can't be promising people that this will happen next year or
the year after, unless the regulations are changed. If you get money or
support with false premises, there's always a backlash.

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