Now how did you copy that? I have been trying to since last night. Nita Hans van der Genugten wrote: > Stem Cells Frustrate Scientists, Politicians > > By Rick Weiss > Washington Post Staff Writer > Saturday, October 9, 1999; Page A1 > > It has been a year since researchers announced they had discovered in human > embryos and fetuses a unique type of cell with the potential to treat a host > of ailments, including diabetes, Parkinson's disease and even paralysis > caused by spinal cord injury. > > Now, in the final weeks of bargaining over a new federal budget, a divided > Congress is struggling to decide whether the medical promise of these "human > embryonic stem cells" is great enough to justify the use of taxpayer money > to study them, despite the fact that embryos and fetuses must be destroyed > to get them. > > Congress has blocked federal funding of human embryo research for the past > four years, but the discovery of stem cells has upped the ante in the embryo > research debate. The research ban, which is attached to the appropriations > bill for the departments of Labor and Health and Human Services, underwent > several radical changes while the Senate addressed the bill last week, at > various times containing prohibitions far stronger or weaker than in > previous years. On Monday, the House will begin action on the issue. > > For many lawmakers, it is largely a question of whom they least wish to > alienate: highly motivated and perhaps overly optimistic members of patient > groups who believe that stem cells may soon save their lives or the lives of > their loved ones, or equally passionate antiabortion activists who believe > it is unethical to experiment on embryonic and fetal tissues. > > But for the many publicly funded scientists who want to investigate the > cells, the issue is a no-brainer: The nation ought to enlist their help, > they say, because it is becoming increasingly clear that it will not be easy > to turn stem cells into cures. > > Among the more frustrating problems is how to get the cells to grow into the > specific kinds of cells needed by patients, such as heart cells to be given > to a heart attack victim or pancreas cells to be given to a diabetic. Today > the cells behave as though they have a mind of their own, becoming whatever > kind of cell they choose, and for no apparent reason. > > "You smile at them and they become heart, you frown and they become brain," > complained Tom Okarma, president and chief executive officer of Geron Corp. > of Menlo Park, Calif., which has funded most of the human embryonic > stem-cell work in this country. The challenges ahead, he said, "are > formidable." > > Indeed, while Okarma and others still hold high hopes that stem cells will > lead to medical breakthroughs, ongoing studies by privately funded > scientists at Geron and elsewhere have lent an air of sobriety to a field > that a year ago seemed almost drunk with promise. > > For example, it is still difficult to keep stem cells alive in the > laboratory, and it has been impossible to grow them in numbers large enough > to be medically useful. Moreover, scientists still don't know how to > engineer the cells so they won't be rejected by patients. > > "The only way we're going to figure all this out is to roll up our sleeves > and do the nitty-gritty research," said Harvard University cell biologist > Evan Snyder. "There's such a clamor in the stem-cell field, but we should > not let the clamor or the substantial promise seduce us into thinking we can > do this quickly." > > Embryonic stem cells are the basic, "plain vanilla" cells present at the > core of newly developing animals. During prenatal development, they > differentiate into more specialized cells, such as those that form the skin, > liver, kidneys and brain. > > What makes them unique is their ability to multiply indefinitely in > laboratory dishes, where they can give rise to offspring cells that also > have the ability either to blandly reproduce or, under the right influence, > specialize into any of the body's tissue types. Doctors hope they will be > able to grow a smorgasbord of replacement tissues from stem cells, for > transplantation into people who need them. > > After years of funding from Geron, two research teams announced > simultaneously last fall that they had finally isolated human embryonic stem > cells. One team retrieved them from young human embryos and the other from > the immature sex organs of aborted fetuses. > > The best news so far is that the cells seem to be as immortal as advertised, > said James Thomson, the University of Wisconsin researcher who isolated > human stem cells from leftover fertility clinic embryos. After almost two > years of living and dividing in laboratory dishes, every new generation of > cells seems just as young and full of potential as the previous one. > > To prove that, Thomson has injected into mice freshly grown human stem cells > that are more than 300 generations removed from the parent cells he isolated > from his original human embryo. Stem cells that have retained their full > potential should, when they are injected into mice, differentiate into all > the many kinds of tissues that they can become. And these 300th-generation > cells have done so with exquisite creativity, Thomson said, with some of > them becoming hair, others teeth, and still others little masses of cardiac > cells that soon begin to beat in unison like a miniature heart. > > In fact, it is not difficult to get stem cells to differentiate into various > tissues. The hard part is growing them into the specific kind of tissue you > want – and keeping them from specializing until you are ready. Scientists > will have to grow huge vats of stem cells in their undifferentiated state if > they are ever to commercialize them. Currently, however, the only way to > keep the cells in this "primordial" state is to grow them in small dishes > along with a special type of mouse cell. > > The mouse cells – known as "feeder cells" – somehow keep human stem cells > from spontaneously following their urge to specialize. But despite valiant > efforts, Thomson and others have failed to identify how the feeder cells do > that. It is a bottleneck scientists will need to get through if the research > is ever going to become useful for patients, because the mouse-cell system > is too cumbersome to scale up to commercial levels. > > It's not an impossible task. Several years ago, researchers working with > mouse embryonic stem cells were in the same bind: Those cells only retained > their full potential when grown with finicky feeder cells. Then researchers > found that a compound secreted by the feeder cells, called leukocyte > inhibitory factor, or LIF, was the magic substance that was keeping the stem > cells vital. Since then, scientists have just had to add some LIF to their > dishes of stem cells, eliminating the need for feeder cells. > > "After that, the mouse studies took off," recalled Roger Pederson, a > Geron-supported researcher of human stem cells at the University of > California at San Francisco. Unfortunately, LIF does not do for human stem > cells what it does for mouse stem cells, Pederson said. "Someone has to > discover the LIF counterpart for human stem cells." > > Perhaps even more daunting is the task of learning how to prod batches of > stem cells to mature into specific kinds of cells for transplantation into > people, such as liver cells for patients with cirrhosis or specific kinds of > brain cells for patients with Alzheimer's or Parkinson's disease. > > Scientists have had some small successes in encouraging stem cells to turn > into desired types, such as blood cells and nerve cells. > > Last December, for example, Johns Hopkins University researcher John > Gearhart stood before a Senate subcommittee and unveiled a poster-size > photograph of spidery living cells with branched, outreaching arms. These > appear to be healthy human brain cells, said Gearhart, grown in a laboratory > dish from a starter batch of stem cells by feeding them a special recipe of > nutrients. He plans to inject some into the brains of rodents this fall, to > start assessing their potential as a treatment for brain diseases. > > But Gearhart's method is far from foolproof. Many stem cells treated with > the same nutrients do not become neurons, and retain the potential to become > bone, muscle or other cells later on – cells that would not be welcome in a > patient's brain. > > Even less is known about how to spur stem cells to grow with assuredness > into other kinds of cells, such as the insulin-secreting pancreas cells > that, given the prevalence of diabetes in this country, are foreseen by > Geron as the first "blockbuster" moneymakers. Somehow, researchers will have > to overcome stem cells' apparently fickle nature. > > Finally, there is the problem of immune-system rejection. Researchers want > to figure out which molecules on stem cells are recognized as foreign by a > patient's immune system. In theory, researchers could genetically engineer > the cells to lack those molecules – a simple-sounding strategy that > scientists concede will probably take many years to implement. > > Depending on who is talking, problems such as these add up to an argument > either for, or against, a quick infusion of federal funds. > > To some on Capitol Hill, including Sen. Arlen Specter (R-Pa.), the many > difficulties scientists face suggest that federal funds are needed if cures > are to be developed within the next decade. Federal funding also would > ensure a level of public oversight not possible when research is left to > private concerns. > > But others, including Rep. Jay Dickey (R-Ark.), say that given the vast > number of unanswered questions in the field, the government could satisfy > itself by funding basic studies on animals and less controversial human > cells, without venturing into the ethical minefield of embryo research. > > Further complicating the political problem, preliminary evidence from mice > suggests that stem cells retrieved from embryos may have medical advantages > over those isolated from aborted fetuses. That revelation, described in the > Oct. 1 issue of the journal Science, is problematic for legislators such as > Dickey. Last week, he sought to reword the ban in a way that would have > precluded research on embryo cells while allowing studies on aborted > fetuses. Fetal research is less controversial than embryo research, because > the former can be done on fetuses already aborted but the latter involves > the direct destruction of embryos. Dickey later withdrew the proposal. > > In the end, Congress may manage to duck the issue. During the past few > months, the National Institutes of Health has created a set of guidelines > and ethical standards that publicly funded scientists wishing to study human > embryonic stem cells would have to follow. > > The guidelines would preclude researchers from retrieving stem cells from > embryos directly, because that act causes the destruction of live embryos. > But researchers would be allowed to study stem cells from embryos that > someone else had destroyed or from aborted human fetuses. > > Many in Congress see the guidelines as a good compromise – and as a way to > eliminate at least one controversial element from a bill that is already > making waves with provisions relating to abortion and birth control. On > Thursday, the Senate passed its version of the HHS bill with no restrictions > on stem-cell research. > > On Monday, the House will take up its version of the bill. And if > representatives decide they can live with the NIH guidelines – a far from > foregone conclusion – they too may drop the ban. > > But the suspense might not end there. Many Congress-watchers predict that > the House and Senate versions will defy congressional consensus on other > counts, and ultimately will get folded into a huge omnibus spending bill. > > Omnibus spending bills are negotiated outside the usual committee circles > and are famed for ending up with unexpected changes – the result of > horse-trading efforts in the wee hours of an already extended budget > process. That means that, for all the lobbying on both sides of the issue, > the legislative resolution to this year's biggest biomedical controversy may > not become clear until the dust settles at the end of a frantic, closed-door > session. > > © 1999 The Washington Post Company