Embryos and antioxidants

 

My heart almost stopped when I read the headline on Wednesday’s BBC article, “Human ‘cloning’ makes embryonic stem cells.” At first glance, I thought that the Holy Grail of embryonic stem cell research had been found: a way to generate personalized stem cells by cloning a person, then destroying (killing) the clone at the early embryonic stage in order to retrieve the stem cells that are oh, so tantalizing for the cures that they might hold: fixing everything from diabetes to heart disease to Alzheimer’s to aging itself.

However, a closer read of the story shows that we are no nearer the Grail than before. Cloning involves removing the DNA from a donated egg cell and replacing it with the DNA from the somatic cell of another person, making that egg cell into a genetic duplicate or clone of the person; the clone can then grow and develop stem cells. But what the scientists actually did here was to create a genetic hybrid: an embryo that contains both the DNA of the woman who donated the egg cell, and the  DNA of the person to be “cloned.” This means that each cell of the resulting embryo has three copies of each chromosome, rather than the two that each of our cells normally carry. Leaving aside for the moment the ethical questions surrounding deliberately creating something/someone so abnormal (there’s a whole book to be written there) and deliberately killing embryonic human beings, the insurmountable problems of using stem cells that are so genetically abnormal make them useless for any “cures.”

Meanwhile, a story in yesterday’s Chicago Tribune reports on antioxidants, “one of the hottest buzzwords in the health and wellness industry. Manufacturers have emblazoned it on everything from water and cereal to alcoholic drinks.” Theoretically, antioxidants, by cleaning up free radicals, can help slow the processes associated with damage caused by free radicals such as heart disease, cancer, stroke, and even aging.

The problem, of course, is that there is little to no evidence that antioxidants actually do anything of the sort, and there is good evidence that in some circumstances they may be harmful. Nevertheless, hundreds of products with antioxidant claims are developed yearly.

What’s the connection between the two stories? Two therapies that don’t work , but for which the public is willing to spend gazillions of dollars. Two therapies that promise, as an antidote to degenerative diseases, regeneration — restoration — to some, the hope of eternal youth, even eternal life.

From the numbers of people who buy into these forms of snake oil, it appears that the longings for regeneration and eternal life run deep in our race. As Christians who have experienced regeneration, and who have met the only true source of Eternal Life, we just might be able to offer some true hope in place of the hucksters’ hope to which so many cling.

Another Promising Result Using Induced Pluripotent Stem Cells

Last Friday it was announced in Medical News Today that researchers at Johns Hopkins have discovered a means to fix the genetic defect that causes sickle cell disease with the patient’s own stem cells.  According to the announcement, “The corrected stem cells were coaxed into immature red blood cells in a test tube that then turned on a normal version of the gene.”[1]  This does not mean that a clinical application is imminent or that the procedure is safe.  As stated in the original abstract from Blood, the Journal of the American Society of Hematology, “the safety and feasibility of stem cell mobilization in individuals with sickle cell trait (SCT) has not been documented.”  However, the report added that “no untoward adverse events occurred in either group, including sickle cell crises.” [2]

The new treatment could prove to be revolutionary; at present the only existing therapy for sickle cell disease is through bone marrow transplantation.  However, the journal Blood reports that, “many patients are ineligible [for bone marrow transplantation] because of either the lack of a suitable donor or their underlying condition.”  The advantage of “peripheral blood stem cells” (PBSC) from the patient are obvious: patients don’t have to wait for a suitable donor – they are their own source of the stem cells.  The study concludes that, “Products from SCT donors require only minor changes in ex vivo cell processing, allowing for the use of mobilized peripheral blood as a potential source of stem cells for transplantation in sickle cell disease.”  Furthermore, as one researcher stated, “The beauty of iPS cells is that we can grow a lot of them and then coax them into becoming cells of any kind, including red blood cells.”[3]  In short, scientists believe they are now one step closer to successful stem cell therapy for sickle cell disease.

Of course, the word is still out on the success of PBSCs.  But ethicists should applaud any research that is as promising as embryonic stem cell research, but does not require the destruction of human embryos.


[1] http://www.medicalnewstoday.com/releases/235221.php

[2] There were two separate control groups with eight individuals in each group – one SCT group and one non-SCT group.  In the words of the research team, the study does “not permit the conclusion that G-CSF is completely without such risk. Our study, however, suggests that the risk is limited…” http://bloodjournal.hematologylibrary.org/content/99/3/850.full?sid=62767506-48e6-45f1-be88-b033f616fcc7

[3] http://www.medicalnewstoday.com/releases/235221.php

Why do people buy snake oil?

There a lot of ethical concerns about stem cell research.  Many have to do with the destruction of embryos for embryonic stem cell research.  Those of us who oppose embryo destructive research frequently promote the potential for adult stem cell research as a better and less ethically problematic alternative.  But adult stem cell therapy has a different problem. It is becoming the most recent version of snake oil.

While legitimate research involving adult stem cells should be supported, everyone from Texas Governor Perry to Indianapolis Colts quarterback Peyton Manning have been getting unproven adult stem cell treatments outside of valid research protocols.  Why would otherwise intelligent people subject themselves to unproven and potentially risky treatments?

Part of it may have to do with our human tendency to believe that something is true when we strongly desire for it to be true.  Our desires can be so strong they cloud our ability to reason and there are plenty of people who understand they can take advantage of that for their own profit.  They sell everything from snake oil to mangosteen juice to stem cells to people whose desire for a cure makes them vulnerable.

Another part may be our society’s unrealistic belief that scientific medicine should be able to cure everything.  Researchers’ hopeful expression of what may be possible with treatments such as stem cell therapy can make people with medical problems for which there are not effective treatments susceptible to trying an unproven treatment because of that potential.

Then again there is always the possibility that an unproven treatment may work.  Snake oil was actually a traditional Chinese remedy that used the fat of the Chinese water snake that was high in a prostaglandin precursor to help relieve inflamed joints.  When used correctly it may work.  Adult stem cell therapy may turn out to be effective for some of the things it is being used for by those selling unproven treatments.  But we won’t know unless those treatments are done in properly controlled trials.

The marketing of umbilical cord blood banking

 

One stem-cell success story has been the use of stem cells derived from umbilical cord blood. The list  (more here) of diseases treatable by transplants of such stem cells is impressive, even more so when compared to, say, embryonic stem cell treatments, which are currently used in therapies such as . . . well . . . hmmm . . . uh, let me get back to you on that one.

One gratifying aspect of the use of umbilical cord stem cells is that obtaining them carries none of the unethical aspects associated with embryonic stem cell use. Nobody is killed in collecting umbilical cord blood; after the delivery of a baby, blood is removed from a vein in the umbilical cord, causing no harm to mother or newborn.

This does not mean that there are no ethical issues surrounding umbilical cord blood. There are currently two ways to “bank” umbilical cord blood, either through public or commercial cord blood banks. The public banking option is free to the parents, strictly quality controlled, and the blood is available to any patient who needs it and is a correct match. Commercial banks, on the other hand, typically charge $500-$2000 to collect the blood, along with an annual storage fee of $110-$150; are not as quality-controlled; and the blood is available only for the exclusive (potential) use of the patient.

Ethical issues arise from the marketing tactics employed by some of the commercial banks. The premise underlying the marketing is, Bank your child’s cord blood for his or her own exclusive use, so that if your child gets a disease sometime in his or her life, we’ll have perfectly matched stem cells to treat their disease, and you’ll have peace of mind! It is not unusual for companies to advertise cord blood as “Life insurance,” or to warn that “This may be your one opportunity to save your child,” or to promise “Potential regenerative therapies from stem cells such as treatments for arthritis, heart disease, etc.”  — therapies which currently do not exist. (The quotes are from commercial websites.)

These ads are based on hype and fear: hype, because they seem to promise treatments that are not currently available and may never come to pass; fear, because they play on every parent’s concern about terrible diseases their child could contract.

(Hype and fear: aren’t those are the same tactics used to promote embryonic stem cell research?)

Embryonic stem cell research and umbilical cord stem cell therapies are ethical worlds apart in their practice, and we should aggressively oppose the former and actively pursue the latter. But we should also oppose unethical commercial exploitation of otherwise ethical therapies through false advertising. Commercial umbilical blood banks should be held to strict “Truth-in-advertising” standards, and stopped from falsely promising anything more than we know they can deliver. This might save a lot of parents their hard-earned cash.

And while we’re at it, we ought to hold the promoters of embryonic stem-cell research to the same standards of truth. This might save a lot of embryonic persons their lives.

South Korea Takes an Ethical Step Backwards

This week (Sept. 19) it was reported that the government of South Korea will invest $89 million to recommence its pursuit of human embryonic stem cells (http://www.bbc.co.uk/news/world-asia-pacific-14968613).  You may remember the scandal that erupted in 2006 when a South Korean scientist (Hwang Woo-suk) declared that he had generated human embryonic stem cells by means of cloning.  Later it was discovered that the research had been faked.  Woo-suk, who was considered a national hero before the scandal, “caused inevitable damage to the entire stem cell research community in Korea,” according to South Korea’s president, Lee Myung-bak.  The money will be invested, proclaimed Lee, to “…restore our national fame as a stem cell powerhouse.”  The BBC report ends with the oft-cited list of all the diseases that may be treated by stem cells including, “Parkinson’s disease, heart disease, stroke, arthritis, diabetes, burns and spinal cord damage.”[i]

The announcement by President Lee troubles me on several levels:

1) there is no evidence that human embryonic stem cells (hESC) can actually treat human diseases.  Yet, the technology is touted as the panacea to all the major diseases that inflict humans today.

2) thus far, the research has produced more hype than tangible hope.  Indeed, the promises of hESC therapy entice those with money to burn in the search for a magic cure.  For example, recently it was reported that Peyton Manning traveled to Europe to seek stem cell treatment for a neck injury.  ABC News referred to Manning’s efforts as a “Stem Cell Hail Mary.”  Apparently the treatment was unsuccessful.  The ABC News article included the following statements by Dr. Ruth Macklin (bioethics professor, Albert Einstein College): “We live in an era where physicians are encouraged to practice ‘evidence-based’ medicine.  However, a sports superstar has the money… to travel anywhere in the world to receive an experimental procedure that is not based on any evidence that works for his condition.”  Another stem cell researcher, Dr. Lawrence Goldstein, noted that “he was unaware of any stem cell approach that is proven to help any sort of spinal issue.”[ii]

3) hESC research, of course, destroys human embryos.  Yet we know that zygotes formed at fertilization are genetically unique with an intrinsic capacity of self-development.  The zygote does not become a human being at some later stage (e.g., implantation); it is a human being!

4) other types of stem cell research, such as somatic stem cells and induced pluripotent stem cells, show far more promise for present and future therapy than hESCs.  Furthermore, somatic stem cells and induced pluripotent stem cell research are not ethically problematic because they do not entail the destruction of embryos.

It is unfortunate that South Korea has renewed its pursuit of the unethical practice of hESC research.  It could instead follow the example of several Japanese scientists (e.g., Shinya Yamanaka and Kazutoshi Takahashi of Kyoto University) who have researched ways to reprogram skin tissue in mice to mimic embryonic stem cells.  In the end, South Korea’s effort to become a “stem cell powerhouse” will be overshadowed by its moral compromise.


[i] http://www.bbc.co.uk/news/world-asia-pacific-14968613

[ii] http://abcnews.go.com/blogs/health/2011/09/19/peyton-mannings-stem-cell-hail-mary/

See also The Center for Bioethics and Human Dignity website for the story on Peyton Manning.  http://cbhd.org/ is an excellent source for bioethical news.

Of horcruxes, stem cells, and the quest for immortality: the bioethics of Harry Potter

 

CBHD has partnered with author Austin Boyd and publishing house Zondervan for a suspense-fiction series entitled The Pandora Files. The first installment, Nobody’s Child, is about designer babies, body parts sales, and the thorny ethical issues they engender. It is a laudable effort to use the power of story to get people thinking about important issues; to show us rather than to tell us something is often the better strategy, and highlights the power of all the arts, whether visual, written, or performed, to touch hearts as well as minds.

I recently finished reading with my family one of the more wildly popular contemporary works of fiction, and found many points of contact for thinking about current bioethical issues. I realize that J.K. Rowling did not write the Harry Potter series as a bioethical parable, but the themes in her writing and the values her characters espouse are striking in their applicability.

(Warning: SPOILERS) In the series, an evil wizard named Lord Voldemort is obsessed with power, and with his own mortality. In the effort to overcome death, he resorts to what is the worst of imaginable dark magic: the creation of horcruxes. In order to make a horcrux one must commit murder, and the process causes irreparable damage to one’s own soul.

Harry Potter, a student wizard, is a leader of the resistance to Lord Voldemort. Guided by the Gandalf-esque wizard Dumbledore, he grows into his task over the course of seven very exciting (and very long) books. Dumbledore asserts repeatedly that the primary strength the resistance enjoys resides not in any magical power, but rather in the power of love — not the mushy, romantic sort, but the real thing,  self-sacrificing agape-style love. In fact, Harry goes knowingly to his death in order to defeat Voldemort; then, after a brief post-mortem sojourn in King’s Cross (who could miss that symbolism?) he returns and — well, I won’t spoil the entire story for the three people who haven’t read it or seen the movies.

Even in these novels written ostensibly for children, there are shadows of deeper and darker motifs, parallels to our world. The themes of thirst for power and desire for immortality are all too familiar to us, driving much of the most ethically questionable science. That Voldemort would resort to killing in his quest to live forever should have a familiar ring as well: we just make it sound much more civilized when we say “We disaggregate an embryo in a laboratory dish in order to obtain the stem cells that will be the key to regenerative medicine.” Voldemort does terrible damage to his soul each time he kills to make a horcrux;  who can tell what damage we do to our cultural soul when killing human embryos, our own young, becomes accepted by a large portion of the scientific and public community?

Again, Rowling did not intend to write a bioethical thriller as Austin Boyd is doing. But a person reading her books might just feel a bit more the danger inherent in the quest for power, and sense more keenly the contradiction and, indeed, evil, of killing another in order to benefit oneself. And when practices redolent of those values, such as embryonic stem cell research, are brought up, the reader might remember the words of one of the leaders of the resistance who said, “Every human life is worth the same, and worth saving;” and espouse Dumbledore’s prescription of self-giving love as a potent form of resistance to the evil around us.

Another Point for Adult Stem Cells?

A recent development in (Adult) Stem Cell research has proven effective in repairing the heart muscles of mice after a heart attack! Although the procedure has only proven effective–thus far–on mice, the promise of cell reactivation repairing muscle after a heart attack is nothing to sneeze at.

“The researchers examined the hearts of mice at various time points after the operation [procedure that replicates the effects of a heart attack]. They found heart cells expressing Wt1 just two days after the injury. The cells were initially in the heart’s outer layer, but by two weeks after surgery they had moved inside and clustered around the site of the injury. The cells had also changed in size and shape, and looked just like cardiomyocytes.”

This success is another reminder that we (scientists and researchers of today) are still needlessly pursuing the less than ethical embryonic stem cell research that requires the destruction of human embryos, the ending of human lives.   When comparing the two it is difficult to not concede to the preeminence of embryonic alternatives, and still the federal government wishes to fund the destruction of embryos.

While the battle continues, it looks like embryonic alternatives still have the upper hand.

For more information on stem cell research check out this website.