Stem Cells and the Medicine of the Future

Ten years ago, the issue of embryonic stem cell research was controversial. I was torn in both directions. The thought of being able to treat diseases and illnesses by implanting or injecting cells that could develop into any mature cell was a dream come true, providing hope for sufferers of Parkinson's Disease, cancer, heart disease, and other debilitating afflictions. Initially, my one reservation was whether it was morally appropriate to develop an embryo for the purpose of curing illness. The embryo would not survive; I wished that embryos did not have to be sacrificed in the pursuit of a greater good.

Many arguments, both pro and con, were advanced to support both positions. Most of the embryos that were created for in vitro fertilization are discarded anyway. I could see the argument, but still felt uncomfortable hearing it. 

I also believed that there was a compatibility issue, that the embryonic stem cells would likely be rejected by their recipient. I felt that adult stem cells, which were considered to be less flexible than their embryonic counterparts, were a safer option because those cells were donated by the patients who would be using them. Less flexibility, but more compatibility.

However, on the basis of yesterday's announcement of the Nobel Prize winners in medicine, the controversy is over. Mature cells can turn back time and return to their embryonic state--and then mature into an entirely different group of cells. Apparently every cell has the potential of becoming any other cell. This means that the compatibility issue has been resolved. Patients would donate the cells they need to themselves.

Imagine a liver, for example, being ravished by cirrhosis. New cells can be injected into the liver that will become liver cells, cells that never could have been replenished before. This cannot be done today, but maybe in five or ten years, who knows?

According to yesterday's Wall Street Journal:

Experiments by John B. Gurdon of the United Kingdom and Shinya Yamanaka of Japan showed that mature cells taken from the body could be changed to an embryonic-like state in a laboratory dish, a head-spinning discovery that is the biological equivalent of turning back time.

Yesterday's New York Times explains why this is possible:

Working with mice, Dr. Yamanaka discovered in 2006 that the reprogramming can be accomplished by just four specific gene control agents in the egg. The agents, known to biologists as transcription factors, are proteins made by master genes to regulate other genes. By injecting the four agents into an adult cell, Dr. Yamanaka showed that he could walk the cell back to its primitive, or stem cell, form.

Stem cells generated by this method, known as induced pluripotent cells, or iPS cells, could then be made to mature into any type of adult cell in the body, a finding with obvious potential for medical benefits.

When I read about stem cells and get so excited, I wonder how this will affect stem cell companies as well as other firms that are investing in stem cell terminology. I came across Neuralstem, a company that specializes in stem cell research. 

In an article by SeekingAlpha from September 11 of this year, the following enthusiastic comments were written:

For years, embryonic stem cell companies have been running into a brick wall. They could get the cells to reproduce (necessary for manufacturing enough cells to treat patients), but then they had trouble controlling the reproduction process. This is a problem because you do not want unlimited rampant reproduction of cells once the cells are injected into the patient.

Neuralstem was able to solve this dilemma by controlling when the stem cells differentiate into mature cells. Once that differentiation takes place, the reproduction stops, and the mature cells can go on to do what they need to do. This ability of a cell to do the right job is important, because you don't want to put embryonic stem cells into someone's brain, and have them turn into bone cells instead of nerve cells.


Will Neuralstem turn out to be another Solyndra? Who knows? Maybe the answer will take five or ten years to be discovered. In any event, I know I'm excited. I can't wait to see where stem cell research will take us.
 
Best Response
hdavid57:

However, on the basis of yesterday's announcement of the Nobel Prize winners in medicine, the controversy is over. Mature cells can turn back time and return to their embryonic state--and then mature into an entirely different group of cells. Apparently every cell has the potential of becoming any other cell. This means that the compatibility issue has been resolved. Patients would donate the cells they need to themselves.

Ugh with the nobel prize announcement the popular press is writing all this stuff about how iPS cells are gonna cure X Y and Z just around the corner. Most of this stuff is written by journalists who have no idea what they are talking about or by folks who have an interest in promoting the narrative. I don’t see any real cures coming directly out of iPS cells. These things are very cool, and they make great research tools that could lead to real cures for diseases eventually, but iPS cells by themselves are a nonstarter. These things are generally designed by throwing in a handful of oncogenes, it’s rather crude and obviously unsafe. We are so so so far away from understanding how cells actually work, we have only scratched the surface of molecular biology. The idea we can reprogram them to do whatever we want and stick them in humans is the height of hubris (a hubris that is far greater and far worse than those PhD finance quants who thought they had it all figured out with their bs risk management formulas). Don’t buy the hype, short the hell out of any company purports to cure anything with this.

 

Aside to Amphipathic: Show me all the articles by the popular press that mislead people into believing that a cure for X, Y, and Z is "around the corner." Neither of the articles from the Wall Street Journal or The New York Times is conveying that message. What is being said, however, is that this is an exciting time in medicine and that a cure may occur a lot sooner than you think...

Howard Schwartz See my WSO blog
 

Okay, they are not directly saying it will cure "X Y and Z tomorrow." But when you say things like:

hdavid57:
However, on the basis of yesterday's announcement of the Nobel Prize winners in medicine, the controversy is over. Mature cells can turn back time and return to their embryonic state--and then mature into an entirely different group of cells. Apparently every cell has the potential of becoming any other cell. This means that the compatibility issue has been resolved. Patients would donate the cells they need to themselves.

You came up with those conclusions on your own? The media didn't lead you to those conclusions? Your enthusiasm for iPS cell therapy is entirely from your own careful review of the scientific literature?

Of course the media isn't lying and saying "this is gonna cure X Y Z tmrw." But when the author of an newspaper article writes on a subject that is completely foreign to the public and uses language like "a head-spinning discovery that is the biological equivalent of turning back time" and doesn't mention the key problems with the technology, folks are obviously going to get the wrong impression. I call that grossly misleading.

For the record, I am not trying to put down these scientists or their findings. These guys are awesome, and it is a shame that the public idolizes athletes and their silly 'accomplishments' over great minds and their amazing discoveries. But the lack of understanding of mol bio in the public combined with the way in which journalists write about science (which probably stems more from ignorance than purposes of deception) leads to a lot of misperceptions. I would be wary of what anybody writes on this subject unless there is a 'PhD' at the end of their name. Esp if, like the seekingalpha author, they admit to be long the stock.

 

The more we exchange comments back and forth, the more I realize that our points of view aren't so different after all. The title for this post is, "Stem Cells and the Medicine of the FUTURE." I said, to quote from my own article: "This cannot be done today, but maybe in five or ten years, who knows?"

In the same way that my enthusiasm for stem cell research, which I've had for more than ten years, has been spurred on by the media, my caution in expecting wide-spread implementation of this research has been influenced by the media as well.

One of the reasons I thought the Times article was more interesting than the Wall Street Journal article was because it provided greater detail about the process. If you could recommend articles that explore the obstacles that need to be overcome before patients can fully benefit from stem cells, I would love to read them; I really would.

Ten years ago, I remember Michael J Fox and Nancy Reagan speaking out in favor of embryonic stem cell research. The issue had become an indirect referendum on abortion. (When does life begin? Is the embryo being killed?) Now the referendum is over. We don't need embryos anymore to conduct this research! The politics of stem cell research--at least that aspect of it--has been resolved.

Howard Schwartz See my WSO blog
 

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