President's Page

President's Page
April 2006

Stem Cell Research—
Educating legislators on reality

by David M. Bookout, MD
2006 DCMS President

A congressman was asked his position on alcohol. His response was, “If you are talking about that drug that destroys health and relationships, who can be for it? But, if you are talking about that elixir that leads to relaxation and socialization, how can anyone be against it?” Certainly, the issues surrounding stem cell research are even more complex. Human embryonic stem cell research has created the most controversy, even though it is only a small part of stem cell research.

Embryonic stem cells are derived from the pre-implantation blastocyst. The isolation of the inner cell mass destroys the human embryo, thereby causing another controversy. There is no shortage of frozen embryos that have been deserted. These should be donated for research. Many of these are frozen at an earlier stage of development and would not have the potential for development to the blastocyst stage. Federal funding for research is available only for the 15 lines available in the NIH Registry.

Umbilical cord blood is an abundant source of stem cells that can be preserved and used for research or approved therapies. No destruction of a potential human life is necessary, so there are no ethical issues. However, there may be some other issues:

(1) Nearly all the banking done now is through private banking, which requires a significant expense. Should we have public banking where all ethnic groups would be represented? Currently, the stem cells in private banks principally are for Caucasians.

(2) A couple has a child who develops a disease that can be cured by a stem cell transplant, but no tissue match is available. They decide they want to have another pregnancy and “design that baby” as a donor for their ill child. They undergo IVF/ET with Day 3 embryo biopsy and transfer only embryos with a tissue match. The cord blood from the “designed baby” could then be used for the transplant. Is this ethical?

Research has been done on utilization of cord blood stem cells to treat certain neurological diseases (stroke, Parkinson’s, spinal cord injuries), heart attacks, diabetes, and lung disease. Those lucky individuals banking cord blood now may have their own cure for these diseases as they age.

One of the private cord blood companies, Cbr, shared some of its data regarding stem cell therapy. Of the 40 cases reported, 85 percent have been used for siblings, one for a mother, and the remainder used autologously. A majority have been used for people with leukemia. Other uses include Beta thalasemia, Hurlers Syndrome, sickle cell anemia, aplastic anemia, Fanconis anemia, anoxia, traumatic brain injury, and cerebral palsy.

Texans for Advancement of Medical Research states that regenerative medicine—the repair and replacement of diseased cells with healthy ones—will be the medical treatment of the 21st century.

Texas legislators repeatedly have attempted to pass legislation that outlaws forms of stem cell research that could play a critical role in curing disease.

Another aspect of this type of legislation is a potential brain drain. Talented researchers in the field would have to move to other states or countries to perform their research. Current literature is dominated by foreign research.

I encourage physicians to actively participate in educating our legislators and our patients about stem cell research. We must clearly delineate and emphasize the difference between human and embryonic stem cells and stem cells of other origins. Embryonic stem cell research is important and must continue, but all other research in stems cells must not be restricted by the lack of differentiation.

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