Stem cell debate rages on

Despite growing movement by Congress to overturn the Bush ban on federal funding, opponents of such research stand firm.

By Joel B. Finkelstein — Posted June 13, 2005

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Washington -- Passage of a House bill designed to expand the availability of embryonic stem cells has done nothing to quell the controversy over such research. The issue, which divides the public and medical researchers, now moves to the Senate and ultimately could reach President Bush's desk.

The legislation's supporters argue that the hundreds of thousands of frozen embryos in the country will go to waste because of federal policy instead of being used in studies aimed at finding new treatments for chronic illnesses and degenerative diseases.

"Research has been stymied in this country, going into private hands and offshore. Research moves ahead, but not with the resources of the National Institutes of Health and without clear ethical standards," said Rep. Diana DeGette (D, Colo.) during several hours of floor debate on the legislation she helped author.

But opponents of the measure counter that stem cell research has progressed with federal funding. "We've heard for years that the promise is in embryonic stem cells. But, in fact, the research shows that it has been the adult stem cells and cord blood stem cells that have proved to be most useful," said Rep. Dave Weldon, MD (R, Fla.).

The bill, which the House passed 238-194 last month, would overturn current White House policy that bars the use of NIH funding for the study of embryonic stem cell lines established after August 2001. The legislation also would establish ethical guidelines for how cell lines are to be derived.

The measure contains provisions designed to ensure that fertility clinics don't have a financial incentive for creating extra fertilized embryos that then could be sold for research purposes. The bill also contains criminal and civil penalties to discourage attempts at human cloning.

The AMA recently sent a letter to House leadership reiterating the Association's policy, which generally supports "federal funding of biomedical research that promises significant and scientific benefits." Such research includes the study of adult, cord blood and embryonic stem cells, conducted within ethical boundaries ensuring that donors of research materials are anonymous and uncoerced.

The day after the measure passed the House, Senate supporters held a meeting to push for quick passage in that body. Senior Democrats said they hoped to work with Senate leaders, who have not been supportive of such bills in the past, to get the bill on the calendar for a vote.

But President Bush has vowed to veto it because of his moral objections to the destruction of human embryos. If that happens, the House and Senate would need a two-thirds majority to override the veto. Lawmakers who support the measure said they hope that they can work with the president.

The House also passed a less-controversial bill to provide new funds to create a national inventory of cord blood, a source of adult stem cells that is used in treating myriad diseases.

The current policy has significantly frustrated work to unlock the curative secrets of stem cells, according to several researchers.

"I left the practice of medicine to find ways to cure people," said Ping Wu, MD, PhD, associate professor in the Dept. of Neuroscience and cell biology at the University of Texas Medical Branch in Galveston. But so far, the federal restrictions have made it impractical for her to study embryonic stem cells, which she believes hold more promise than adult stem cells.

Because there are a limited number of the federally approved embryonic stem cell lines, they are costly, she said. The firms that provide them usually charge $5,000 to $10,000 a batch. The lines also tend to be very fragile and extremely temperamental. They often don't survive the processes of being thawed out or cultured.

Even researchers who have been able to work with the embryonic stem cells feel frustrated with the prohibitions on federal funds.

The loss of a cell line, which happens frequently with these particular tissues, can resulted in months of lost lab time, said Lorraine Iacovitti, PhD, associate director of the Farber Institute for Neurosciences at Thomas Jefferson University in Philadelphia.

"It's a myth that stem cell lines live forever," she said. "The NIH-approved stem cell lines are expensive, they are hard to work with and they are getting old."

Her lab has four federal grants, which she uses to work with the government-approved embryonic stem cells as well as adult stem cells.

Dr. Iacovitti also conducts research on newer embryonic stem cell lines, for which she has funding from the Pennsylvania government and private foundations.

"It becomes a game of putting together pieces of money from different foundations and state sources," she said. But that funding is a fraction of what is available from the federal government, she said.

Worries about safety

However, not all researchers believe that the prohibitions on embryonic stem cell study have hamstrung the science.

The journal citations for new stem cell research, which continue to increase, speak for themselves, said Gary S. Friedman, MD, medical director at the Center for Regenerative Medicine in Morristown, N.J.

He points out that physicians have been successfully using adult stem cells from bone marrow and cord blood for decades to treat patients. The adults cells are much better tolerated and have much lower risk than embryonic stem cells, which have been shown to produce malignant cancers in animal models, said Dr. Friedman, a stem cell researcher and transplant surgeon.

Other researchers also have pointed out that the controversy over embryonic stem cells might be overshadowing the further promise of adult stem cells.

But Dr. Iacovitti said that although her lab continues to study adult stem cells, embryonic stem cells continue to prove more adaptable and long-lived than stem cells derived from other sources.

For those trying to conquer neurodegenerative disease, there is nothing else as promising, she said.

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Doctors in the House

Several members of the House of Representatives are also physicians. Here's how they voted on the recently passed legislation to expand access to funding for embryonic stem cell research:

Yea: Jim McDermott, MD (D, Wash.), John "Joe" Schwarz, MD (R, Mich.), Vic Snyder, MD (D, Ark.)

Nay: Michael Burgess, MD (R, Texas), Phil Gingrey, MD (R, Ga.), Ron Paul, MD (R, Texas), Tom Price, MD (R, Ga.), Dave Weldon, MD (R, Fla.)

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Public support

A recent survey of more than 1,000 adults found that a slim majority believe the federal restrictions on embryonic stem cell research should be eased or lifted.

Ease current restrictions 42%
Keep current restrictions 24%
Do not fund at all 19%
No restrictions 11%
No opinion 4%
Total 100%

Source: The Gallup Organization, May

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