ScienceLive Chat about The Future of Stem Cell Research

(Stem Cells News image)

Thursday August 4, 2011
3:01

Jocelyn Kaiser:
Hi everyone. This is Jocelyn Kaiser, a news writer for Science magazine. In today’s chat, we’re talking about last week’s court decision finding that federal funding for human embryonic stem cell research is legal. We’ll discuss what’s next for Sherley v. Sebelius and what it’s like to work in an area of research where policies are always changing. Guest Hank Greely, a law professor at Stanford, is here now and we’re hoping to be joined later by Amander Clark, a stem cell researcher at UCLA. Let’s start with a question for Hank.

Hank, why was this lawsuit so important?
3:02

Hank Greely:
Well, when Judge Lamberth ruled last August that the NIH policy was illegal, he stopped, for several weeks, all federal funding for human embryonic stem cell research. That was a pretty dramatic effect, and, as long as this suit is pending, it makes that funding somewhat uncertain.
3:03

Hank Greely:
The most recent decision by Judge Lamberth, following on the appellate court’s earlier reversal of his preliminary injunction, relieves a lot of that uncertainty. It now seems very likely that the plaintiffs will ultimately lose and that the NIH will be able to continue funding some human embryonic stem cell (hESC) research, but some uncertainty will remain until all the appeals are finished.
3:06

Comment From yogale
are there any limits to stem cell research?
3:06

Hank Greely:
Right now, federal law prohibits the NIH from funding any research in which embryos are destroyed or damaged. The NIH therefore cannot fund any research that derives new hESC lines, because that is done by destroying embryos. The federal policy that NIH follows also has some restrictions on informed consent and other ethical issues around hESC research. States with research programs, notably the large program in California, have more detailed restrictions, based on a set of guidelines from the National Academy of Sciences, first promulgated in 2005.
3:07

Jocelyn Kaiser:
Hi, Amander! Amander Clark has joined us now and can address some of the more scientific questions.
3:08

Comment From Mike Bruno
Are induced pluripotent stem cells (from adult cells) precisely equivalent to embryonic stem cells? …or are they somehow adulterated?
3:08

Hank Greely:
We don’t really know yet whether hESCs and iPSCs are equivalent. They do involve transferring either genes or proteins into human cells; that’s a difference from hESCs. How it affects the resulting cells is not yet clear – though it is one of the most important and exciting areas of stem cell research.
3:11

Amander:
Using scientific assays with high power it is now known that human induced pluripotent stem cells are on average different to human embryonic stem cells at the level of DNA and also covalent changes to DNA. However we do not yet know the significance of these changes. The short answer is that the cells are different.
3:11

Comment From Erica Jonlin
Do you think the current Congress would consider NOT adding the Dickey-Wicker amendment to the next DHHS appropriations, letting it “disappear”?
3:11

Hank Greely:
I don’t know whether the current Congress can tie its own shoes, frankly. To be more serious, I am confident that the House of Representatives, with a Republican majority, would insist on retaining at least the current Dickey-Wicker restrictions on research. The Senate might be willing to clarify Dickey-Wicker to make enshrine in the statute the D.C. Circuit‘s interpretation of the amendment, allowing the current research funding, but I doubt that House currently would go along with it. Again, assuming Congress can get anything done at all right now.
3:14

Comment From Nivin Thundiyil
Why do we still used embryonic stem cells and debate over it? Can’t we just use iPCs instead?
3:14

Amander:
Currently human embryonic stem cells are approved by the FDA for use in safety trials to treat macular degeneration and spinal cord injuries. While we do not yet know the significance of the genetic and epigenetic differences between human embryonic stem cells and human induced pluripotent stem cells it is still important to study both.
3:15

Comment From Helen Appleton
How is this decision going to prevent the NIH shutdown of the research when there are two outstanding issues remaining to be resolved?
3:15

Hank Greely:
But there aren’t two outstanding issues. The district court ruled against the plaintiffs on all the issues (except standing, their right to bring the suit) and granted summary judgment for the government. There were two issues that the Court of Appeals hadn’t dealt with, but the district court opinion did. Of course, those questions are still alive on appeal, to the Court of Appeals and, perhaps, to the Supreme Court. My own strong guess is that neither will be reversed – but it’s always risky to predict court decisions.
3:16

Jocelyn Kaiser:
A followon to that. Didn’t Lamberth agree with NIH on one of those issues only because he had to follow the appeals court’s decision on the ambiguity of Dickey-Wicker?
3:18

Hank Greely:
Yes, I think he made it clear that he still thought he was right that the term “research” in Dickey-Wicker had a clear meaning, one that prohibited funding hESC research – but he also made it clear that he realized that the Court of Appeals reached a different conclusion and that when a district court judge and an appellate court disagree, the district court judge loses.
3:18

Comment From Grad Student
What would you say to a graduate student interested in pursuing studies/research in stem cell research/application to treatment of diseases; who is uncertain to pursue the field because of doubts of whether funding will be available in the coming years (especially with election seasons coming up)? Is it still just a gamble that one would get funding in the coming years?
3:18

Amander:
That is a very important question! I would recommend that you pursue a project that you are passionate about. If you are passionate about stem cell research and applications then you should definitely continue along with this line of studies. The recent court ruling has made this a possibility. Earlier this year I would have been more cautious about advising you along this route.
3:19

Jocelyn Kaiser:
Amander, have you seen students or postdocs move away from hESCs in the past year because of the lawsuit?
3:21

Comment From Grad Student
That is helpful advice Dr. Clark. I think there is some concern still though with up and coming graduate students committing to labs that hang in the balance when it comes to how NIH will be able to fund them. But it is good to hear that you are optimistic.
3:23

Amander:
The short answer is that students are excited about induced pluripotent stem cell research, however it is equally as important to compare induced pluripotent stem cells to embryonic stem cells (the current gold standard). The fear is more with losing the best control we have. And as scientists controls are essential!

Hello Grad student – the NIH is funding students who work on human embryonic stem cell projects.
3:23

Comment From Taylor
It doesn’t seem right for a prohibition of funding because some unthinking, unconscious and unfeeling cell or bundle of cells is harmed or destroyed; especially since the embryos in question are donated to scientific research and therefore were not intended to be brought to term. Why is it that people feel the need to let bronze-age religious dogma restrict the efforts of science. We’re talking about a technology that can potentially save people dying from real and painful diseases and degenerative disorders. Is it so bad that some cells get destroyed along the way? If we’re talking about how these cells are potential humans then we might as well say that ALL cells are potential humans since we are getting closer to converting the Heterochromatin DNA in differentiated cells back into Euchromatin DNA; essentially turning differntiated cells back into stem cells.
3:23

Hank Greely:
Well, I think countries have a right to try to limit scientific research done in their country, if they want to. They may pay a price for that, in competitiveness or knowledge, but sometimes that might be a price worth paying. South Dakota makes hESC research a crime; California has provided $3 billion to fund it. The democratic process in each place has reached a conclusion, at least tentatively. Whatever its basis (as long as it doesn’t violate, say, the First Amendment’s ban on the establishment of religion), I do think science does need to respect the democratic process . . . and also to participate vigorously in it.
3:26

Comment From Jessica
how can you get hESCs without damaning or destroying a human embryo?
3:26

Amander:
Hello Jessica, it is possible to derive embryonic stem cell lines from single blastomeres. Isolating single blastomeres is sometimes done in in vitro fertilization clinics for clinical genetic testing. This can be achieved without destroying the embryo.
3:26

Jocelyn Kaiser:
So why doesn’t everyone use that method?
3:27

Amander:
The single blastomere technology is incredibly inefficient and technically challenging.
3:27

Comment From Nivin Thundiyil
Why don’t we spend money to figure out if the differences between iPCs and eSCs are significant, and not waste it on furthering eSCs? Most people that support or go against stem cell research, are not aware of iPCs. It is important to use eSCs now, but we should also make people aware of iPCs so that it gains more funding and interest.
3:27

Hank Greely:
We do. A lot. But we can’t answer that question without knowing more about hESCs in order to be able to compare them to iPSCs. After all, we know that hESCs can make healthy versions of every human cell type because they have done that, in each of us. We don’t know that about iPSCs. So, in short, it’s too early to know which will work, so we need to research both.
3:28

Jocelyn Kaiser:
Here’s one for Amander. You’re Australian. Have you thought about going back there because the rules are less restrictive?
3:31

Amander:
Over the last twelve months while federal funding for hESC research has been under a cloud, I have certainly thought about scientists in other countries who can just think about their science, and not have the additional worry about funding and finishing projects prematurely due to the threat of funding cuts.
3:33

Comment From Taylor
What was the case for the call of banning federal funding for embryonic stem cell research?
3:33

Hank Greely:
Well, the basis for the Dickey-Wicker amendment was that Congress either thought (and has continued, through 15 years, to think) that destroying embryos is morally wrong, or, that given the sentiments of their constituents, that it was improper for the federal government to fund it. And on that point -funding the destruction of embryos – there actually is a fair amount of Democratic support for that position (though not support for preventing all hESC funding.) To eliminate Dickey-Wicker requires changing the minds of members of Congress (or changing who the members are).
3:34

Jocelyn Kaiser:
Hank, What’s next with Sherley v. Sebelius? Can researchers stop worrying that their research will be shut down?
3:36

Hank Greely:
The plaintiffs get to decide what they want to try next. They might ask Judge Lamberth to reconsider, but that’s very unlikely to work. They might appeal to the Court of Appeals, which I suspect they will do. Given the decision by the Court of Appeals panel that overturned the preliminary injunction, that appeal would probably be denied, but they need to go through that stage in order to have a chance either to ask the full 10 judge Court of Appeals to hear their appeal or to appeal to the Supreme Court. (Actually, they could ask the Supreme Court to hear a direct appeal from Judge Lamberth, but that has no chance of happening – the Court only does that in real emergencies.)
3:37

Hank Greely:
So researchers can’t be completely confident yet – but I have to say that it is looking good for their funding, at least under the current Dickey-Wicker language.
3:37

Comment From Erica Jonlin
I am also wondering if the clients of fertility clinics, who have excess embryos in storage that they WANT to donate to research, have any clout. They are also taxpayers.
3:37

Amander:
Hi Erica,
If couples have embryos left over from their fertility treatment they have a number of options. These include donating the embryo to other couples, leaving them in storage, discarding them or donating to research. Donation to research involves a lengthy consent process prior to the donation. There are a number of sites in the United States that use non federal funds to derive new embryonic stem cell lines, as new derivations still have much to teach us about the acquisition of pluripotency and self renewal. If these hESC lines are consented and approved with appropriate institutional oversight, they will have the opportunity of being registered on the NIH registry for federal funds as a cell line.
3:40

Comment From Grad Student
In your opinion, what is the most common misconception (scientifically or legally) that the talking heads debating funding for this field have?
3:40

Hank Greely:
People seem to think that funding hESCs and funding iPSCs are mutually inconsistent. We can, and should, fund both, at least now. If it turns out that one is much more promising than the other, it will be time to narrow the research focus, but right now we just don’t know which approach, if any, will work. That applies to Mohamed’s questions, too – we ARE doing research with other types of human stem cells. hESCs and iPSCs are, in some ways, the most promising because they offer the broadest hope of making the most kinds of cells, but all this research IS being pursued.
3:41

Amander:
My worry is that the argument is being framed as “adult” verses “embryonic” stem cell. This is simply not true as scientists we just want the best type of stem cell to be used for each disease or injury. In some cases this could be adult stem cells and in other cases this could be embryonic stem cells. We need to keep evaluating all types of stem cells
3:44

Comment From Marie
Amander, how did the lawsuit affect research in your lab? Did you have to put projects on hold, or change plans for certain projects?
3:45

Amander:
Hi Marie,
It was the most stressful time in my scientific career. I stopped accepting graduate students, I began the discussion with my postdocs that there may be no more funding to support their salary, we started to wrap up projects prematurely. Fortunately I have wonderful institutional support, and the UCLA Broad Stem Cell Research Center was there to provide the necessary support.
3:45

Comment From Guest
Hank, I’m a political consultant. In your opinion, to your point about changing the minds of members of Congress, roughly what percentage of opponents do you think are changeable, which kind(s) of members are they, and what points or discussion approaches seem to lead to making the most headway. Thanks.
3:45

Hank Greely:
Well, first, I don’t think Dickey-Wicker is terribly important from a scientific perspective at this point. Deriving stem cells from embryos is not that difficult or expensive; there is enough funding without federal research dollars to get that done. Federal funding would have been useful 10 to 15 years ago, but now the hard part is then figuring out how to use those derived cell lines for good medical and scientific ends – that’s where the NIH funding is needed. Under the current status of the lawsuit, that’s still allowed. So I don’t think repealing Dickey-Wicker should be a high priority. IF this case had come out differently, or if, on appeal, it gets reversed, then rewriting Dickey-Wicker to make it absolutely crystal clear that it allows federal funding for research done with cell lines otherwise derived WOULD be important. But I don’t think that will happen.
3:48

Comment From David
Can you address the tendency of both embryonic and induced pluripotent stem cells to become cystic and tumorous when used in treatments?
3:48

Amander:
There are some studies indicating that following differentiation human embryonic stem cells and induced pluripotent stem cells will still generate tumors. This is not a common occurrence, but has been observed in animal models. These tumors are most likely are due to small populations of failed to differentiate cells. Scientists are working very hard to eradicate these from differentiated cultures.
3:49

Comment From Grad Student
Do you think scientists in this field are educating the general public to understand these issues, in order to make informed decisions when it comes to voting for representatives that will be eventually determining the fate of these debates? If not, how to you think this process of informing the public should be carried out?
3:49

Hank Greely:
Some scientists are being quite active in educating the public – and not just Amander! But that’s a tough job and most scientists aren’t trained for it, aren’t very good at it, and don’t really want to spend the time away from the bench (or writing grant applications) to do it. We need to encourage more scientists, of all perspectives, to communicate to the public. Sometimes that’s through lectures, podcasts, radio appearances, internet chats, etc. – often it will be through the intermediation of science journalists. We need to make sure that scientists are encouraged to do this and get some credit at their institutions for these very real contributions.
3:53

Jocelyn Kaiser:
Question from Sara – Hello, How hESC could be therapeutic applied in real pacients? Well, let me explain better my doubt. I can understand that with iPSCs we can differentiate it into cells aimed to cure a specific disease. But with hESC how we can take advantage, if they are only available during an embryonic stage?
3:53

Amander:
Hi Sara, Embryonic stem cells and induced pluripotent stem cells are both pluripotent cell types that proliferate while still remaining undifferentiated. It is true Embryonic stem cells are made from pre implantation embryos at a very specific time in development, but will grow indefinitely in the lab.
3:54

Comment From Bryan Dychingco
Might the destruction of a single embryo be justified if it provides a cure for a countless number of patients? Since ES cells can grow indefinitely in a dish and can, in theory, still grow into a human being, is the embryo really destroyed?
3:54

Hank Greely:
It depends on your own moral positions. If you really believe that an embryo in a dish is a real person, entitled to full rights, I can see someone saying that destroying it to save others would be like killing you in order to use your heart as a transplant to save someone else. On the other hand, if you think an in vitro embryo is something less than a full person, then you could reach (as I personally have reached) a different conclusion.

As to your second point, going from an hESC to a full human is not so easy – you can’t just make that cell into a full embryo, fetus, and baby. It needs a lot of other cellular apparatus, the stuff found in eggs and zygotes, to develop. That might ultimately be possible, but, as far as I know, it isn’t now.
3:55

Comment From David
Since adult stem cells have shown so much promise and are now getting a lot of attention (Diane Sawyer’s piece on heart disease and stem cells, the generation of ‘body parts’ including hearts, urethras and most recently a trachea from autologous stem cells and Governor Perry receiving his own stem cells last week during spinal surgery) what do you see as the future of adult stem cells in medicine?
3:55

Amander:
Adult stem cells have an incredibly bright future in regenerative medicine. Embryonic stem cells or induced pluripotent stem cells will never detract from the critical role adult stem cells already play, and will continue to play in therapy.
3:57

Jocelyn Kaiser:
For Hank, What are the odds that the current Lamberth ruling will be reversed?
3:58

Hank Greely:
Well, as Niels Bohr said, it’s always hard to predict things, especially the future – and that goes double for court decisions – but I think the chances the plaintiffs will win a reversal in this case are well under 10 percent.
3:58

Comment From Jessica Dominguez.
thanks for all the insight and information!
3:59

Jocelyn Kaiser:
Yes, thanks, Amander and Hank!
3:59

Amander:
You are very welcome Jocelyn! Thank you for the opportunity.
3:59

Hank Greely:
You’re welcome! It has been fun.
4:01

Jocelyn Kaiser:
And please join us next Thursday at 3pm Eastern when we look at the Science Behind Diabetes.
4:01

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