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RAISMAN/ The best results are coming from the adult stem cell research programmes

In many countries - and certainly in the media - stem cell research seems to be concentrated on embryonic stem cells as the way to treat many genetic disease that are currently not curable


In many countries, and certainly in the media, stem cell research seems to be concentrated on embryonic stem cells as the way to treat many genetic diseases that are currently incurable. This approach risks to overshadow research on adult stem cells which has been demonstrated to be more effective and closer to yielding results. Professor Geoffrey Raisman is the director of the Spinal Repair Unit at the University College London Institute of Neurology. He leads a research team whose work could ultimately lead to the repair of spinal cord injuries in humans and he is working with adult stem cells. Ilsussidiario.net has asked Professor Raisman to take stock of the situation.

Professor Raisman, stem cells and particularly embryonic stem cells are at the centre of media attention. But, from a scientific point of view, what is the real state of the art in the research on stem cells?

Embryonic stem cells have the property to divide indefinitely and turn into any tissue in the body. From the point of view of transplanting embryonic stem cells these are not entirely an advantage. Uncontrolled division would lead to an invasive tissue not properly integrated into the body. What is required for repair are cells already differentiated into the tissue type requiring repair. Embryonic stem cells used as donor issue would be foreign to the host and therefore under immune attack.

You recently said that adult stem cells are much more promising therapeutically. Could you broaden this statement?

Transplants of adult stem cells are matched in state of maturity to the recipient, they are already committed to making the tissue required, and they are not immunologically incompatible.

As reported in the discussion in the House of Lords, you made a hard comparison between the scramble to fund human embryonic stem cell experiments and the sub-prime mortgage affair. What did you really mean by this?

The public see stem cells as a repair for incurable conditions. For the reasons given above, this is an unrealistic expectation within any conceivable time course. Government funding agencies seem to be simply responding partly to this public expectation, and even more to industry who see embryonic stem cells in a bottle as an inexhaustible source of wealth. Therefore, despite the disadvantages and distance in time for the use of embryonic stem cells, and the advantages of adult stem cells, the technology for using transplants of adult stem cells is not regarded as similarly fund worthy.

Do you see some possible change in the UK in the future in this regard?

I have no crystal ball to see into the minds of those who govern funding. In this area I am a victim, not a perpetrator. But maybe they should recall that cell transplantation derived from adult stem cells is the most successful treatment we have; it has been applied throughout the world for over half a century. It is called blood transfusion. Adult skin transplants (autografts within the same patient) work because they are derived from adult stem cells committed to become skin, they integrate well into the host area, their division is clearly controlled, and they present no immune problems.

What is your opinion on induced pluripotent stem cells? Does their use still add some risk of collateral effects?

They are not suitable for transplantation. They provide an excellent system for studying disease processes, especially genetic diseases, in tissue culture.

At the University College London you are also involved in a very important research on the autotransplantation of adult olfactory cells to repair spinal cord injury. Could you say something more about your research?

Animal models indicate that transplants of adult olfactory ensheathing cells can restore very important functions (we have studied hand control and breathing) in rat spinal cord and spinal root injuries. So encouraging are these results, that while we are able we will not desist from trying to find the knowledge needed to transfer these benefits to patients currently without cures. We are investigating how to obtain these cells from adult human tissues, and whether OECs from the lining of the nose can be made as effective as those obtained from within the skull.

If we can solve these problems, we plan to carry out the first transplants, based on the patient’s own cells, in injuries where the arm nerves are torn out of the spinal cord. Success will open the door to the development of technology needed for the future treatment of spinal cord injury, stroke, blindness and deafness. The goal of research is knowledge. Knowledge provides hope.

A final question. In the debate on embryonic stem cells ethic issues are involved, because the inevitable destruction of the embryo is for many the destruction of a human life. What is your view on this question?

There is no logical answer to what is human life. The majority of fertilised eggs do not survive in normal conception. Nature, driven by evolution, wields it own axe. Fertilised eggs used for in vitro fertilisation are discarded. At what point a living egg capable of becoming a human being acquires the properties of human life cannot be answered scientifically, nor is there any time point in its journey to an individual which can give an absolute answer. All lies in balance, the judgement of moderation.

The facility with which the human race talks about the Fifth Commandment, is totally overwhelmed by our much greater facility in disobeying it. By some strange mental logic we refer to the production of the guns and bombs and all the paraphernalia of mass destruction as defence while all around us this equipment, sold for huge profits, is deployed to the full of a lethal capacity which is for ever increased the development of even more destructive technology. This applies to all societies, times, religions and governments. And the number of those who die of preventable diseases and hunger far exceed the huge numbers we kill. One fraction of the cost of one of the smart bombs rained on Baghdad would accelerate the discovery of a cure for spinal injury.

That we cannot have a perfect world, does not mean we are free from the moral obligation to choose the best world we can. And this decision lies not in correct rules or teachings, but it is for each man to ask himself what kind of world he wants to live in, and what part he can play in achieving it.

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