Why hEsc goes in the wrong direction

Earlier this week, Barack Obama ended the restrictions on federal funding for embryonic stem-cell research, and then oddly reversed himself by signing the omnibus spending bill two days later.  The reversal, which did not get much play, essentially passed the buck to Congress to ban federal spending on destructive hEsc research (via Jill Stanek):

The law banning any federal funding of research that kills or risks injury to embryos was included in the language of the $410-billion omnibus appropriation bill that President Obama signed Wednesday. Known as the Dickey-Wicker amendment, the language has been included in the annual appropriations bill for the Department of Health and Human Services every fiscal year since 1996.

Found in Section 509 of the omnibus bill, the federal funding ban not only prohibits the government from providing tax dollars to research that kills or risks injury to a human embryo, it also provides a comprehensive definition of “human embryo” that includes embryos created in a laboratory through cloning, in vitro fertilization and other means.

“For the purposes of this section,” says the law Obama signed, “the term ‘human embryo or embryos’ includes any organism … that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes or human diploid cells.”

As CNS News reports, this essentially maintains the status quo, at least for the remainder of the fiscal year.  It also moves the battle from the media spotlight, shifting it from a high-profile position as an executive order to the more arcane and less-rigorously reported legislative infighting over the budget.  In essence, it’s the equivalent of voting “present” from the Oval Office, creating a momentary flashpoint with social conservatives as a trade-off for avoiding the problem altogether in the future.  Obama will never have to revisit the issue again, if he’s lucky.

When Obama signed his EO, he and hEsc supporters called it a triumph of science over politics.  Let me explain why, based on personal experience, I think it’s the exact opposite.

The promise of stem-cell research lies in the ability of pluripotential cells to generate new human tissue to cure diseases.  Joe Trippi, for one, hailed Obama’s EO as a triumph for diabetics (Trippi is one) looking for a cure, which would involve growing new pancreatic tissue to replace that which has failed.  As with Parkinson’s and a host of other diseases, the creation of replacement tissue holds great promise.

We can do that now, of course, but we call it something else: transplants.  We can take numerous kinds of human tissue and transplant them from one human to another — kidneys, livers, hearts, lungs, pancreases, and now even faces.  We face two obstacles to making this a massively available technology, though; inventory of replacement materials and the need to suppress the immune system to allow the transplants to succeed.

Both hEsc and adult stem-cell technology address the first issue of inventory.  If we can grow human tissue in directed paths, we will no longer need live or cadaver donors to help save lives.  With waiting lists stretching now for years for cadaver transplants, developing stem-cell solutions makes the most sense to replace existing cures as well as developing new therapies for other diseases.

However, only adult stem-cell therapies address the second problem.  The body’s immune system can detect foreign tissue and attacks it.  Without immunosuppressive therapy, most transplants (excepting, I believe, corneal transplants) would fail and the patient will die.  However, as I know from personal experience with my wife, who has had both kidney and pancreas transplants, immunosuppressive therapy has serious consequences for patients.  It is, in effect, trading a life-threatening illness for a manageable illness.  The drugs used to suppress the immune system have a multitude of side effects, such as with the commonly-used cyclosporine:

Headache, nausea, vomiting, diarrhea, stomach upset, acne, cramps, increased hair growth on the face/body, shaking fingers/hands (tremor), swollen/red/painful gums, dizziness, flushing, and high blood pressure may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Tell your doctor immediately if any of these unlikely but serious side effects occur: severe muscle spasms, fast/irregular heartbeat, muscle weakness, confusion, change in the amount/color of urine, unusual weight gain/loss, tingling of the hands/feet, hearing problems, easy bruising/bleeding, unusual tiredness.

Tell your doctor immediately if any of these rare but very serious side effects occur: dark urine, persistent nausea/vomiting, severe stomach/abdominal pain, yellowing of the skin/eyes, vomit that looks like coffee grounds, change in the appearance or size of skin moles/lesions, changes in skin color, loss of consciousness, mental/mood changes, vision changes, swollen glands, unusual lumps, night sweats.

Most immunosuppressive regimens use more than one drug.  The First Mate takes three: a form of cyclosporine, Myfortic, and Pentamadine.  As a result, she deals with a wide range of side effects, notably high blood pressure and anemia problems, that require more medication, which creates even more side effects.  It’s a chain reaction that requires constant monitoring and adjustment, and which have turned me into a pharmacology major at my own university.

Don’t get me wrong; we’re very grateful for these medications.  They are, however, difficult to manage, and also extremely expensive. And it seems to me that, if we’re truly thinking about science, then we should pursue the solutions for tissue replacement that don’t require patients to trade one illness for another, but which hold the promise of actual and complete cures.  That will only come from duplicating patient-specific tissues from their own cellular structure, not the creation of foreign tissue for transplant.

Given the successes the scientific community has made in generating pluripotential adult stem cells and the derivation of actual successful therapies from adult stem-cell research, that would make the most sense while avoiding the ethical problems of killing human life for therapies that have never succeeded, despite years of trial and billions of dollars in funding.  Now that we can derive pluripotential stem cells from adults, their seems to be no reason to go any other direction, and for any other applications, umbilical and placental stem cells should be sufficient.  That is why it appears to me that throwing federal funding at hEsc despite its failures and inherently limited application of tissue replacement has a lot more to do with justifying abortion than it does with actual scientific progress, at least from my admittedly personal experiences.