The stem cell issue is controversial again because Italy formally approved stem cell therapy in 32 terminally ill patients, the first time a government in the developed world has embraced it. Proponents want more and argue it should be available to all terminally ill patients while scientists, who cheered when celebrities like the late Christopher Reeve and former first lady Nancy Reagan talked about the potential for stem cells to save lives, are saying we need to be more conservative in our approach.
Stem cells have been victims of their own positive public relations machine. Similar to gene therapy, where an abnormal gene is replaced by a normal one, stem cell therapy seeks to replace malignant cells with healthy ones. But to-date there have been no published studies showing stem cell therapy actually works, at least not the kind being sold to the public. Bone marrow transplants have been successful since the 1960s and that's stem cell therapy, argue proponents. It’s too risky, argue scientists. Like happened with gene therapy in the 1990s, a death attributed to an unproven treatment - even in a terminally ill patient - could set back legitimate research. The public remains confused by the difference between embryonic and human embryonic stem cells, adult stem cells and mesenchymal stem cells and induced pluripotent stem cells and the various protocols in pre-clinical studies. Such confusion is a call for action, not a signal to retreat.
Following the decree by the Italian Health Ministry allowing terminally-ill patients (including children) already using the treatment to continue, scientists in Europe released a statement that these treatments are exploiting desperate parents and are nothing more than expensive placebos. It is not that they have been shown to be dangerous, it is that the effects are unknown because the stem cell 'cocktails' used are unknown and untested. The patients are part of an unregistered clinical trial outside European licensing criteria. Elena Cattaneo from the University of Milan told Nature magazine, “It is alchemy.”
Alchemy sought to find the scientific secret of a ‘Fountain of Youth’ and also to turn base metals, like lead, into gold. Its practitioners used scientific methods and were versed in chemistry and even medicine, giving alchemy an air of legitimacy. In that sense it was a proto-science and it certainly advanced those fields. Sir Isaac Newton, famous for his Three Laws of Motion, was intrigued by the promise of alchemy and may even have taken the job running England’s national mint to further his work in it. But they didn't experiment on desperate families and the secrets of transmutation remained closed even to Newton; current stem cell therapy success may be just as elusive. Like homeopathy, it could be more like a high-priced placebo than a clinical treatment.
Still, as long as people are willing to buy a Fountain of
Youth, someone else will sell it. In the Philippines, cosmetics salons are
offering collagen stem cell therapy they claim will make skin look younger. Customers may find they purchased lead rather than gold because their ‘stem
cell therapy’ is simply transferred fat with fluid removed. There is no
evidence at all these fat stem cells can ever ‘self-renew’ just by being moved
from the abdomen to the face.
You don't have to go to the Philippines, Sears will sell you a jar of stem cell therapy goop for $95. Go USA!
Yet there is also real science being done and scientists worry it will be lumped in with cosmetic claims. Since 2008, when researchers made severely disabled mice walk again using human glial progenitor cells injected into rodent brains, the race has been on to get proof-of-concept for treatment in diseases like Parkinson's disease.
Whether to embrace and license stem cell therapy, so that stem cells can be manufactured according to scientific standards and patients can have protection, or to invoke the precautionary principle and ban it altogether is the policy struggle that will soon confront us. It could be that the real breakthroughs in stem cell therapy will happen in corporate labs rather than academic ones, but in order for that to happen stem cell therapy needs to emerge from the shadows.