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Stem cell politics shifting

For President Bush and other opponents of human embryonic stem cell research, this week's news that ordinary cells that can be reprogrammed to act like the most versatile stem cells couldn't have come at a better time. And although the news is also welcome to the proponents of embryonic research, who include some Republicans as well as lots of Democrats, they're suddenly facing a more complicated political challenge.

The shift in the political landscape is evident in the statements issued soon after Tuesday's announcement about the cell reprogramming technique. Take this statement from Sen. Sam Brownback, R-Kan., an erstwhile presidential candidate who is among the most vocal opponents of embryonic stem cell research:

"This exciting breakthrough means that we can conduct embryonic-type stem cell research without destroying human life, and I call on supporters of embryonic stem cell research to recognize that we have no realistic need to destroy embryos. I congratulate the research teams led by Shinya Yamanaka of Kyoto University and James Thomson of the University of Wisconsin for pioneering a route away from questionable science that is destructive to human life."

Sen. Tom Coburn, an Oklahoma Republican who's also a physician, issued a statement in a similar vein:

"This breakthrough provides further evidence that the most promising avenues of stem cell research are also the most ethical. Politicians should note that the scientific community is moving rapidly without the assistance of laws requiring the taxpayer-funded destruction of human life."

Both statements have a strong "we told you so" quality to them. They downplay the fact that the newly reported research couldn't have been done without embryonic stem cells, that further research with embryonic stem cells will be required to move the work forward, and that both of the scientists congratulated so warmly by Brownback insist embryonic research is essential for developing future therapies.

Thomson and most other researchers hope that they'll eventually be able to distill the secret of embryonic stem cells - that is, their ability to become virtually every kind of tissue in the body - without actually using the embryonic cells themselves. This week's revelations represent a major step toward that goal. But there are still years of work ahead before scientists can reach that point.

Defensiveness from defenders of research

On the other side of the issue, the proponents of embryonic research delivered their own congratulations - with a bit of defensiveness as well. A case in point is the statement from Rep. Diana DeGette, D-Colo., a principal sponsor of vetoed legislation that would have loosened restrictions on federal funding for embryonic stem cell studies:

"While today’s scientific breakthroughs are exciting, this research is still in its early stages. It is not a substitute for embryonic stem cell research, which is the most promising research to date. The broad, bipartisan majority of Congress that supports embryonic stem cell research remains committed to supporting all forms of ethical stem cell research.

"These scientific breakthroughs also highlight the need for the creation of a strict ethical framework – including firm guidelines and strong oversight by the National Institutes of Health. Politicians should not be cherry-picking the preferred method of stem cell research; the soundness of the science should be dictating the form of research under strict ethical guidelines."

Sen. Tom Harkin, an Iowa Democrat who chairs the appropriations subcommittee that deals with health spending, had this to say:

"These scientists have performed truly groundbreaking and historic accomplishments. Still, our top researchers recognize that this new development does not mean that we should discontinue studying embryonic stem cells – as Dr. Thomson has said – scientists may yet find that embryonic stem cells are more powerful. We need to continue to pursue all alternatives as we search for treatments for diabetes, Parkinson's, and spinal cord injuries."

DeGette, Harkin and their colleagues have been hopeful that the hunger for cures will drive up the support for wider embryonic stem cell funding - generating support for Democrats in the process. But the new strains of genetically modified cells promise to provide an alternate route to the same cures, without the moral and ethical baggage. So although embryo-based research is still necessary for further progress on the technology, there's no question that the stem cell spotlight is shifting.

Good news for the president

That's good news for President Bush, who has taken a lot of heat for his serial vetoes of DeGette's bill. The White House said Bush was "very pleased" by this week's developments.

"By avoiding techniques that destroy life, while vigorously supporting alternative approaches, President Bush is encouraging scientific advancement within ethical boundaries," the White House statement said.

"We should all give credit to President Bush for challenging our nation to find a solution," said William Hurlbut, a physician and consulting professor at Stanford University Medical Center who serves on Bush's bioethics panel.

Sen. Coburn took a similar tack, saying that the new research "helps vindicate President Bush's policy and his vetoes of Congress' short-sighted and outdated approach to stem cell research."

It's also good news for GOP presidential candidate Mitt Romney, who is currently on the conservative end of the spectrum when it comes to stem cell research. Hurlbut noted that Romney consulted with him three years ago on stem cell policy. "He's the one guy on this issue who was ahead of the curve all the way," Hurlbut told me.

Worrisome for stem cell pioneer

Suddenly, it's the embryonic stem cell proponents who are being cast as the scientifically backward fuddy-duddies. And that's extremely worrisome to Robert Lanza, chief scientific officer for Advanced Cell Technology. Lanza has been working with human embryonic stem cells for years.

"We have cells right now, human cells, that could prevent heart attacks or repair the damage, or restore the flow of blood to limbs that might otherwise be amputated," he told me.

He can't promise exactly when those cells will be turned into approved therapies - but the first human clinical trials involving embryonic stem cells could come as early as next year.

Lanza has even bigger ideas for an embryonic cell bank that would do for tissue regeneration what blood banks have done for transfusions.

"One hundred tissue types will give you a complete match for 50 percent of the population," he said. "We could literally in a few months, using somatic cell nuclear transfer [also known as therapeutic cloning], create these embryonic stem cell lines. ... I'd really hate to see all this get wiped out like a tidal wave."

Lanza is the first to acknowledge that the newly published research holds great promise in the long term. He's the guy who has been comparing the research to the Wright brothers' first airplane flights or the alchemists' dream of turning lead into gold.

But he's also wary about shifting the focus to an unproven approach that won't be available to patients until years from now. After all, human embryonic stem cells were first isolated nine years ago, and researchers are just now at the point where they are beginning to test potential therapies. 

"We've been fooled many times before," he said. "A delay of 10 years would mean writing off half a generation. ... Just a few years makes an incredible difference."

At this point, it's hard to predict exactly when the first treatments will be available to the public, using either embryonic stem cells or these newly developed pluripotent cells. But Lanza's larger point is this: If embryo-based research is somehow stopped in its tracks - as some would like to do - diseases that could soon be treatable using embryonic stem cells would have to wait until pluripotent cell therapies go through their entire development cycle. And patients who already have been waiting for years would be in for an even longer wait. 

Pluripotent perspectives

Is it more ethical to hold back on the use of embryonic stem cells, even though that might slow the progress toward future cures? Or is it more ethical to move forward with embryo-based research as well as the alternatives, in the hope of accelerating that progress? Although the political landscape has shifted, the fundamental dividing line is still pretty much where it's always been.

For additional perspectives on the politicization of pluripotent cells, check out this Associated Press report from our politics section, this analysis from The New York Times, and this one from The Washington Post, as well as these e-mails:

Jim Hassinger: "I'm all for not using embryonic stem cells, if this or another method works. But that can only be established by decades of research. Is  there something unique about embryonic cells? Are they by nature more potent? Or is there some trapdoor about using this or other methods? I think science writers should make it a little more clear that 'may' is not 'does.'"

Margie Taulbee, Tennessee: "This would be a wonder. I would gladly donate my skin to regrow my husband's depleted heart cells. It is hard to find the help he needs because we live in a state that does not support (very little) stem cell usage. Vanderbilt Medical does do research for children who have cancer. I do understand not taking baby embryos, but adult cell to adult cell is a breakthrough for many diseases."

Cathy Titchenal, Klickitat, Wash.: "It seems to me that I wrote to you once before about a year or two back about this chimera and embryonic stem cell experimentation stuff, and the possibility/probability that mankind could really cause their own extinction with experimentation along these lines, not to mention the ethical/moral dilemmas involved with embryonic stem cell research, chimera creation, IVF techniques, etc.

"So this news today, hopefully true and workable for medical treatments and cures for diseases and injuries, is indeed a welcome respite.  I am one of those who thinks that men should not really be playing God with human biology and when the choices involve sacrificing one human life (no matter how young) to serve another's desires, needs or whatever, that we should all take a step back and consider the consequences to all the human lives involved and stick to the Hippocratic oath of 'first do no harm.'

"God, in His infinite wisdom, has again opened a door to our salvation and redemption from going down the wrong path.  You have to really appreciate the way He keeps prodding us in the right direction, not always the easy way, but always the right way.  Apparently, some scientists have been doing their own moral battles along these lines and have made a breakthrough that will allow us to preserve our best ethical values and still solve the problems that need solving. ..."

Dan Spano, Kent, Ohio: "Your article on stem cell research is very promising. It would be great to silence the critics on the ethical side of stem cells and embryonic cells.

"My problem is one sentence that I seem to read over and over. It is: 'In their current state, the recipes are too risky for disease treatment, and even the scientists behind the latest studies cautioned that therapies are still years away.' Some people, like me for instance, don't have years. I'm 51 years old and have been a spinal cord injury patient since I was 24. How many more years is this going to take?

"The FDA is very quick about approving drugs like Celebrex and Vioxx and even Viagra, but when it comes to something that could save lives or turn lives around they take forever. It might as well be forever for me, because I'm not going to live to be 70 years old or however long it will take the scientists to even start clinical trials on patients, or even primates for that matter."

Glenn: "If they're looking for a volunteer for something...I suffer from Ehlers-Danlos Syndrome (with complications), and the pain will eventually kill me. ('Pain isn't fatal.' I know. There are variations on the recipe.) The only solution to the problem looks to be injecting something that will grow into cartilage between vertebrae ... and what the 'something' has to be looks to be fairly obvious.

John: "Non-embryonic stem cells are the only type that has actually been used in real applications. Your article is good news – that non-embryonic cells from skin are very useful for this, but is it really news that embryonic stem cells are even useful at this point, not to mention they come from a person who had no choice in the matter of his or her death?

"This is not even a religious opinion. It is a product of honest observation of man and his abilities – in a different category from other animals. Man writes books and articles in accord with his nature – a human nature, not just the law of nature found in irrational things. Our culture is now worshiping before an empirical science that can’t even understand the true cause of even the most rudimentary laws of nature – like gravity. Is that where our limited reason has led us?"

Feel free to add your own pluripotent perspective as a comment below.