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Two Steps Forward: Keeping the Momentum in Stem Cell Research
http://www.100md.com 《干细胞学杂志》
     1 Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland

    2 Professor, Oncology and Pediatrics, Co-Director, Division of Immunology and Hematopoiesis, Herman and Walter Samuelson Professor of Cancer Research, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland

    Politics and science have always been bedfellows, and they are becoming increasingly intertwined as knowledge and research capabilities expand. This trend comes to the forefront in a recent editorial in the New England Journal of Medicine that highlights two recent, important steps forward in stem cell research: first, the derivation of human embryonic stem (ES) cells from a cloned blastocyst in South Korea and second, the derivation of 17 new human ES cell lines that are well characterized and potentially easier to maintain in tissue culture than already existing cell lines . It has been proposed that these new cell lines be added to the National Institutes of Health Human Embryonic Stem Cell Registry; otherwise, given current federal regulations, these cell lines will not be available to most U.S. researchers using federal funding, and the potential research and therapeutic benefits of this advance may never be fully realized.

    Research with human ES cell lines offers great promise in allowing us to better understand human disease. In addition, human ES cells may also offer direct cell replacement therapies for future patients. Admittedly, it will be a long journey before we are able to translate enhanced disease understanding into better diagnosis, treatment, and prevention. The new ES cell lines made by Melton’s team at Harvard may offer significant technical advantages for the research journey—they have the ability to grow in the presence of antibiotics, which will allow for easier handling in certain experiments, and some of the cell lines grow more rapidly than the ES cell lines available now .

    Understandably, the use of ES cells opens the door to a barrage of ethical questions, which make policymakers’ decisions difficult. The continuing challenge is to strike the right balance between appropriate ethical regulation and needed medical progress. Keeping patients in mind, we must find a way to maintain, and ultimately enhance, the momentum that these recent breakthroughs has spurred. A major strength of federal advisory committees is that they have a diverse group of members with different viewpoints. This is why the recent replacement of two outspoken members of the President’s Council on Bioethics who supported research on human stem cells is worrisome. It appears that new appointments are resulting in federal advisory committees whose members may not adequately represent the diversity of expert opinions. Similar changes in other committees have stirred significant controversy in the scientific community . The very nature of "balanced advice" suggests that a requisite of the memberships of these committees should be diverse opinions and perspectives. Experience has taught us that it is important to hear all perspectives. Failure to do so limits a committee’s ability to question all the issues and to generate creative solutions. Ensuring these capabilities is essential to guide appropriate ethical regulation in stem cell research.

    It is unclear at this time what effects these changes in this bioethics committee will have on stem cell research. Although the future looks bright in terms of the therapeutic possibilities, the experience of a dismissed member indicates the pace of this progress remains uncertain . Perhaps it is important to remember that this kind of struggle is not a new phenomenon. Historically, major barriers have had to be removed to realize the full value of a novel idea or approach. Forging new frontiers always requires great effort. From Darwin’s theory of evolution to recombinant DNA research, novel scientific concepts and discoveries have been wrought with ethical complexities, and it took considerable time for these two concepts to become widely accepted by both the scientific and lay communities. The progress made on the science front is inspiring and hopefully will strengthen the resolve of the biomedical research community and others to support efforts to broaden federal guidelines and funding. An encouraging fact is that a recent survey by the Civil Society Institute found that two out of three voters in 18 key states support overriding the Bush administration’s limits on federal government funding for stem cell research . We believe that the U.S. must safely and responsibly foster all promising forms of stem cell research, and that the U.S. federal government should be instrumental in this endeavor.

    REFERENCES

    Phimister EG, Drazen JM. Two Fillips for human embryonic stem cells. N Engl J Med 2004:350;1351–1352.

    Gearhart J. New human embryonic stem-cell lines—more is better. N Engl J Med 2004:350;13:1275–1276.

    Steinbrook R. Science, politics and Federal Advisory Committees. N Engl J Med 2004;350:1454–1460.

    Blackburn E. Bioethics and the political distortion of biomedical science. N Engl J Med 2004;350;14:1379–1380.

    Civil Society Institute. Survey: Expanded stem cell research backed by strong majority of voters in 18 states. Available at: http://www.resultsforamerica.org/calendar/files/stemcellsurvey.pdf. Accessed April 26, 2004.(Jamie Palaganas1, Curt I.)