Brussels, 01 Feb 2006
The intergroup on bioethics met for a symposium in the European Parliament in Brussels on 31 January, with appeals for stem cell research to be included in the Seventh Framework Programme (FP7). Experts addressing the symposium explained the current state of stem cell research and highlighted the EU funding gaps compared to research in the US.
Stem cells are the focus of ongoing research because they are undifferentiated, but may be used to develop into any other type of cell. This in theory means that stem cells could be used in treatments for a very large number of ailments.
The event began with a talk from Colin McGuckin, Professor of regenerative medicine at the University of Newcastle, and an acknowledged expert in the field of stem cell research.
Many of us are quick to associate stem cell research with the brave new world of cloning and embryonic research. This is one area of stem cell research to which the disgraced Korean researcher Hwang Woo-Suk dedicated his time. Professor McGuckin looked instead at ways in which stem cells could be harvested from cord blood.
'Cord blood is another name for placental blood, which can be easily collected during a birth. The cord blood is a good source of stem cells, and the cells harvested can be used as embryonic-like cells, which can be differentiated into a wide variety of different cell types,' said Professor McGuckin.
Professor McGuckin considers cord blood to come with little ethical baggage, as the placenta and cord blood would otherwise be incinerated. Therefore, collection of the cord blood provides an the opportunity for what is currently wasted to be used proactively. Stem cells may also be harvested relatively easily from the human body directly, from, for example, bone marrow. But this technique is invasive and therefore costly and time consuming.
Cord blood from births can be frozen and stored for stem cell research. Professor McGuckin has succeeded in expanding (increasing the numbers of) and then differentiating (guiding stem cells into specific types of cell) cord blood stem cells. Cord stem cells from a single birth could be used for both the newly born baby, and a number of other, unrelated cases. However, tissue types need to be matched, and some ethnic groups are currently under-represented in cord stem cell banks.
'We need to develop a registry to monitor where embryonic stem cells derive from, and a genetic database as we need to know how many types of stem cell are needed,' explained Professor McGuckin.
Professor Elaine Gluckman, the head of haematology and bone marrow transplantation at Saint Louis hospital in Paris, also addressed the group. 'Under FP6, there was no direct stem cell research, so we have lost five years, and this has been an impediment. At the time, stem cell research was not then taken seriously enough. Now, cord blood is easy to harvest, and can be kept almost risk-free at -70 degrees Celsius almost indefinitely,' she said.
Professor Gluckman is a world leader in stem cell transplants. She explained that the project EUROCORD was funded under FP5, and had a focus on cardiac and blood function. More than 5,000 transplants have been made since 1989, with treatments for diseases such as leukaemia, lymphoma, anaemia and heart disease. Cord blood has been found to be a very good vehicle for transplants, with most of the immune reactions adequately managed.
Professor Gluckman proposes more investment in the NETCORD public cord blood bank, which will have a high quality product and high internationally recognised standards. This will also provide a central resource for matching tissue types, and donations from minority ethnic groups could be increased easily.
Another reason for a central European cord blood bank is competition. 'The US congress has approved USD 79 million to develop a US bank in New York that will have the capacity for 150,000 units. If nothing is done, we will have to rely on US imports, which could cost USD ,000, making transplants difficult to afford. Also, ethnicity is rather different in the US compared to the EU,' said Professor Gluckman
Transplants would cost about USD 2,000 from an EU cord blood bank. Professors Gluckman and McGuckin were both wary of private cord blood banks. Private banks are more common and store a greater number of deposits in the US compared to the EU.
'We need more research into storing cord blood under FP7. Many of the stores from the early days, even in hospitals, may have been stored imperfectly and may now be useless. We need to address this,' said Professor McGuckin.
Dr Sigrid Grauman from the Institut Mensch, Ethik und Wissenschaft, Berlin, explored some of the ethical dilemmas presented by stem cell research. For embryonic stem cells, she pointed out that 'There is a conflict of interest. Many eggs for developing embryos come from procreative therapies, as the surplus embryos are used in research.'
In the UK and South Korea, there has been the problem of obtaining a good number of fresh eggs. The danger is that some women are given more hormones to generate more eggs so that the surplus could be used for research. In the UK it is not legal to donate just for research, so surplus eggs produced during fertility treatment are is used. In South Korea there is some speculation as to where eggs have come from. The South Korean press states that 75 women were paid USD 1,500 per donation, and others were coerced into donating with promises of publication in Nature.
'Harvesting eggs is also complex and invasive. Hormone injections make the body produce more eggs, which are extracted using an ultrasound-guided needle. Infertility could be a consequence. The hormones themselves are also considered to be carcinogenic. Hyperstimulation by hormone injection can also prove to be fatal in some 0.3-0.6 per cent of cases. Social or economic coercion must be eliminated, and only surplus cell use is justified, as in the UK. Scarcity of eggs could give rise to 'research tourism',' says Dr Grauman.
Professor McGuckin agrees: 'Stem cell tourism is already a problem. In the Ukraine and Holland, I have personally been involved with cases of desperate families from the UK who have gone to centres where they were kept in for less than a day with unproven techniques for treatment of Multiple Sclerosis and strokes. We found no evidence of any effective treatment at all. We need to find a way to bar people from going abroad - false hope is bad hope.'
Business has steered clear of stem cell research. 'At an industrial level, stem cell research is not yet 'proven', which is why pharmaceutical companies have been reluctant to contribute. There is still no good understanding of the limitations of stem cell research,' said Professor McGuckin.
All three contributors were wary of issuing patents for stem cells. 'It seems difficult to patent cells - cell therapies or possibly some of the underlying cell processes, but a cell is simply too complex,' said Professor McGuckin.