Thursday, July 5, 2007

Embryonic Stem Cells and Brain Disease

Many clinicians are deeply skeptical that embryonic stem cells are any better than adult stem cells in treatment for brain conditions, such as Alzheimers, Parkinsons, Huntingtons, amyotrophic lateral sclerosis, stroke, or traumatic brain injury. Some clinicians worry that embryonic stem cells (ESCs) create a risk of tumor in the transplant recipient. Yet we simply don’t know the potential of human ESCs for treatment of brain disease.

Use of Federal dollars for research on human ESCs was sharply restricted in 2001. At that time, President Bush mollified his conservative allies by approving research on 64 human embryonic stem cell lines, maintaining that research was permissible on these cell lines since they were already in culture. Yet this argument fails to resolve the question of whether or not ESC research is morally permissible. There is a degree of duplicity in simply ignoring the source of those human ESCs that are already in culture, because some of these cell lines may have been morally tainted.

It is now clear that most of the human ESCs that Bush has approved for research are contaminated or otherwise unsuitable. Scientists are currently limited to using no more than two dozen cell lines for all research funded by Federal dollars. Research continues with private donations, using unapproved human ESCs that have been, for the most part, created abroad. Research on such stem cell lines is extraordinarily expensive, because scientists who do the research cannot use any research equipment that was purchased with Federal dollars. The reasoning behind this rule is arcane, but it makes research, which is already quite expensive, even more so, since costly pieces of equipment are often purchased in duplicate. The general difficulty of obtaining Federal money for research on human ESCs seems to have slowed the pace of stem cell research overall.

President Bush’s attitude to human ESCs seems to be indicative of a general hostility to medical research in the current Administration. In April, 2006, the New England Journal of Medicine reported that the budget for the National Institutes of Health had suffered the first budget reduction since 1970. This may be the most damaging downturn in funding that medical scientists have ever faced, as medical schools years ago have staked their financial health on the continued availability of Federal research money. Now that money is drying up. Until perhaps 20 years ago, the clinical income generated at a medical school was sufficient to subsidize medical research, but managed care and an emphasis on clinical efficiency has made profit margins far too narrow to support the research mission now. Whereas national defense spending stands at roughly $1,600 per person in the United States, funding for biomedical research is just $97 per capita. This is a paltry investment in the health and well-being of the American people.

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