When Stem Cell Research Gets Personal (Part 2)

Interview With Bioethicist on Umbilical Cord Cell Banking


By Kathleen Naab

PHILADELPHIA, Pennsylvania, JUNE 9, 2009 (Zenit.org).- The debate about stem cell research is under way in legislatures around the world, but there is an element to the research that is debated within the home.

This intimate level of the discussion happens every time a pregnant couple faces the possibility of storing their newborn's umbilical cord blood (or rather, the stem cells it contains) in hopes of future treatment or cures, should they be necessary.

ZENIT spoke with Father Alfred Cioffi about stem cell research and the particular promise offered by these powerful cells found in umbilical cord blood.

Father Cioffi, a priest of the Archdiocese of Miami, is a research ethicist for the National Catholic Bioethics Center. He has done extensive study and work in bioethics and research, focusing his first doctoral thesis from Rome's Pontifical Gregorian University on "The Fetus as Medical Patient: Moral Dilemmas in Prenatal Diagnosis." He earned a second doctorate in genetics from Purdue University, with a thesis on "The VWG Hypothesis: Predicting Distinct Chromatin Structures from the DNA Sequence."

Part 1 of this interview, detailing the basics of stem cell research, was published Monday.

ZENIT: Going to a more particular question, what is the difference between adult stem cells and stem cells taken from umbilical cord blood?

Father Cioffi: Regarding umbilical cord stem cells, bioethically, they represent a special category. It turns out that the blood inside the umbilical cord also contains stem cells. Since the umbilical cord comes from the human embryo (or fetus), then these are embryonic stem cells. The umbilical cord is normally discarded once the baby is born, but these embryonic stem cells can be extracted from that cord blood without having to do the least damage to the baby. In a sense, this is the best of both worlds because, on the one hand, umbilical cord stem cells have the plasticity and high-quality healing capacity of embryonic stem cells and, on the other, the baby certainly doesn’t have to be killed in order to obtain them.

ZENIT: So then let's turn to another side of this issue: parents considering storing their newborn's stem cells. Some -- perhaps most -- pregnancy books, obstetricians and pediatricians are cautious about recommending umbilical cord banking and even somewhat discouraging. Would you say this is a justified attitude? Does it reflect a lack of information? Or perhaps the effects of an anti-life ideology?

Father Cioffi: The downside of umbilical cord stem cells is mostly financial. It is relatively expensive to extract them -- I've heard for the United States, perhaps about $1,000 -- and then there's a monthly fee -- of about $100 -- to store them. How long would they be stored? Essentially, for life, or until the newborn has an injury or disease sometime in his lifetime. And, hopefully, that injury or disease could be healed with the saved umbilical cord stem cells.

ZENIT: So what would you recommend for pregnant couples? Is umbilical cord banking worth the price tag?

Father Cioffi: You have to consider several factors: How much is it likely to cost; up front and in the long run? What cures could be expected realistically, and in what time frame? Since cord blood stem cell research is an industry that is just now beginning, perhaps for now the couples who would benefit the most from storing cord blood stem cells are the ones who have another child who was either born with some illness or acquired some illness or injury that could be cured with the stem cells of the sibling, since coming from the same parents the tissue match would likely be a good one.

In the long run, umbilical cord stem cells offer tremendous potential, so my bottom-line recommendation for couples considering their storage when giving birth is this: If the couple can afford it (perhaps even with some help from family and friends -- “baby-shower donations accepted!”), then they should do it. Why? Because, in addition to obvious advantages to their baby, siblings and close relatives, this would also further this fledging industry that is indeed very pro-life, and needs all the help it can get in getting started.

If the couple cannot afford it, they could consider putting some “friendly pressure” on their health insurance company to cover, at least, some of the cost. I think that it is important to get health insurance companies to understand that their investment in umbilical cord blood stem cell storage is to their financial advantage in the long run. Why? Because, as more and more cures come about in this field, on average, more and more of their clients would benefit from them -- say, for instance, an injured teenager whose cord cells were saved, and who will now heal better and faster because of them, thus reducing his hospital stay and treatment sessions, thus reducing health care insurance costs.

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On the Net:

National Catholic Bioethics Center: www.ncbcenter.org

Stem Cell Research: www.stemcellresearch.org

Part 1 of this interview: www.zenit.org/article-26117?l=english

When Stem Cell Research Gets Personal (Part 1)

Interview With Bioethicist on Umbilical Cord Cell Banking


By Kathleen Naab

PHILADELPHIA, Pennsylvania, JUNE 8, 2009 (Zenit.org).- The debate surrounding embryonic stem cell research is portrayed as an exercise in discerning politics from science.

But there are undoubtedly some personal issues involved. The stem cell debate gets personal when citizens' tax dollars are used to fund the research, regardless of if the citizens are in agreement.

As the U.S. government follows President Barack Obama's March 9 executive order to direct U.S. tax dollars to the funding of embryonic stem cell research, ZENIT spoke with Father Alfred Cioffi about stem cell research and the particular promise offered by these powerful cells found in umbilical cord blood.

Father Cioffi, a priest of the Archdiocese of Miami, is a research ethicist for the National Catholic Bioethics Center. He has done extensive study and work in bioethics and research, focusing his first doctoral thesis from Rome's Pontifical Gregorian University on "The Fetus as Medical Patient: Moral Dilemmas in Prenatal Diagnosis." He earned a second doctorate in genetics from Purdue University, with a thesis on "The VWG Hypothesis: Predicting Distinct Chromatin Structures from the DNA Sequence."

ZENIT: There is still a lot of public confusion about stem cell research and what it's all about -- oftentimes confusion amplified by false or misleading press reports. Could you explain the basics of the research?

Father Cioffi: The cell is the basic unit of life on this planet earth. All living creatures are made up of cells. Our bodies are made up of trillions of cells: bone cells, skin cells, liver cells, brain cells, etc,. Stem cells are cells deep within our body that produce other cells; stem cells make other cells. So, when we are either developing, or when there is an injury or disease, stem cells are active making new cells -- either to form an organ or tissue, or to repair a damaged organ or tissue.

Stem cell research uses stem cells in the lab to try to heal injured organs and tissues of the human body. It does this by seeking to turn human stem cells into cell lines. Our bodies are made up of approximately 220 cell lines: bone cells, muscle cells, brain cells, liver cells, etc,.

According to their origin, there are two types of stem cells: embryonic stem cells and adult stem cells. Embryonic stem cells come from embryos; adult stem cells come from "adults," that is, from people who are already born -- so, even babies have "adult" stem cells, because they are already born. So far, the only stem cells that have given results are the adult stem cells, and there's a fairly simple explanation for this.

Embryonic stem cells actually have too much potential; why? Because all of the organs and tissues of the embryo come from embryonic stem cells -- the whole embryo is formed from embryonic stem cells. So, when embryonic stem cells are transplanted into an injured organ or tissue, they actually grow uncontrollably, too fast, too much. The end result is a tumor: cancer. Why? Because, essentially, the whole little embryo wants to grow there, where the embryonic stem cells have been placed.

To obtain embryonic stem cells, the embryo has to be killed, destroyed. That is why the Catholic Church, and many people of conscience, are opposed to embryonic stem cell research.

In contrast, adult stem cells, coming from the various organs and tissues of our bodies, are more tame, and do not grow as fast or as much. Why? Essentially, because all that is needed to heal, say, a skin cut, is for the adult skin stem cells to grow just enough skin to replace the damaged area. In other words: Adult stem cells are already pre-programmed to replace the various organs and tissues of our body, each according to its type.

No one has to be killed to obtain adult stem cells. In fact, an added advantage is that they can be obtained from the same patient, thus avoiding the problem of immune rejection of the embryonic stem cells. That is why the Catholic Church actually encourages adult stem cell research.

ZENIT: So when U.S. President Barack Obama spoke of the triumph of science a few weeks ago with his reversal of the Bush ban for federal funding on stem cell research, he missed the mark?

Father Cioffi: He missed the mark indeed. Sadly, that decision was entirely driven by an ideology that puts a particular agenda in front of whatever scientific evidence there is. The reader can go to www.stemcellresearch.org, and see for himself the dozens of cures that have already been obtained with adult stem cells, and the zero cures with embryonic -- all documented with research articles in scientific journals.

ZENIT: So why is there interest in embryonic stem cells?

Father Cioffi: Three main reasons, I believe: finances, theoretical biology, and ideology.

Finances: Sadly, because of the money involved. It's all about the patents. It turns out that, since there have been so many successes in adult stem cell research, practically all of the patents are already taken up by biotechs and pharmaceuticals. However, due to the lack of results with embryonic stem cells, the slightest success in a particular biochemical pathway breakthrough is patentable, and the patent field here is wide open. Certainly, this is highly speculative research (using embryonic stem cells), which is what tends to give better returns when there is the tiniest hint of possible success. At a time when the economy is struggling, these speculative investments are a big temptation to provide the “quick fix” that everyone is desiring, so promises sell big during these times. To witness: In 2004, pro-embryonic stem cell ideologues convinced the people of California to devote $3 billion of their state taxes to this research, sold as the “cure-all” for the state’s financial bankruptcy.

Theoretical biology: Theoretically, embryonic stem cells should be able to regenerate and replace all of the 220 cell lines that make up the tissues and organs of our body. Why? Because they come from the Inner Cell Mass of the very early human embryo (the blastocyst: about one to two weeks old), and the entire embryo develops from the Inner Cell Mass. In practice, however, as I explained above, these cells have too much potential, and end up growing uncontrollably, causing tumors. Therefore, some scientists are saying: “Give us enough time and money, and we’ll tame these ‘wild’ embryonic stem cells to grow into the various cell lines needed.” And that’s precisely what we, as pro-life people, don’t want scientists to do, because using more time and more money means destroying many more human embryos in the process. And, of course, if they are successful eventually, that would only stimulate even more scientists to destroy more human embryos for their coveted stem cells.

Ideology: Embryonic stem cell research has nothing to do with the legalization of abortion, and has everything to do with the legalization of abortion. It has nothing to do with the legalization of abortion because there is no pregnancy involved. That is, these early embryos (blastocysts) are typically frozen in liquid nitrogen (cryopreserved) in in vitro fertilization clinics, and are considered “excess” by their parents, since their parents already obtained the pregnancy and birth of the baby that they wanted. If there is no pregnancy, then there is no “conflict of interest” between the mother and her unborn. On the other hand, it has everything to do with the legalization of abortion. Why? Because, by giving some human status to these frozen human embryos, it begins to undermine the abortion mentality that says, “They are not really human beings.” In other words, the pro-abortion (pro-choice) forces in our society are adamantly opposed to any suggestion of even the earliest human embryo being recognized as human. In the mind of these ideologues it is essential to continue to promote the perception that these early human embryos are “just a clump of cells” that should be used for advancing medical cures.

[Part 2 of this interview, offering a look at the pros and cons of umbilical cord banking, will be published Tuesday.]

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On the Net:

National Catholic Bioethics Center: www.ncbcenter.org

Stem Cell Research: www.stemcellresearch.org

Windpipe transplant breakthrough

source: BBC News

Surgeons in Spain have carried out the world's first tissue-engineered whole organ transplant - using a windpipe made with the patient's own stem cells.

The groundbreaking technology also means for the first time tissue transplants can be carried out without the need for anti-rejection drugs.

Five months on the patient, 30-year-old mother-of-two Claudia Castillo, is in perfect health, The Lancet reports.

She needed the transplant to save a lung after contracting tuberculosis.

The Colombian woman's airways had been damaged by the disease.

Scientists from Bristol helped grow the cells for the transplant and the European team believes such tailor-made organs could become the norm.

To make the new airway, the doctors took a donor windpipe, or trachea, from a patient who had recently died.

Then they used strong chemicals and enzymes to wash away all of the cells from the donor trachea, leaving only a tissue scaffold made of the fibrous protein collagen.

This gave them a structure to repopulate with cells from Ms Castillo herself, which could then be used in an operation to repair her damaged left bronchus - a branch of the windpipe.

By using Ms Castillo's own cells the doctors were able to trick her body into thinking the donated trachea was part of it, thus avoiding rejection.

Two types of cell were taken from Ms Castillo: cells lining her windpipe, and adult stem cells - very immature cells from the bone marrow - which could be encouraged to grow into the cells that normally surround the windpipe.

After four days of growth in the lab in a special rotating bioreactor, the newly-coated donor windpipe was ready to be transplanted into Ms Castillo.

Her surgeon, Professor Paolo Macchiarini of the Hospital Clínic of Barcelona, Spain, carried out the operation in June

He said: "I was very much afraid. Before this, we had been doing this work only on pigs.

"But as soon as the donor trachea came out of the bioreactor it was a very positive surprise."

He said it looked and behaved identically to a normal human donor trachea.

The operation was a great success and just four days after transplantation the hybrid windpipe was almost indistinguishable from adjacent normal airways.

After a month, a biopsy of the site proved that the transplant had developed its own blood supply.

And with no signs of rejection four months on, Professor Macchiarini says the future chance of rejection is practically zero.

"We are terribly excited by these results," he said.

"She is enjoying a normal life, which for us clinicians is the most beautiful gift."

Today Ms Castillo is living an active, normal life, and once again able to look after her children Johan, 15, and Isabella, four. She can walk up two flights of stairs without getting breathless.

I was a sick woman, now I will be able to live a normal life ~ Claudia Castillo

Professor Martin Birchall, professor of surgery at the University of Bristol who helped grow the cells for the transplant, said: "This will represent a huge step change in surgery.

"Surgeons can now start to see and understand the potential for adult stem cells and tissue engineering to radically improve their ability to treat patients with serious diseases."

He said that in 20 years time, virtually any transplant organ could be made in this way.

US scientists have already successfully implanted bladder patches grown in the laboratory from patients' own cells into people with bladder disease.

The European research team, which also includes experts from the University of Padua and the Polytechnic of Milan in Italy, is applying for funding to do windpipe and voice box transplants in cancer patients.

Clinical trials could begin five years from now, they said.

Between 50,000 and 60,000 people are diagnosed with cancer of the larynx each year in Europe, and scientists say about half them may be suitable candidates for tissue engineering transplants.