On May 9, Cafe Scientifique hosted a discussion titled “Stem Cells and Regenerative Medicine and Personalized Medicine: Where are we now and where can we get to?” at York University in Toronto.
The event was part of the city’s Science Rendezvous. Stem cells are in the news a lot these days, from the ethics of their use to the rapid advancements that they have brought to medicine and drugs.
The CIHR (Canadian Institute of Health Research) hosts several Cafe Scientifique’s around the nation each month. The Cafe’s are a way for the public to get a better understanding of different health issues by discussing topics with the real experts.
The latest for Toronto, “Stem Cells and Regenerative Medicine and Personalized Medicine: Where are we now and where can we get to?” had a smaller than average turnout due to the rain that kept many inside today.
Three experts discussed their work with stem cells in a clinical setting and in a broader setting, the ethics of use and what they can help or not help with.
Dr. Andras Nagy is part of the Samuel Lunenfeld Research Institute in Toronto. He started off the lecture with a background on stem cells.
In 1960 Dr. Gordon Keller discovered the human embryonic stem cell while working in Toronto. Dr. Keller was working on cancer research at the time and had no idea where that discovery would lead. Canada has been on the front lines from that beginning and remains so in the field of stem cell research.
In 1981 pre-floating embryonic stem cells in the uterus were discovered in mice. Research from that discovery showed that from one embryo every type of stem cell in the body could be grown in a petri dish.
What have we learned from the humble beginnings? That the human body is made up of 30,000 genes. That apart from bacterias and viruses almost all diseases that face humans are a mutation of one or more of those genes.We also have had to deal with the ethics questions as researchers have found that from just a few embryonic stem cells new life can be created. In 1993 Dr. Nagy knew that mice could be made from stem cells from a mere 10 cells.. Sheep have followed. the news has gone wild this spring when a researcher attempted again to clone a human baby.
Ethics has been a big part of stem cell research, mostly because of where human embryonic stem cells come from, fetuses. Today though most of the human embryonic stem cells that researchers work with come from IVF labs where the ‘parents’ have donated their cells. In Canada and many other countries only a small number of human embryonic stem cells are allowed to be used with each IVF procedure but the ‘harvesting’ process makes between 10 to 15 embryos. Parents can use the additional embryos in future IVF treatments, donate them to other infertile couples, have them destroyed or donate them to science. Nagy believes that by donating these cells to science the couples are rescuing human embryos in a real sense.
There are some drawbacks to stem cells being used in medicine. One is, like organ donation stem cells have to be compatible to the person that they are helping. If they are not then the body will reject them causing even greater problems.
One powerful breakthrough for researchers came in 2006 when it was discovered that it was possible to generate stem cells from skin cells. Using the HIV virus researchers were able to find the genes that had to be removed that left a clean cell. By removing four genes from the skin turned stem cells researchers are able to work with a fresh cell that can be turned into any type of cell.
Researchers have been able to stop type 2 diabetic sufferers from having to use insulin by transplanting pancreatic cells into diabetics. There is a limitation though. Within two years the body goes back to the diabetic state and the mean for insulin comes back. That has told researchers that we are still not at the stage that we can repair genes completely. But in the future that could happen.
When asked about the ‘evils’ about science Nagy compared those in science for the wrong reason with a kitchen knife.
“It’s a big dilemma. Take a kitchen knife. It is useful in the kitchen but can also be used as a deadly weapon. We don’t blame the knife.Stem cell research is the same. The benefit is worth more than the harm.”Dr. Ron Pearlman, Professor of Dept. of Biology, York University was the next to speak. His field focus with stem cells is very personal; the structure, organization and expression of genetic information as it deals with personalized medicine. He and his colleagues are working on ways to analyze a person’s DNA and then sequence it rapidly to identify health risks.
This field has come leaps and bounds within a fairly short time. At the beginning of this decade it cost a person $100 million to know their personal DNA genome. Today that cost is a mere $1,000.
A large spectrum of diseases stem from one single base change in a cell. By learning more about these changes researchers are now able to pinpoint risk factors when studying a person’s DNA. Associate studies of stem cells and DNA have added to a database that helps in the process of going from looking at the population as a whole to each individual person.
At this time many companies like 23 & Me and KnowMe are jumping on the DNA database wagon. Even IBM and National Geographic are teamed up. That team can give people a little information about their ancestors just by looking at a sample of their DNA.
In a more medical sense what these databases in the pharmaceutical genome tell us is that medicine is not a one size fits all. Years ago doctors thought that adult medicine just needed dosage changes when giving it to a child. That science research has uncovered does not work. Children, women and men all have different risk factors that affect medicine. That’s important. Every year 12 to 15 per cent of hospital admissions are a result of adverse drug reactions.
One example of these drug reactions took place in Toronto. An infant died from morphine overdose at Sick Kids Hospital. How could that happen? Why on earth would doctors give an infant to much morphine. The answer is simple, they didn’t. What they did do though was give the right dosage to an infant that was nursing. That infant’s mother was also taking a medicine with codeine in it. In breast milk codeine breaks down and becomes, you guessed it, morphine.
‘Many in the science community fear that they are being held back. We’re in danger of losing the pipeline of information and of innovative ideas. We have to build the building up from the ground instead of from the roof.We, in the science community need for the government to step up and push for more funding.”
As we move into more personalized medicine there are questions about ethics and privacy that will have to be addressed. Will insurance companies be allowed to use the information of risk factors that DNA reveal to deny coverage?
“Science is way ahead of ethics. Ethics has to catch up to science instead of the other way around. We can not hold back research. It’s too important for the society.”
Stem cell research makes medicine safer for the population. We are past the time for using mice on medicine trials. Mice prolong the trials. Things do take time but let’s do what we can to speed up the process.David Brener, PhD. from Pfizer Canada Inc. was the final guest to speak Saturday.
Dr. Brener started off with a question, “What doesn’t personalized medicine do? We can’t cure everyone. We can though start picking patients who will respond the best to medicines.”
By using genetics Pfizer is able to help reduce adverse effects of medications. Genetics allows the company to enhance safety while researching conditions and diseases that medication is used for. It is enabling us to make ‘designer drugs’ at a more rapid pace. In the end stem cells and genetics reduces the time that it takes to develop new drugs at much less the cost than in the past.
In Toronto and Canada we have a wealth of research ongoing. Research is unlocking the academic teaching hospitals making us a leading center of the world for stem cell research.
“Nothing in life is 100% sure. The net benefit vs. net losses shows the miracle of the pharmaceutical industry, by in large we are the breeding ground of the future.”
The health of humans is changing. We are reaching a point where we may be able to reduce the onset of diseases as we learn more about stem cells and the genetics of conditions. This is of great value not only to the individual but to the economy and society as a whole.
We, as researchers will make mistakes and pick bad markers. We won’t always be on point like we have been with Huntington’s Disease, which we now can say 100% if a person has the markers unless they are hit by a car or die in some other manner will come down with the disease. While there are the times researchers think they have gotten something down and then find that they were wrong, it’s those mistakes that are learning processes. The best researchers learn from their mistakes.
When I asked the doctors on the panel about the swine flu vaccine they were hopeful. Asked if Canada will be the one to come up with the final product I was told that it’s possible but what was most important is that it is found, not who finds it. As for Canada, we have the infrastructure in place to be in the lead.
As for where stem cell research is going there is no telling. We can’t predict the future but there is a future. There’s no telling when or where the next big breakthrough will be but we do know it will be exciting. That’s how research is, just a step away from the next big step and it’s always an amazing adventure.