Monday, 24 March 2008

Embryo/ stem cell research

Last night I went to a cystic fibrosis fundraising event, organised by my sister, whose 3 year old has CF. It was a great evening, with several bands playing and a good turnout. The aim was to raise sponsorship for a friend who's running the London maration next month for the CF Trust - see (My good friend John is also running the marathon on behalf of Heart UK, so best give him a plug too:

The day before, on arriving back in the UK from India, I'd picked up several messages asking me to do media on the Human Fertilisation and Embryology Bill - too late to actually do them, but I spent Sunday morning catching up on what the Catholic church had been saying on hybrid embryos. The term 'hybrid embryos' conjures up a Frankenstein vision of mutant babies growing into monsters, but I'm sure the majority of people will back the Bill once they realise what is really involved - I've taken this from a Q and A on the BBC's site, ( just to make sure I get it right:

What is a hybrid?
The experiments involves transferring nuclei containing DNA from human cells, such as skin cells, into animal eggs that have had almost all of their genetic information removed.
The resulting cytoplasmic embryos are more than 99% human, with a small animal component, making up around 0.1%. The embryo would be grown in the lab for a few days, then harvested for stem cells - immature cells that can become many types of tissue.

When I Googled the Bill just now to check I'd got the science right, the first hit was on this site: The blurb suggests it's an impartial guide to the Bill - "This website has been created to provide briefing material and information on the Human Fertilisation and Embryology Bill. Here you can keep up to date with the latest news, press articles, bill amendments, parliamentary questions and much more". The site is, however, hosted by the All-Party Parliamentary Pro-Life Group, so I suspect it's far from impartial on the key issues. I wonder if, for example, they'll be adding a link to Lord Winston's comments today:

For the record, I'm very much in favour of the Bill, not least because of what I've learnt over the last few years about cystic fibrosis. Here are some links which tell you a bit more about how advances in gene therapy could help find a cure for the disease:


Elizabeth Bateman said...

As a doctor I was very interested to read your comments on medical research and the HFE bill. I have friends and family members who are directly affected by some of the genetic diseases that could be helped by research into these areas, not to mention the patients I treat on a daily basis.

However, I have grave concerns about the ethical implications of creating human embryos and hybrid embryos as a source of stem cells for such research given alternative sources are already known. Research from internationally respected teams such as that of Prof M. Alison at the Hammersmith Hospital have shown that many cells found within the normal human body have potential to develop into more than one differentiated cell type i.e. are stem cells. I have copied an abstract below, all of which is available freely over the internet (for example from PubMed Medline). In summary, where stem cells are needed for research into conditions such as cystic fibrosis, I would much rather donate a sample of blood than have a scientist create a hybrid embryo.

I would urge you and your fellow MPs to consider the available, much less controversial, alternatives to creating hybrid embryos when voting on the HFE bill.

With best wishes,
Dr Elizabeth Bateman

Summary from one paper:
"A large body of evidence supports the idea that certain adult stem cells, particularly those of bone marrow origin, can engraft at alternative locations, particularly when the recipient organ is damaged. Under strong and positive selection pressure these cells will clonally expand/differentiate, making an important contribution to tissue replacement. Similarly, bone marrow derived cells can be amplified in vitro and differentiated into many types of tissue. Despite seemingly irrefutable evidence for stem cell plasticity, a veritable chorus of detractors has emerged, some doubting its very existence, motivated perhaps by more than a little self interest. The issues that have led to this situation include the inability to reproduce certain quite startling observations, and extrapolation from the behaviour of embryonic stem cells to suggest that adult bone marrow cells simply fuse with other cells and adopt their phenotype. Although these issues need resolving and, accepting that cell fusion does appear to allow reprogramming of haemopoietic cells in special circumstances, criticising this whole new field because some areas remain unclear is not good science."

[Recipes for adult stem cell plasticity: fusion cuisine or readymade? J Clin Pathol 2004 Feb;57(2):113-20
MR Alison et al.]

Kerry said...

I appreciate you taking the time to explain this, and certainly can't claim your level of expertise on the subject. But why do so many within the scientific/ medical community believe that hybrid embryos are needed - or at least, would be useful - for research?

Elizabeth Bateman said...

Apologies it's taken me so long to reply - I've been working nights and only just came across your reply.

In response to your question; I think there are probably as many different reasons as there are different people, some that I can think of:

1) Lack of knowledge of alternatives. A lot of new science takes a while to make its way into the public arena, and perhaps only those particularly looking for it would find it.

2) Lack of understanding of the implications of different research. For example Prof Alison works with a cellular pathology unit; researchers within embryology may not realise its possible application within their own area (please see suggestions for practical demonstration below!).

3) Most scientists enjoy the challenge of pushing back the boundaries of what we know and what we can do, sometimes ethically, sometimes less so. Perhaps in some, a case of climbing the mountain because it's there?!

4) As in any other walk of life, scientists have different reasons and motivations for doing research. For many, publicity and money will be more than a contributing factor, both of which have good potential in more controversial areas of research.

5) Doctors and other healthcare professionals are as dependent on, and affected by, media coverage as anyone else. Media coverage is something that is frequently more the preserve of politics and larger corporations than individual scientists. Media coverage has been quite favourable towards the HFE bill; other political motives for wanting positive coverage and success of the bill is something I am less qualified to comment on.

6) The majority of healthcare professionals are not significantly more qualified to formulate a scientific opinion than the general public as medical degrees do not tend to cover these areas of science in any great depth (it happens that I have a separate BSc that covered it). The majority of doctors I have spoken to on the subject have expressed opinions such as, "Well if it helps cure Parkinsons like the news says, then it must be a good thing, so yes, I'll support it, why not?".

7) A debate which should and could have been very much science against different scientific possibilities with the ethical considerations of both, has unfortunately been turned into a polarised, massively oversimplified "science vs religion" debate. (Unfortunate for healthy, productive debate that is. Fortunate for those who would like the bill to succeed!). I would imagine that the large majority of scientists asked to choose between "science" side and "religion" side would opt for science! Again, much of this comes back to the particular direction of media coverage.

As a possible quick practical demonstration (for your non-existent spare time!) can I suggest you visit a commonly used scientific research search engine by typing "PubMed Medline" into Google and clicking on the first link (starts www.ncbi...). By typing different searches in at the top we can see what scientists see when they search the literature for previous research in their own area e.g. "embryology". To keep up-to-date in your own area of research apparently takes on average 8 hours of reading a day. Understandable then if scientists haven't come across particular research that is outside their own area, even if it would be relevant (as above).

As I mentioned, these are just some of many possible reasons, some of which being much more political in nature would be outside my area of expertise. Still, I hope this is helpful, and provides some more food for thought.