When I investigated human embryonic stem cell (hESC) research for Christianity Today in 2005, the debate about the ethics of the science was heated and tense. I was a pro-lifer whose child had an incurable disease. What I wanted to know was: what would I do if hESCs could cure my child's Neurofibromatosis? As part of that investigation, I spent 10 days attending a National Institutes of Health (NIH) training course for post-doctoral scientists at Children's Hospital of Orange County (CHOC) in Southern California. Every other attendee was there to learn how to create and grow stem cell lines from five-day-old human embryos (blastocysts). Because it was an NIH-funded course, no new embryos were destroyed to grow the lines the researchers manipulated.
I was the invited guest of Phil Schwartz, who is both director of the Human Neural Stem Cell Resource at CHOC and a Christian opposed to embryo destruction. Schwartz ran the course with Jeanne Loring, director of the Center for Regenerative Medicine at the Scripps Research Institute in San Diego, California. Loring is a cell biologist who has been working with hESCs since 1997. Before that, she worked with another Christian, Francis Collins, on mapping the human genome. She describes herself as a "cultural Catholic" but practices no religion and has never had any doubts about the ethics of her hESC work.
In 2008, Schwartz invited me to attend the course again and I did. The political tenor had changed considerably with the advent of induced pluripotent stem cells (iPSCs), which are derived from adult somatic cells and thus are not controversial. Writing in November 2008 on the Center for Genetics and Society's blog, Project Director on Biotechnology Accountability Jesse Reynolds predicted:
With the end of stem cell research as a political vehicle, its advocates are likely to temper expectations. They'll not just move out the goalposts on the timeline towards treatments, but the touted uses of stem cells will shift from potential cellular therapies to models of human diseases in Petri dishes and better drug testing methods. These new purposes will win fewer votes than "your own personal biological repair kit," but they are also much more realistic.
And yet, here we are again, with advocates lamenting a lawsuit that brought a temporary injunction against NIH funding of hESC research. (The injunction was quickly lifted.) So, I called Jeanne Loring and asked her thoughts on the law, the ethics and the science of stem cell research. Here's that interview, edited for space:
SCHELLER: What do you think of the NIH legal situation?
LORING: For scientists, the embryonic stem cells have been the basis for all of the research, including the induced pluripotent stem cell research. Also, they've had a lot of influence over adult stem cell research, although I don't think those guys would admit it. ... There's a gradual growing excitement ... because of what you can do with them. So we have people with all sorts of different skills that are all focusing on hESCs or iPSCs or stem cells in general. What the legislation does is it puts a halt to an awful lot of research that's ongoing right now. Maybe in another 10 years, it wouldn't have such an impact because people would have already done all these things and it would all be in the hands of companies, but right now it's in a really frantic research phase. We're discovering things all the time. It's the worst possible time to have money taken away.
SCHELLER: Who brought case?
LORING: A researcher who used to be at Harvard. Harvard denied him tenure and he went on a hunger strike. That's what he was famous for. I knew I'd heard of him before.
SCHELLER: Was he opposed to the research on ethical grounds?
LORING: There are two people: a woman from Louisiana, I believe, opposing the research on ethical grounds, and this guy. In legal terms, in order to get an injunction, you have to show financial harm. He said he was being financially damaged because hESC research was unfairly competing with adult stem cell research at NIH. It's outrageous. It's foolish. It's silly, because research funded by the NIH is funded on merit, and there's no one pot for all stem cell research that gets divided up differently. There's a big pot for all sorts of research, and depending on the stage of the science and the urgency of the need, the research dollars go in a lot of different directions. Adult stem cell research gets far more funding than embryonic stem cell research and it continues to, mostly because it's already well established.
SCHELLER: Do you think the spinal cord hESC therapy human trials that have been approved by the FDA [the first of their kind] at the Reeve-Irvine research Center in Southern California will work?
LORING: I don't know. Scientifically, I think there's a possibility. As a scientist, what I really want are for those cells to not harm anybody because it's a Phase One trial, and the object of a Phase One trial is to show that it doesn't do any harm, and that will be a huge step forward if they can show that.
LORING: No. They are going to have an immune problem, but they're going to treat it like an organ transplant. They're going to use the minimum amount of immune suppression that they can get away with. ... This is not a fix for immune rejection. I just got a grant to develop a way to trick the immune system into thinking transplanted cells are theirs. There are several projects going on along those lines. The cells themselves are not going to move into another body and not cause a reaction, which is actually good because if your immune system is not aware of something and that cell became cancerous, you couldn't do anything about it.
SCHELLER: California Institute for Regenerative Medicine (CIRM) co-founder Robert Klein is the father of a diabetic child. I've never understood the trade-off of insulin dependency for immune suppression that diabetic patients would potentially make if hESC therapies become available. Do you grapple with that at all?
LORING: Sure. Ranking diseases is always difficult. A lot of what diseases are going to be treated with cell therapy really depends on a balance between how serious they are and how deadly they are and how easily they can be treated with cells. So, diabetes seems to be, relatively among all diseases, probably easier than most to treat, but it's not life-threatening. So you have to get a really good therapy, but definitely require immune suppression before you would actually use it.
SCHELLER: So there's a risk/benefit analysis?
LORING: Yeah, that's right. So there is progress to be made. All this immune system stuff is sort of catching fire now, so people are not going to just stand by and let the immune system reject everything. They're going to try to modify the immune system, not with immune suppression, but in a way that will last. Now people are also encapsulating cells so that the immune system can't get at them.
SCHELLER: They're still able to function when they're encapsulated?
LORING: Yeah, in diabetes they certainly are because all they have to do is react to glucose in the blood and make insulin.
SCHELLER: Last time I talked to you, you sounded more excited about iPSCs than hESCs.
LORING: I am more excited for a lot of reasons about iPSCs because you can make them from any individual. As far as the way they act in the culture dish, they're exactly the same as embryonic stem cells. You have the same problems and the same advantages.
SCHELLER: Is it much harder to get them to turn into other cell types than it is with hESCs?
LORING: No. It's very easy to get them to turn into other cell types. They're essentially equivalent. If you look at 100 iPSCs and 100 hESCs, you'll find there are outliers in both groups -- cells that are difficult or act funny. But on the average, among those 200 cell lines, you really couldn't tell them apart.
SCHELLER: 2009 was the last NIH-funded course you directed with Phil Schwartz. Is there no longer a need to train scientists?
LORING: My lab is still running courses. We're doing it semi-independently and also for CIRM. They are more popular than ever. We modified them so we are actually offering them every couple of months because there are so many people in line waiting to take them.
SCHELLER: So it's not the case then, as it was in 2005, that you have more cell lines than scientists to do the research?
LORING: No, it's not like that at all. People really want to get involved in this field. We still teach embryonic stem cell culture methods because that is still the fundamental technology that underlies all of this work.
SCHELLER: Do you need new hESC lines?
LORING: No, I don't need to make hESCs. This is a dilemma. You make hESC lines from five-day-old blastocystes that have been donated by people in in-vitro fertilization (IVF) clinics. I've been getting repeated frantic emails from people who want to donate their embryos. I don't really have any need for them, but I'm feeling like I should start a bank. The alternative is throwing them away. Nobody's going to adopt the embryos, so they're paying to have them stay frozen and they want to see some good come of them. I want to start a bank. It's just that I don't have funding for it. I'm cooperating with an IVF physician who's temporarily taking the embryos in. We definitely don't need to make embryonic stem cell lines. There are probably 400 around now. All you have to do is call somebody and ask them for them.
SCHELLER: At the 2008 course, an IVF physician called his field "Cowboy Science" because of the lack of regulation. It seems to me that this lack of regulation may be a bigger problem than hESC research because it creates the excess embryos.
LORING: I have no objection to increasing regulation of IVF. It's like any medical practice. It shouldn't be hurt by oversight.
SCHELLER: We also heard about the potential for exploitation of egg donors in 2008.
LORING: The egg donation issue in 2008 was very hot. That's died out considerably with the advent of iPSCs because people were looking for alternative sources for pluripotent cells, and now there is an alternative source.
SCHELLER: As you know, I initially investigated this topic because my first pregnancy was unplanned and I didn't believe I had the right to end it. My child was then born with Neurofibromatosis. So I had an ethical dilemma to think about when hESC research emerged.
LORING: Yeah, I understand. I obviously don't feel it in my heart, but I understand.
SCHELLER: How would you describe your ethical convictions about hESC research?
LORING: I find it completely ethical. I have absolutely no problems with it. It isn't abortion, so my opinion about abortion is irrelevant. The fact that these embryos would be thrown away and not used for research, I think it would be unethical not to use them.
SCHELLER: You've never had any doubts?
LORING: I've never had a doubt.
SCHELLER: How long have you been doing this research?
LORING: I started in 1997 in northern California. I started my own company to make hESCs. I didn't know then that there were so many embryos being thrown away every day. So it made me nervous to have embryos in the lab, and I made sure that I got good cell lines out of them. It would still do that to me now. They are really precious, but you can't do anything else with them. I was interviewed by a reporter for a Christian newspaper maybe a year ago. I actually wanted to talk to this guy because I wanted to suggest that the churches should put up embryo banks because there's no adoption for embryos. It would be like starting an orphanage. If they want to keep the embryos from being used for research or being thrown away, then they should set up a bank, a freezer somewhere and just keep them.
SCHELLER: And then do what with them?
LORING: Whatever they want.
SCHELLER: In other words, we should take responsibility for our convictions?
LORING: Exactly. Nobody took me up on it. I'm happy to say that again, though.
SCHELLER: People say similar things to pro-life Christians about abortion.
LORING: This would be really simple, though, simple and cheap because you don't have to raise them. All you have to do is keep them frozen. And then you can figure out what should happen to them after that. That's not my problem.
SCHELLER: Do you get any flack from your Catholic relatives about your work?
LORING: No. As you know, many Catholics also think birth control is okay and a lot think IVF is fine. So it all follows from that. My relatives are pretty intelligent people, so I don't get any trouble from them. There might be an outlier somewhere, but not a close relative.
SCHELLER: Thanks for talking to me Jeanne. I always appreciate the fact that you shed light rather than heat on this issue.
LORING: If somebody wants controversy, they're going to have to go somewhere else.
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