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 | You and Yours - Transcript 91Èȱ¬ Radio 4 |
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| TX: 26.09.03 – ARE SCIENTISTS PROMISING TOO MUCH FROM STEM CELL RESEARCH? |
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| PRESENTER: JOHN WAITE WAITE Finding a cure for things like Parkinson's, diabetes, Alzheimer's or MS is the dream of many research scientists who want to help the millions of people afflicted by degenerative diseases and conditions. And the discovery of stem cells has given those scientists new hope. Our bodies are made up of around 200 different cells - nerve cells, skin cells, heart cells or brain cells - and diseases happen when certain key cells die - brain cells, for example, in the case of Parkinson's. The idea of stem cell research is to make new versions of the dead cells and then transplant them into people. But how realistic is it to rely on this relatively new area of research? Are public hopes being raised too high? Are some scientists promising too much and is the industry itself moving too fast? All things we'll be discussing in a moment, with, amongst others, Sir George Radda, head of the Medical Research Council. But first Carolyn Atkinson has been talking to one British man who says he's already benefiting from work done by German stem cell researchers trying to find a cure for heart disease. IAN ROSENBERG I was going upstairs probably about one or two only at a time and resting and then going further. Today, if you want to come with me, I'll run up the stairs. ATKINSON Two months ago Ian Rosenberg could hardly manage the bottom step, never mind a whole flight. But two months ago he had not had bone marrow stem cells injected into his heart. Today he and his wife Jennifer are enjoying Ian's new lease of life after enduring 25 years of degenerative heart disease which has left him with hardly any working heart at all. IAN ROSENBERG I couldn't have done that before I went to Frankfurt, I would stop there in the middle for a start and have quite a little rest. JENNIFER ROSENBERG It was getting so distressing seeing him only being able to climb two or three stairs and then stop and then almost sometimes sitting down on the stairs and it was getting worse and worse. ATKINSON When Ian found himself virtually grounded his cardiologist referred him to Professor Andreas Zeiher at the University of Frankfurt. The technique uses bone marrow stem cells, which are thought to convert themselves into new heart cells and thereby repair the damage to Ian's heart. IAN ROSENBERG He took the stem cells from the back of my pelvis, he started to inject the stem cells into the artery. A million stem cells into me. And he feels it's worked. My cardiologist feels it's worked. The one person who could tell is myself and I know it's worked. ATKINSON Stem cells are the building blocks of our bodies, they have the ability to turn themselves into almost any type of cell like heart, nerve or skin. Professor Chris Higgins, director of the Clinical Sciences Centre at the Medical Research Council says there are two types of stem cell. HIGGINS Adult stem cells are taken from the adult body and they can be used in some cases, such as the case of Ian we've just heard about. Embryonic stem cells come from the very early embryo, which is a small ball of simple cells and these embryonic stem cells have the potential to change into all other cell types in the body and we're very excited about these cells because they therefore at least give us the potential to treat all diseases which are due to loss or death of cells in the body. RAISMAN What we're talking about is transferring cells from one part of the body to another. ATKINSON There are hundreds of stem cell researchers working around the world. At the National Institute of Medical Research in London Dr Geoffrey Raisman's team is transplanting stem cells from the lining of the nose to try to repair spinal cord injury. RAISMAN What Sharlee's [phon.] doing now is she's cutting a very small sample of spinal cord on this machine. Sharlee how does this one look? SHARLEE In the middle part it's a little bit looks like … RAISMAN The first type of injury that we plan to look at, the one you see here, is an injury where nerves are pulled out of the spinal cord in road accidents - they hit their heads or their shoulders, the nerves are pulled out of the spinal cord. The effect of that is that the arm is completely paralysed. So the idea is to reinsert those nerves that have been torn out, surgically back into the spinal cord using the stem cells at the repair site to make the fibres grow back. ATKINSON And he's confident the principles of this research will eventually be applied to more complicated spinal cord injuries and to stroke damage. And he plans to start his first human trials on road crash victims in about a year or so's time. But that worries some scientists who think stem cell research is going too fast and heading towards human trials without really understanding how and why something is working and because any injection of stem cells is irreversible there are calls for more research into the risk of tumours and other abnormalities. Professor Austin Smith, who's the director of the Institute of Stem Cell Research at EdinburghUniversity, says at the moment there's too much phenomanology and not enough science. SMITH There is some concern that stem cells are being thrown up as a panacea - as a cure for all diseases - and that this will happen overnight. Amongst basic scientists there is some concern at the moment that in some situations people are rushing ahead too fast into the clinic. It may turn out that these types of approaches have been premature and that this could then provoke a backlash in the same way as we've seen for gene therapy. ATKINSON But heart patient Ian Rosenberg is not worried. In fact he has set up a foundation to push for this type of procedure to be available in the UK within the next nine months. He feels he's at the cutting edge of science and is comfortable with any risks he may be taking. IAN ROSENBERG I feel very confident otherwise I don't think I'd do it. I've got all sorts of ambitions, including skiing and playing 18 holes of golf. The future is not light years away, it's something that is happening now. It's just as important to me as penicillin was when that was invented. RAISMAN …okay, good, that looks very nice, how many sections have we got today. SHARLEE Sixteen. RAISMAN This is the first time that we're thinking of repairing the brain and spinal cord, it's a door which is opening and where that door leads to is an enormous area and for the first time we're beginning to see a chink of light, we're beginning to force it open. ATKINSON What do you say to people who say all of this is going too fast, the biology, if you like, hasn't been done yet? RAISMAN Ask the patients who have got heart disease or have got paralysed limbs whether they think it's going too fast, they'll tell you it's going too slowly. WAITE Dr Geoffrey Raisman ending that report from Carolyn Atkinson. Joining me now Professor Sir George Radda, who's chief executive of the Medical Research Council, Dr Anthony Mathur, a consultant cardiologist at Bart's and the LondonHospital, who's hoping to start a clinical trial in this country for the sort of stem cell heart treatment Ian Rosenberg received. And in ourSussex studio Sylvia Tobert whose 13-year-old son has juvenile diabetes. Sir George where are we at present in Britain when it comes to stem cell research? RADDA We have a great advantage. First of all we have the legislation to be able to work both on embryonic stem cells and adult stem cells. We also have the expertise, we have a long tradition - in fact stem cells were discovered in this country and we, I think, have the scientific opportunities that we want to explore. WAITE So we're really world leaders are we here? RADDA We are world leaders because we have been able to put together a programme that involves a whole range of funders, we have 15 agencies who have agreed to be part of a funders forum, to work out a coordinated programme of stem cell research in the UK. I agree with the patients who said we want to do this quickly, yes we want to do it quickly but we want to do it properly, with the proper biology, as Austin Smith has given us the caution, being understood before we can go into the clinic. WAITE And how do you decide Sir George what diseases are chosen to be targeted and to have all these researchers working on them and which are turned down? RADDA Well I think at the moment we really want to support the best science so that we can then tackle whatever is the most appropriate disease. Everybody has their own views and which one can be tackled first. And I think that there are a number that are more likely to be tackled earlier than others. WAITE This is Parkinson's I think isn't it and diabetes? RADDA Parkinson is clearly on the top of the list, diabetes and heart disease we have seen. WAITE And why is that? RADDA Well Parkinson's - in Parkinson's case it's a very localised damage and you know precisely what cells you want to replace. In diabetes the same story applies. WAITE So presumably for something a little more intricate - Alzheimer's - that isn't going to be so easy? RADDA Alzheimer's, MS are the sorts of diseases that are likely to be long, long away. WAITE Dr Mathur we heard in ourreport a few minutes ago from your heart patient, because you referred him to your colleagues in Germany, Ian Rosenberg, who's one of a handful of people in the world who've had stem cells from their bone marrows transplanted into their hearts, you want to introduce this procedure into this country but aren't you worried at all that you're jumping the gun? We know stem cells treatment works somehow but we don't exactly know why or how. MATHUR Absolutely, I mean I share the concerns that have been expressed about sort of running before we can walk in this whole field at this moment in time. I would say however that there's plenty of data now that's published from other groups around the world - particularly in the field of cardiology - that have looked at stem cells and the treatment of patients. And so far the data looks very encouraging, it's very preliminary, very early days but it would appear to be using adult stem cells where the beauty of adult stem cells is that it just seems to be such a simple process of using these very clever cells that naturally occur in our bone marrows and just putting them back where we think they're going to have a massive effect. Preliminary days but I believe also linked to my role as a clinician and a scientist that we're at a stage where we can start looking to do the important clinical trials to answer those important questions. WAITE Yeah, early days and so in a sense aren't you using people like Ian as human guinea pigs? MATHUR Personally not in that we haven't started this as yet, our aim is to try and develop a facility where we can start to look at treating human beings but with the premise that we must do the basic science that needs to go with it. WAITE Yeah, you heard Austin Smith saying more basic biology is needed to assess the risks, he doesn't think enough has been done, you clearly do. MATHUR No, I believe that we need to do more of it and I think when the time is right we'll all feel happy about treating human individuals in this way but I think we're there or thereabouts, as I say. WAITE Do you know though why stem cells work? MATHUR That's a big area that is one of my main interests of research, we don't for a fact know exactly how these stem cells work. All we have is observational data, subjective data and objective data from patients that have been treated that suggest it's a good thing and that it's safe. WAITE Professor Radda, I mean that begs the question if you don't know how this works are we moving too fast? RADDA Well I think that what my colleague here said is entirely right, that we need to be able to at some point get into the patients and it's a decision we have to make of when. I think we are fortunate in this country that we have of course very good regulations of when you can do clinical trials and ethical committees have to be involved in such decisions. So I think the patients can be assured that any trials that we are going to do in this country won't be too early. WAITE Let me bring in, if I may, Sylvia Tobert. Sylvia your 13-year-old son has juvenile diabetes, do you think we're moving too fast? TOBERT No I don't think we're moving too fast at all. Like all people who are very directly involved with chronic illness it can't be fast enough can it. I agree with Sir George entirely that we have very good safeguards, we have excellent committees monitoring this sort of work, we are very careful, the British are good at careful generally. We're also good at creativity and I think that if you give scientists the freedom to be creative within the right parameters it has to be best for all of us. WAITE Would you be happy for your son to take part in any trials, as opposed to someone else's son? TOBERT Well it's never wise for a mother to second guess a 13-year-old's reaction of course but if he wished to, I certainly wouldn't try to prevent him. Obviously if I was happy with all of the science first. WAITE I mean why are you holding out so much hope for stem cell research? TOBERT I've been watching the developments closely, I was at the meeting when Sir George launched the stem cell bank, I think that this has such huge potential, it seems to me - I'm not a scientist but I'm interested in the science - it seems to me an obvious thing to do, to try to replace the bits that are broken, you do that with everything in life - if something breaks you try to repair it orreplace it. It seems logical to do that with people. WAITE And even if those people run a risk in doing that? TOBERT There's a risk with everything. The disadvantages of having a chronic illness, I mean for my son, for example, he has to take several injections a day, he has to monitor his blood glucose, he's never free, when a child develops type 1 diabetes his life changes completely, he's got to think about carrying insulin, about carrying glucose, he has to be careful before he does sport or exercise. Actually my son's brilliant at all of that but not all children are and not all adults are, it's a hard thing to live with. WAITE Because I mean Dr Mathur, sorry to bang on about this to you, none of these transplantations though can be reversed, so if something goes wrong that's it, it goes wrong. MATHUR Partly but as I say so far it all looks to be very safe and the beauty of it is its simplicity, it's cells that are naturally occurring in your body and they're just being concentrated and put into another area where there's perceived damage. We don't fully understand how it works but it clearly seems to be having a good effect. WAITE Sir George. RADDA Can I just compliment the lady, the mother of this child, for such a measured reaction, I think an understanding. I think juvenile diabetes is one area where we are likely to be making progress relatively soon and we have been working very closely with our American colleagues … WAITE But what about - people will have seen this - Christopher Reeve, the Superman actor, who says I'm going to be walking within 10 years because of stem cell research? Now do we applaud him or do we feel sorry for him, is he fooling himself Sir George? RADDA Well 10 years is a possible timescale and you heard Geoffrey Raisman I think who has got some very exciting animal experiments to show that it is possible, it's a question of what is the timescale and 10 years is not at all a bad guess. WAITE Where do you think we'll be in 10 years Dr Mathur? MATHUR Well relating to the heart and the treatment of heart disease, in particular heart failure and the damage that occurs following a heart attack, I'm really encouraged by the data that we have at the moment, it is preliminary, very early days, but I would hope that in 10 years time what we're looking at is at being able to repair the damaged heart and improving the quality of life of patients like Mr Rosenberg, who as you heard had essentially been crippled and lived a dreadful sort of existence with the condition they have. WAITE And briefly Sylvia it's very cruel isn't it if lots of people, at the moment, hurt in car crashes think oh within a few years I might be walking again, it's very cruel if that doesn't happen? TOBERT Well I think that everybody needs to have something to look forward to, and particularly so if you have chronic illness and the rolling five years is okay, provided people are still working towards it, they don't lose sight of these things and provided there isn't too much negativity. Everybody wishes to see a cure for chronic illness, for serious nerve damage, such as spinal injury, of course we do. We want it to be reasonably safe but keeping focused on the end game is important and it doesn't matter if the five years turns into 10 or 15 or even 20 provided that progress is being made and that people do have that beacon of light. WAITE Sylvia Tobert and Dr Anthony Mathur and Sir George Radda thank you all very much indeed. Back to the You and Yours homepage The 91Èȱ¬ is not responsible for external websites |
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