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Stem cell scrutiny


Sifting through the science, fiction and controversy surrounding stem cell therapy.

By Adrienne Dy, M.D.

 
NOVEMBER 2013 


Stem cell therapy could possibly be the medical buzzword of the century. Conversations about it are spilling from the confines of laboratories and healthcare facilities into media platforms—and even everyday curbside talk. Some laud it as the now-accessible fountain of youth; others are convinced it’s the magical cure-all that will solve maladies that have baffled medical experts for years.

But the world is still for the most part divided about this medical breakthrough. The answers won’t be found in the shadows of rumors, anecdotes or ambiguity—so it’s high time that light gets shed on the topic. What exactly is stem cell therapy, and how much do we know about it with certainty?


Cells of unlimited potential

The first Philippine Stem Cell Therapy (SCT) Summit held last August was an endeavor to demystify the treatment. Organized by Powermax, it featured comprehensive talks by today’s experts in the field. One of them was Rey Melchor Santos, M.D., the founding president of the Philippine Association of Laparoscopic and Endoscopic Surgeons, and past president of the Philippine College of Surgeons and the Philippine Medical Association. He defined stem cells as “immature cells that have the potential to become specialized into different types of cells throughout the body,” elaborating that they are characterized by the ability to self-renew and differentiate along multiple cell lineage pathways.

In other words, stem cells have the power to renew themselves, or transform into a variety of cell types—a phenomenon called stem cell plasticity. It sounds miraculous, but the truth is, we all came from stem cells—a single cell from the fusion of our parents’ cells, which later transformed or differentiated into the myriad cells that make up our present bodies. The real breakthrough was in discovering that this very natural process could be harnessed for various medical benefits.


Where past and future collide

Administrative Order 2013-0012—the document released by the Department of Health containing the rules and regulations surrounding SCT—opens with a powerful statement: “Stem cell science and technology is considered the future of medicine.” But Samuel Bernal, M.D., Ph.D., whose areas of expertise include biochemistry, molecular biology, oncology, jurisprudence and law, has a different take.

Also a speaker at the SCT summit, Dr. Bernal declared, “SCT has been around for over 40 years—it is the past and present, not the ‘future.’” He narrated how Georges Mathé, a French oncologist, performed the first bone marrow transplant in 1959, while E. Donnal Thomas, a US hematologist and oncologist, pioneered stem cell transplantation—a feat that earned him a Nobel Prize in medicine. “He showed that human bone marrow cells infused intravenously could repopulate the bone marrow and produce circulating blood cells,” said the pioneer in stem cell work in the Philippines.

In fact, bone marrow transplantation is also called hematopoietic stem cell transplantation. With over 50,000 transplant procedures done annually worldwide, it has been considered a mainstay in the treatment for blood disorders like aplastic anemia and leukemia, as well as other immune and metabolic disorders—even before everyone was talking about stem cell therapy.


Bioethics versus scientific progress

If SCT has been around for so long, why the controversy? A lot of it has to do with the source of stem cells. They may be harvested autologously, or from the patient himself—such as from his fat cells, marrow, or umbilical cord blood harvested at birth and preserved in special facilities. Others are taken from compatible donors—this is called allogenic. But others are harvested from plants, animals, human embryos and aborted fetuses; some employ genetic alteration. These are often the cause for controversy. Our DoH has drawn the lines with strict rules and regulations regarding SCT. “[Local regulations] make the Philippines one of the most restrictive countries in the world for stem cell applications,” says Dr. Bernal.

Hardcore scientists might argue that experimentation is the way to scientific progress, and are willing to overlook the ethical issues in the name of new knowledge that may benefit many in the long run. But others rebut this in the name of human dignity; for them, life holds a certain sanctity that we cannot forego. Kenneth Hartigan-Go, M.D., the director of the Philippine Food and Drug Administration and another speaker in the summit, was quoted on his stand on balancing innovation and regulation: Too much regulation stifles innovation, but innovation not balanced by regulation can be dangerous. “Safety precedes profits,” he emphasizes.


Aside from the regulatory framework that the government has put in place, patients are encouraged to do their own investigations regarding claims of “rejuvenation,” “anti-aging” and “cure-all” with SCT. Want to know about the status of SCT in the Philippines? Grab a copy of the November issue of HealthToday for DoH’s rules and regulations, as well as the lowdown on approved SCT applications.






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