Daria Martin, Schering Stiftung Projektraum

 

Regenerative Medicine? Where Are We Today? Hopes and Challeng

Stem cells are something like the magical table cloth in fairy tales. With this comparison, Tim Radford, Science Editor of The Guardian, opened the expert panel discussion: You spread it out, murmur some magic words, and food appears out of nowhere. The comparison is by no means outlandish, since the Schering Prize recipient, Ronald McKay, succeeds in doing exactly that in his laboratory: The magic words consist of a complex series of neurotransmitters which control the differentiation of cell cultures into nerve cells, liver cells or other cell types. Cell cultures are considered a great hope for aging societies, since they can be used to treat more effectively degenerative diseases of old age such as arthritis, Parkinson's and Alzheimer's, said Professor Günter Stock.

The road from the petri dish in the lab to the finished product, however, will be a rocky one, emphasized John Sinden, head of the British company ReNeuron. This is due to a huge financing gap between publicly sponsored basic research and marketing, which small companies cannot bridge themselves. But Ronald McKay believes that it will be worth it, because cell cultures, especially those derived from embryonic stem cells, will drastically change the field of medicine. Moreover, stem cell research allows a fascinating insight into the self-healing powers of the body, said neurologist Johannes Schwarz. Studies showed that the antidepressant Prozac probably acts by activating the body's own (endogenous) stem cells, which in turn stimulate the dopamine production in adjacent nerve cells. Similar processes can account for the regeneration of the heart. Schwarz hopes that stem cell research may be able to teach us how to specifically stimulate the body's self-healing potential. Physician Arndt Rolfs pointed out that the term 'regenerative medicine' did not refer to the transplantation of cell cultures only, but also to the transplantation of human, animal or artificial organs and the development of new biocompatible materials.

In today's clinical practice, one uses predominantly cell cultures from adult stem cells. McKay is convinced, however, that in the long run embryonic stem cells will gain the upper hand. Currently scientists such as McKay are in the process of investigating the basic mechanisms through which embryonic stem cells differentiate into the specialized cells of the various tissues. Based on our knowledge about the biology of stem cells, it will then be possible to develop new therapy approaches, McKay explained. In comparison, adult stem cells are not an ideal material to start from: In theory, one can, of course, also grow a new plant from a bud, but, the basic researcher asked, who would go to this effort if the seedlings are available?

The legal conditions markedly limit stem cell research in Germany, Günter Stock noted with regret. Legal scientist Hans-Georg Koch agreed and said that legislation should differentiate: On the one hand, there are cell groups that have developed from the fertilization process of egg and sperm and that carry the potential for the development of an identity. The law has to protect these so-called entities or forms of being. On the other hand, there are cell clusters deriving not from the combination of two sperm cells (fertilization), but from a single cell with a double set of chromosomes through cloning. These cell clusters do not have the potential to develop an identity. German lawmakers could allow research with such entities. The fact that researchers are granted significantly less freedom in Germany than, for example, in Great Britain, may have historical reasons, but it is also indicative of a deep-seated mistrust of science. The homunculus created by Doctor Faustus in the test-tube or the creature made of dead body parts in Dr. Frankenstein's lab still lurks in many people's minds. But why, McKay asked, is only the beginning of life seen as worthy of protection and not the health and dignity of old people? Nature itself is very wasteful with life in the making, added Radford. Only a fraction of fertilized eggs is implanted in the uterus. Rolfs suggested that if we could produce a successful technology that helps sick people, then it would become more difficult to raise ethical objections. The first heart transplantation was accompanied by an excited discussion about the identity of a human being, and in the Middle Ages it was considered unchristian to study corpses to learn more about the anatomy of the human body.

Günter Stock emphasized that almost all ethical convictions were deeply rooted in culture and conventions. In Japan, organ transplantations are seen as problematic, while stem cells research is not even discussed from an ethical point of view, it being about skin, cartilage, nerve cells, in short: the raw material of life. A person, however, is more than the sum of individual cells, and a fertilized egg without a mother who wants to carry it, remains a bunch of cells. McKay concluded that stem cells were natural and fascinating and the best point of departure that one could imagine for a new medicine.

The panel discussion with experts from science and business took place in the context of the award ceremony of the Ernst Schering Prize 2004 to Ronald McKay on September 22, 2004, in the British Embassy in Berlin. Ronald McKay was honored for his basic contributions to our understanding of the biology of the stem cells and his great accomplishments in the field of stem cell differentiation.

Panel participants included:

Tim Radford, Science Editor, The Guardian

Prof. Ronald McKay, Laboratory of Molecular Biology, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, U.S.A.

Dr. Hans-Georg Koch, Max Planck Institute for Foreign and International Criminal Law, University of Freiburg

Dr. John Sinden, ReNeuron, Guildford, Surrey, UK

Prof. Günter Stock, Member of the Foundation Council of the Ernst Schering Foundation, Member of the Executive Board of Schering AG

Prof. Johannes Schwarz, Deputy Director of the Department of Neurology, Leipzig University Clinic

Prof. Arndt Rolfs, Department of Neurology, University of Rostock


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