How Will The 2012 Election Affect Scientific Progress And Leadership In America?

Posted on | May 19, 2012 | 2 Comments

Mike Magee

I’ve been following the policy and scientific issues related to stem cells pretty closely for over a decade. During my tenure as director of the Pfizer Medical Humanities Initiative, it was about pushing back inside a scientific company bending over backwards not to offend the Bush administration. On the research and discovery side, it was about trying to make some ethical sense of how far to go with human research brought to an early critical focus by the death of Jesse Gelsinger on September 17, 1999 who was under the care of a research team led by James Wilson at the University of Pennsylvania.(1) And then on the patient side, having some personal contact with Christopher Reeves, it was about supporting the hopes of so many families with loved ones who have suffered from spinal cord injuries or neuro-degenerative diseases.(2)

The long and the short of all this is “it’s complicated”, “it’s political” and “it’s high stakes”.

On the “it’s complicated” side, Evan Snyder and Yang Teng spoke with admirable clarity on the research complexity of studies in “Stem Cells and Spinal Cord Repair” in the May 17, 2012 issue of the New England Journal of Medicine.(3) In their words, “For the past couple of decades, clinicians have watched the stem-cell field with a mixture of anticipation and skepticism. No group of patients has been more expectant than those with spinal cord injuries. Therapies for spinal cord injury have been promised almost since the dawning of the stem-cell field.”

They then go on to outline the challenges and realities in trying to conduct research in this field including:

1. That “spinal cord injury is not a monolithic entity but rather a series of concurrent and interacting pathological processes.”

2. That “multimodal actions will be required to combat the various facets of this malady.”

3. That “stem cells, in fulfilling their fundamental teleologic role of maintaining homeostasis in a perturbed system, may be capable of intrinsically exerting many of these requisite multifaceted actions.”

4. That “the stem cell may serve as the glue that bonds and focuses many of these multidisciplinary approaches.

5. That “the cascade of pathological processes that characterize spinal cord injury … is complex, with connections and functions that have been rendered regionally discrete within a span of millimeters, if not microns, during a finely tuned process that is part of embryonic development.”

6. That “despite attempts to standardize experimental models, procedures, readouts, and instruments, there can nevertheless be variability from animal to animal and investigator to investigator.”

7. That “the presence of spared fibers after transaction is often difficult to detect.”

8. That “substantial degrees of spontaneous recovery that are not related to treatment can occur for reasons not entirely known or controllable.”

9. That “much of this spontaneous recovery is attributable to the resolution of processes such as edema, inflammation, altered perfusion, shock, and transient channelopathies.”

10. That “it is also probably due to gradual behavioral compensation by the animal, redundancy in connections, and the disinhibition of certain intraspinal reflexive movements.”

Adding emphasis, they summarize, “The field itself is inherently vulnerable to observer bias because it lacks adequate varieties of truly objective, quantifiable, discrete measures of spinal function attributable purely to single pathways. Other confounders include related maladies (e.g., pain, bladder and bowel dysfunction, muscle atrophy, osteopenia, skin breakdown, and fatigue); the unmonitored effects of learning, environmental stimulation, motivation, and rehabilitation; the effect of immunosuppressant drugs or use of experimental animals with immunodeficiency; the sex and strain of experimental animals; and in stem-cell transplantation, the fusion of donor cells with host cells, leading to the mistaken identification of a host cell as having come from the graft.”

Translation – it’s really, really complicated considering….

“relative contributions of the multiple pathological events””ascending sensory and descending motor connections””preserve the intricate connections established during embryonic development””neutralizing toxins to prevent the death or impairment of neural tissue from secondary injury processes””excessive extracellular glutamate, inflammation, free radicals, ischemia, and impaired axonal transport””protecting or regenerating myelin sheaths or inducing the growth cones of axotomized fibers””suppressing scarring and inhibitors to neurite growth””preventing the formation of syrinx or bridging gaps””re-creating a supportive niche, including adequate vascularization”

But, they add…. “the use of stem cells — in conjunction with other approaches — can mediate many of these therapeutic actions by virtue of the inherent biologic properties of such cells.”

So a decade later, where are we and what have we learned. I would say three things.

1. There is a great deal about human biology and physiology that we still do not know.

2. Addressing complexity with clarity requires critical thinking, super-human determination, and basic science insights.

3. Mixing politics and science – as we saw occur in the past decade, led by Washington but reinforced by timid voices in both academia and corporate America – not only slows progress but undermines hope and confidence in our Society and her leaders.

We can not afford to either go backward or ignore our recent past experience. Science must stand on its own two feet. Our citizens deserve nothing less.

For Health Commentary, I’m Mike Magee.

References:

1. Wilson J. Gene Therapy Researcher Warns Stem Cell Scientists Not To Repeat His Fields Mistakes. Nature. May 7, 2009. http://www.nature.com/news/2009/090507/full/news.2009.455.html

2. Magee M. The Importance of Stem Cell Policy. Health Politics. October 27, 2004. http://web.me.com/drmikemagee/Site/HealthPolitics_Archive/Entries/2004/10/27_The_Importance_of_Stem_Cell_Policy.html

3. Snyder EY, Teng YD. Stem Cells and Spinal Cord Repair. NEJM 366;20. May 17, 2012. http://www.nejm.org/doi/full/10.1056/NEJMcibr1200138

Comments

2 Responses to “How Will The 2012 Election Affect Scientific Progress And Leadership In America?”

Thomas Noonan
May 22nd, 2012 @ 3:43 pm

I found this article to be a disappointment. Although it was very informative about stem cell research and how a politician’s bias was able to inhibit scientific progress, it never answered the question in the title. The issue is the 2012 election. I was hoping for a distinction between the two candidates and never got it.
tyler
June 13th, 2012 @ 2:14 pm

it is amazing how a politician’s bias was able to inhibit scientific progress on stem cell research. Mixing politics and science does undermine confidence in our society and slow progress in science. his is very distressing as technology is affording us the ability to push science like never before, yet political agendas and opinions can keep it from progressing at the rate that it has the potential to.