FAITH IN REGENERATION

In a week-long diary on science in the Bay Area, a science correspondent for The Economist reports from the front lines of embryonic stem-cell research ...

From ECONOMIST.COM

It is a classic San Francisco morning. The downtown skyline is shrouded in a blanket of fog. By noon the sun has finally burned its way through, but the fog will likely roll back in with the cool evening breeze. It’s a bit like scientific progress, actually—an endless ebb and flow from haziness to clarity and back again.

Today I’m downtown to cover a town hall meeting hosted by the California Institute for Regenerative Medicine (CIRM). From the subway I head to one of the Palace Hotel’s elegant chandeliered ballrooms. It holds around 300, and eventually fills to standing capacity.

Though it seems like a euphemism, “regenerative medicine” does not refer to plastic surgery (that is, dare I say, an Angeleno rather than a San Franciscan pastime). From its office in San Francisco’s Mission Bay, CIRM oversees California’s $3 billion investment in stem-cell research.

In November 2004, California voters passed Proposition 71, a ballot measure allowing the state to fund research into human embryonic stem cells. Overnight, California became one of the largest backers of stem-cell research in the world. At a time when the federal government was unwilling to invest in regenerative medicine, the message from the state’s voters was clear: the incredible therapeutic promise of stem cells outweighs the moral objections to using them.

That therapeutic promise, the meeting’s three panellists explain to us, comes from stem cells’ chameleon-like ability to turn into any of the cells that make up the body’s tissues and organs. Most cells are tailored to perform a particular function. Heart cells are good at beating, neurons transmit electrical signals and pancreatic islet cells produce insulin. While they all contain the full set of instructions of the human genome, each uses only the small subset that directs its particular task.

A stem cell, on the other hand, is a cellular jack-of-all-trades. Given the right signals, it can become a brand new heart cell or neuron or insulin-producing cell. Bruce Conklin, a professor at the University of California, San Francisco and the second speaker of the evening, plays us a dramatic video of 2,000 human heart cells that had been derived from embryonic stem cells. Sitting in their Petri dish, they wriggle and beat, just like a human heart.

Embryonic stem cells were first isolated in 1998, and since then the pace of progress has been furious. Much work has gone into figuring out how to reliably and efficiently generate the different cell types that doctors would like to use in patients. In addition, as the speakers emphasise, understanding exactly when and how implanted stem cells can go awry and cause tumours remains an essential research task that confronts all potential therapies.

Such therapies are slowly, but surely, making their way towards the clinic. In January, Geron, a biotechnology giant, got FDA approval to conduct the first clinical trial testing the safety of an embryonic stem cell therapy. It will work with patients with severe spinal cord injuries. For its part, CIRM is hoping to get ten to 12 human stem cell trials going in the next four years. In December, it will award $20m to researchers and their corporate partners with that goal in mind.

After the speakers finish their presentations, the moderator opens the floor to questions from the audience. From the front row, a young girl raises her hand. In a high-pitched, slightly faltering voice, she asks a deeply personal question: “I was burned very badly in August 2008. How might this help me, and how can I help in your research?”

After the dry PowerPoints and data-filled charts, the scientists seem slightly taken aback by the raw emotion. They stammer through some answers, but none seems satisfying. Despite stem cells’ promise, the science just isn’t quite there yet. This moment brings home both the deep hopes and the urgent desperation that surround what are undoubtedly the early days of regenerative medicine.

Picture credit: jurvetson, Sarah G... (both via Flickr)

(This is part of a week-long correspondent's diary about Bay Area science, published on Economist.com.)