Should the fight against bogus stem cell therapies be turned back to the lab?
by Lisa Willemse
This morning's news scan turned up yet another sad tale about the dangers of unproven stem cell therapies and a warning to consumers to once again be skeptical of the claims made by the many unscrupulous clinics operating abroad. For the most part, the article echoes repeated calls made on this blog and numerous other sources, including the ISSCR's Closer Look at Stem Cells, to draw more attention to the issue of "stem cell tourism" in hopes of reducing the numbers of patients paying for such potentially harmful treatments.
Interestingly, I also had an email in my inbox today that contained a recently published paper in EMBO reports that addresses the same topic, albeit in a very different fashion. The authors of the paper, Zubin Master and David Resnik, argue that stem cell scientists could do more to curb stem cell tourism in the face of the questionable success gained from such public education initiatives such as Closer Look at Stem Cells. In fact, the authors suggest that in the case of stem cell tourism, a successful strategy requires the active involvement of scientists.
Scientists are uniquely positioned to help quell stem cell tourism because of their knowledge and control over stem cell materials. We propose that scientists could use existing contracts called MTAs (material transfer agreements) to share materials and reagents only with responsible scientists. This would require researchers to evaluate the requestor’s CV, supplementary documentation, a clinical protocol, and website before providing reagents such as stem cell lines, nucleic acid sequences, growth factor enriched cocktails, or purified proteins to others. Those requesting materials would have to sign an MTA, which would outline the intended purposes of the materials. For example, MTAs for sharing stem cells that are not clinical grade or are not being used to develop clinical grade cells should stipulate that the cells are to be used for non-clinical research purposes only.
Although our proposal places limits on scientific openness and sharing, we believe it is necessary to have such restrictions in this situation in order to prevent greater harms—potentially worsening the condition of patients who receive fake treatments and the possibility of reducing public trust and undermining legitimate stem cell research. Our proposal also adds additional time and resource burdens to stem cell researchers, but again, this is a necessary inconvenience to stop the growing illegitimate stem cell industry. There is also concern that MTAs themselves will be ineffective, says Robin Lovell-Badge, a renowned stem cell scientist at the MRC National Institute for Medical Research in London. His contention is that rogue clinics can themselves derive embryonic stem cells from embryos, create induced pluripotent stem cells from patients, or simply not transfer anything into a patient, providing nothing more than a placebo (Robin Lovell-Badge, EuroStemCell, 2011). These are definitely valid concerns and we agree that MTAs, by themselves, will not stop stem cell tourism. But if they can deter some irresponsible stem cell therapy and research, why not use them? As with education and international policies, control of materials is simply one strategy in the scientist’s arsenal that can help mitigate the use of bogus stem cell remedies.
The problem of stem cell tourism raises a host of questions, not the least of which is who should take up the fight? Is it the scientists? Advocacy groups? Governments? Up till now, a simple, single source solution has not emerged. Master and Resnik may not earn any popularity points among over-stretched scientists for their suggestion, but if a more coordinated effort is required, then scientists have an important role to play.