India embraces stem cell research
By Indrajit Basu
KOLKATA - Ajit Jogi, a member of the
Indian parliament and a former chief minister of
an Indian state, almost lost his life in a motor
vehicle accident while traveling at night during
an election in April 2004. He survived due to
prompt medical attention, but was left paralyzed
to the extent even breathing was an ordeal.
But Delhi-based Dr Geeta Shroff's
"revolutionary stem cell therapy" caught the
attention of his family. He has been conducting
embryonic stem cell-based treatment and research
since 2000. Jogi, 59, called the treatment
"remarkable" to the
point
he was thinking of returning to politics and
joining Prime Minister Manmohan Singh's
government.
"My organs made dramatic
improvement after I received Dr Shroff's
treatment. I am almost normal," he said in an
interview prior to suffering a heart attack
November 23 that left him in serious condition.
"This cutting-edge tool [stem cell
treatment] of medical science has the potential to
put India on the global map as a major contributor
in the field of stem cell therapy," Shroff said.
She raised a furor in the global stem cell
research fraternity last week when she claimed she
has beaten the world in treating incurable
diseases with stem cells harvested from human
embryos.
Shroff, however, wasn't the first
to create a sensation in the world of stem cell
research. About three years ago, India first made
waves in the international arena when LV Prasad
Eye Institute, a Hyderabad-based eye-care and
research institute, announced it had pioneered the
use of adult stem cells in the treatment of human
eye diseases. It claimed it had invented a new
technique that successfully harvests (Limbal) stem
cells to fight sight deficiency caused by the
inability of the eye to repair the cornea, which
was considered untreatable until then.
Also, other prominent institutions such as
the National Center for Cell Science and Ruby Hall
Medical Research Center - both in Pune - and the
Indian Institute of Science in Bangalore as well
as the Asian Heart Institute and Research Center
and the Maulana Azad Medical College - both in
Delhi - are among about 15 organizations working
on stem cell projects. They are using both adult
and embryonic stem cells as well as more readily
available sources such as bone marrow, peripheral
blood and umbilical cord blood cells to hunt out
possible cures for many incurable diseases.
"India could be one of the forerunners of
stem cell research," Shroff said.
Though
ethical and governmental barriers impede stem cell
research in Western countries (where Christianity
is dominant) - particularly involving embryonic
stem cells - experts say such barriers are a boon
for countries such as India, which have a large
pool of scientific talent and do not face such
opposition.
Despite some early evidence
stem cell treatment may be able to cure ailments
such as diabetes, renal failure, paralysis,
Parkinson's, heart diseases and cancer, research
involving embryonic stem cells has been highly
controversial in many developed countries, and
most notably in the US.
Stem cells are
non-specialized generic cells that can
indefinitely make exact copies of themselves and
have the capacity to turn into any specialized
cells in the body - such in muscle cell, red blood
or the brain. In other words, stem cells have the
ability to generate brand new cells that may
replace diseased or body tissue organs.
It
is this capability of stem cell that has triggered
enormous medical interest globally. There are two
types of stem cells: adult - examples include stem
cells isolated from bone marrow, and embryonic -
stem cells isolated from a four- or five-day-old
human embryo. The adult stem cells have the
potential to regenerate with two core functions -
to maintain the cell population by replacing
worn-out cells and to repair tissues or organs.
However, their scope is limited as they are
location-specific. This means that stem cells
obtained from bone marrow, for instance, can only
give rise to blood cells and thus treat
blood-related disorders but cannot be used to
treat, say, spinal cord injuries or heart disease.
Embryonic stem cells on the other hand, are
undifferentiated and can develop into any adult
cell. However, embryonic stem cells also pose a
big challenge: scientists say they have been
unable to "tame" such cells yet, which means that
they have been unable to reliably guide embryonic
stem cells to differentiate into the desired
tissue in a controlled manner.
"The
biggest risk that embryonic stem cell treatment
poses as a result is that of teratomas - tumors -
and antigen-antibody reactions," said Dr Satish
Totey, stem cell research director at Manipal
Hospital, Bangalore.
There's another
problem. In Western countries, the main objection
to stem cell research has been raised by the
church, which is against abortion. According to
the staunchest critics, which include US President
George W Bush, stem cells are mostly derived from
embryos that have the potential to create life,
hence any research involving such stem cells is
akin to murder. There is also a fear that
embryonic stem cell research can lead to
unfettered termination of pregnancies. As a result
of these views, research has been slow, especially
in the area of embryonic stem cells globally.
A big reason why stem cell research
flourishes in India is the absence of any
religious or political opposition. The Hindu
religion does not consider experimenting with
human embryos developed by way of in vitro
fertilization of human eggs (that creates
test-tube babies) immoral, and "India in fact has
an MTP [Medical Termination of Pregnancy] Act that
allows [abortion] within 20 weeks of conception,"
Shroff said.
Experts also argue that since
stem cell research can alleviate human suffering
it cannot be considered unethical. "India's
population is growing rapidly and so are disease
conditions," Totey said. "Soon India will have the
world's largest [population of] diabetic patients;
heart patients ... Parkinson's disease is also
increasing rapidly. Stem cell research emerges as
a necessity then for the country."
However, concerns are being raised by the
possibility that the lack of formal guidelines and
"constructive opposition" regarding stem cell
research in India may leave Indian doctors
virtually free to conduct stem cell research
without following established scientific
principles and medical ethics. Shroff's latest
claims, for instance, have evoked sharp reactions
in the global medical community because "she has
failed to provide evidence for scientific
scrutiny."
Criticizing Shroff's "new" stem
cell therapy, The Indian Council of Medical
Research, the medical body that regulates medical
research, said, "In India, embryonic stem cell
research is allowed but ethically it should be
peer reviewed for scientific content for the
safety and protection of research participants. Dr
Shroff submitted a list of diseases treated along
with patient's health status but these lacked
technical details."
Shroff, however, said
her method is proprietary and she has subsequently
submitted information about patients' case
histories and clinical investigations, along with
informed consent, to the Indian Council of Medical
Research though the ICMR said, "These were few and
far between."
Still, even as this
controversy rages, the unanimous feeling is that
India is well positioned to emerge as a
significant player in the global stem cell
research area.
"India's biggest plus is
its genetically diverse population [which] is so
important for embryonic stem cell lines," Totey
said. "Additionally, with its vibrant
pharmaceutical and biotechnological companies, a
large pool of scientific talent and a mature
information technology industry, the country can
boast of a [big] platform for research and its
clinical application which no other country has."
Indrajit Basu is a Kolkata-based
equity-analyst-turned-journalist with more than 12
years of experience in business/finance and
technology journalism. Besides writing for Asia
Times Online, he also writes for US-based
publications, as well as IT companies.
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