Western Australia may be the only state in Australia to have crushed the chances of scientists here using therapeutic cloning to cure hitherto incurable diseases but could the decision prove a global turning point?
Ethicist Dr Stephan Millett of Curtin University of Technology thinks so.
Dr Millett, who is the chair of the Human Research Ethics Committee, says the Upper House’s rejection of embryonic stem cell cloning is a reflection of a rapidly changing landscape where laws struggle to keep up with scientific advances.
“I think the Legislative Council thought very deeply about the issue, exercised moral caution and were probably swayed in the end by the possibility of embryonic stem cells being found or created from other sources,” he says.
He believes the debate was irrevocably altered last year when Professor Shinya Yamanaka of Kyoto University managed to turn adult skin cells into induced pluripotent stem cells – which, like embryonic stem cells, can be grown and encouraged to make healthy replacement cells for any tissue in the body.
Professor Yamanaka’s technique has since been replicated successfully by other research groups.
“The WA decision is really a sort of test case, post-Yamanaka,” says Dr Millet, director of Curtin’s Centre for Applied Ethics and Philosophy.
“The whole debate has changed, and it’s changed dramatically since the Yamanaka discovery because, while both his method and therapeutic cloning technologies have their problems, the advantage of the Yamanaka method is that you get 100 per cent of the donor’s own DNA and, of course, collecting skin cells involves minimum invasiveness and trauma. Most importantly, it is far less morally problematic than creating an embryo with the sole purpose of destroying it.”
Embryonic stem cells – which, in nature, appear for just a short time in new embryos – offer tantalising promise for the treatment of debilitating diseases such as Alzheimer’s, Parkinson’s, type 1 diabetes and motor neurone disease, as well as spinal cord injuries, because of their unique ability to be transformed into any human tissue.
Adults, too, make stem cells – five million a second, in the case of our blood stem cells – but they are normally dedicated to making cells for a single particular tissue.
In therapeutic cloning, or somatic cell nuclear transfer, the genetic material of an unfertilised human egg is removed and replaced with DNA from the cell of an ill or injured adult, then grown into an embryo. Stem cells are then harvested from the embryo, destroying the embryo itself, and transplanted into the adult.
Despite the moral debate, there is scientific consensus that it could be many years – even decades – before stem cell therapies are a safe, effective and affordable means of treating patients.
“One of the arguments against therapeutic cloning is that the research has a low likelihood of a short- to medium-term outcome,” Dr Millett says. “So we have to ask ourselves, what is the opportunity cost of funding this research? By spending millions on embryonic stem cell research, what other important science is missing out? Are there better things to spend our money on?
“The largest medical research institutions in the world are switching a lot of research away from embryonic stem cells to adult stem cells. Adult stem cell science is much further down the track and it certainly doesn’t have all the ethical objections.”
Leading Perth neuroscientist Professor Alan Harvey of the University of Western Australia agrees that embryonic stem cell science needs to be much more robust before it can be green lighted as a matter of course.
“There is a great deal we don’t understand about embryonic stem cells, about what drives their differentiation, what will happen to them after transplantation,” he says.
Professor Harvey, former chair of the scientific advisory committee for WA’s Reproductive Technology Council, points out that no current WA research will be jeopardised by the Upper House decision.
“I am unaware of any ongoing research that will be stopped in this state as a result of this, although the decision may affect future research planning,” he says.
“My own view is that funding for all types of biomedical research must continue, but when it comes to stem cells, there’s a lot more we need to look at. Many of us in neuroscience feel that embryonic stem cells will almost certainly not be the only way of fixing neurological problems.
“In the case of diseases such as Alzheimer’s, unless we understand why cells are dying and circuits are becoming disrupted, any transplanted cells may be subject to the same degenerative processes. Some neurological conditions may have an auto-immune component and, if there is, cloned cells may turn out to be the wrong cells to transplant unless previously manipulated in some way. Transplantation really is a last resort. In my view, earlier diagnosis and prevention of further degeneration is the optimal strategy.”
He points out that his colleague Dr Giles Plant is performing world-leading neuroscience using adult bone marrow stem cells as a potential regenerator for damaged spinal cords.
Renowned Alzheimer’s researcher Professor Ralph Martins from Edith Cowan University believes that while stem cell therapies will not be the answer for Alzheimer’s, they could offer great hope for treatment of other neurodegenerative conditions.
“In Alzheimer’s it’s early days because we have to determine the underlying cause of the degeneration before we look at transplanting cells. But Parkinson’s disease is different because the disease is more localised in the brain. I believe this decision could have a dramatic impact on Parkinson’s research here because scientists were starting to do this kind of research and they will be the first group to be affected (by the ban).”
Dr Millett, however, is taking an optimistic approach. “This could be the turning point for stem cell science here. It is entirely feasible that the (Upper House) decision could lead to WA becoming one of the world centres of research into alternatives to embryonic stem cell research.”
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