After 5-Year Wait, Scientists Are Set to Resume Research on Fetal Cells : Medicine: Clinton’s lifting of ban paves way for experiments on means to combat Parkinson’s disease, other maladies.
Dr. Edward Oldfield remembers the fall weekend in 1987 when he and Dr. Robert Plunkett, a fellow neurosurgeon at the National Institutes of Health, were preparing to take a historic step--performing the world’s first fetal-cell transplant on a patient suffering from Parkinson’s disease.
Instead, less than 48 hours before the scheduled brain surgery on a middle-aged patient, the operation was canceled as a five-year moratorium began on federal aid for fetal-tissue research.
Now, following President Clinton’s order Friday lifting the ban, which had been imposed by the Ronald Reagan and George Bush administrations, Oldfield and scores of other scientists across the country are hurrying to pick up where they left off with research they believe promises important benefits in a range of fields.
“As far as I’m concerned our proposal is still alive,” Oldfield said. “We’re just waiting for the green light.”
The “real loss here was to that group of patients who might have been treated in the years in between,” he said.
Opposition to the research was based on the contention that it encouraged abortion. The ban provoked an intense national debate that pitted medical researchers and disease organizations against abortion foes.
Parkinson’s, a neurological malady that currently afflicts an estimated 500,000 Americans, is the disease for which fetal cell research has shown the greatest promise. But researchers predict significant benefits can also be made in diabetes and other diseases now that the restrictions have been removed.
Many medical experts also believe that the significance of Clinton’s decision goes beyond simply making federal money available for fetal tissue research. They say that it also could create a climate in which that research is more generally accepted and send a signal about the limits of political intrusion into scientific pursuits.
“We’ve opened the door,” said Richard Fuller, a spokesman for the American Federation for Clinical Research. “Researchers who previously felt uncomfortable about doing the work will feel they now have a green light.
“And even more importantly, we face political interference in the scientific process every single day,” he said. “I don’t think it will ever be over. But President Clinton certainly has made it easier.”
Dr. Eugene Redmond Jr., program director for the Yale University neural transplant program, said that “there have been major private foundations and drug companies that otherwise would have supported this research, but wouldn’t because of the moratorium.”
“One drug company, in fact, gave us some drugs,” to use in conjunction with transplantation surgery, “but only under the condition that we didn’t identify them,” said Redmond, whose team has performed 13 fetal transplants into Parkinson’s patients using private funds.
Also, because the NIH grants are for multi-year periods, researchers will have more security than they did with private funds, which usually are made available on a year-to-year basis.
“What we’re hoping to do now is get longer-term footing for our program,” said Redmond, who was feverishly working Monday to finish his grant proposal. “For the last several years, you never really knew where the money was coming from or when it might stop. Now, if you get a multi-year NIH grant, you know the money will be there.”
Dr. Curt Freed of the University of Colorado Health Sciences Center, where 12 such surgeries have been performed with private funds, wants to be among the first to apply for federal money.
“We have a grant proposal ready to go and intend to submit it Feb. 1,” Freed said. He and his colleagues are “delighted to see this change in the atmosphere of research” because “we feel we’ve got something real here.”
Scientists working on fetal tissue research hope that transplanted fetal cells can take over the functions of cells in the body that have been damaged or destroyed. Fetal tissue is much more desirable than adult tissue because it grows more easily and rapidly when implanted and because it is less likely to be rejected by the body’s immune system.
Parkinson’s results when an area of the brain called the substantia nigra is damaged or destroyed. Cells in that part of the brain are responsible for manufacturing and secreting dopamine, a chemical needed by nerve cells to control muscle movement. A shortage of dopamine causes the tremors and muscle rigidity that are characteristic of the disease.
Although fetal transplant work on Parkinson’s is still in an early phase, it is the disease where the greatest strides have been made thus far. But researchers predict that with the restrictions lifted, significant advances also are likely in other diseases, such as diabetes, Alzheimer’s, Huntington’s and spinal cord injuries.
With diabetes, which affects more than 1 million Americans, federal funding for U.S. researchers was limited to using transplants obtained from cadavers at the time of death. U.S. researchers have performed 109 such transplants, with mixed results.
Type I diabetes, also known as insulin-dependent diabetes, is caused by the death of insulin-producing cells, called islets of Langerhans, in the pancreas. When these cells die, the body is unable to regulate the use and storage of sugars from the diet.
Outside this country, however, 221 fetal islet transplants had been performed as of mid-November, most of them in China, Russia and Australia. Only a handful of such transplants have been performed in the United States. The results are still under evaluation.
“Fetal islet research in the United States is really behind,” said Dr. Daniel H. Mintz, an islet transplant surgeon at the University of Miami School of Medicine.
“I think that those groups who worked in this area will now have a new impetus to follow through on leads” developed before the moratorium, Mintz said. “There will be a resurrection of a lot of work on fetal cell transplants.”
UCLA researchers are also expected to move now that the ban has been rescinded. Drs. Charles Brunicardi and Yoko Mullen performed three transplantations last year using adult cells. This year, they plan to perform five transplantations using both adult and fetal islets.
“We think the fetal cells will grow over time, whereas we don’t think the (adult) islets grow,” Brunicardi said. “The patients will get immediate benefits from the adult islets, and the fetal cells will grow to help out.”
