A FUTURE VISION

STEM CELLS are cells that are at an early stage of development and have the ability to turn into almost any other type of cell in the body. There are embryonic stem cells, which are derived from embryos, and adult stem cells, which can be found in some adult tissue, such as bone marrow.

By developing these cells, scientists hope they can produce a form of repair kit for the human body and reverse the effects of chronic diseases that doctors cannot cure today.

As yet, none of the very many potential treatments is ready for use in patients. However, Professor Sir Graeme Catto, chairman of the Scottish Stem Cell Network, has previously said that Scotland is at the “leading edge” in the field of stem cell research. A belief has always existed that the country should be ready to invest should a breakthrough occur.

LIVER

Scientists based at Edinburgh University have generated human liver cells from embryonic stem cells. It is ultimately hoped they could be used to treat patients with liver disease, sparing patients a potentially vital wait for a liver transplant. Liver disease is ranked as the fifth most common cause of death in the UK and its incidence is known to be rising.

However, while scientists and researchers are investigating how such generated liver cells could or might be used in treatment, there is another field where they could revolutionise medicine sooner.

… “STEM CELLS are cells that are at an early stage of development and have the ability to turn into almost any other type of cell in the body.”

Pure liver cells grown in a laboratory could be used to test drugs for potentially harmful side-effects before they are trialled in patients. Problems in the liver serve as a warning sign when a substance is toxic. Currently, livers left by donors which are not of a good enough quality for transplants are used to test new drugs, but supply of these is restricted. Typically, though, an unlimited stash of liver cells could improve the way new drugs for treating the liver and other organs are tested.

BONE

Radical new ways of mending bones and cartilage using a patient’s own stem cells are also being explored.

This line of work could have a major impact on treating conditions such as osteoarthritis (sometimes known as ‘wear and tear arthritis’) as well as accident victims whose bones have been shattered.

At Edinburgh University scientists are looking to culture bone-forming cells by taking stem cells from the patient’s own bone marrow or even from their blood.

They hope, in time, to be able to place these in the affected area by using a special mesh, coated with a drug that aims to protect and stimulate their growth into the bone or cartilage needed to repair the damage.

Previously, the team involved with this work were awarded £1.4 million in government grants and subsidies to develop and advance the technique. At the time the team said it intended testing in hospitals within two years.

In addition, Aberdeen University is also looking to utilise adult stem cells in aiding the recovery of joints. Researchers have been successful in isolating adult stem cells from joint membranes in patients as old as 101. Already, scientists in Aberdeen have managed to grow these cells into tissue in the laboratory and in animal models. They seek in being able to implant tissue or inject the cells into patients, and are also investigating whether drugs could be given to people with joint problems to stimulate the cells already present to solve the problem themselves. The immediate hope is that treatments could prevent people with lesions in their joints from developing osteoarthritis. These patients are often known to be young sports enthusiasts.

HEART

Clinicians and scientific researchers at Glasgow University are working to make heart muscle and blood vessel cells for repairing the circulatory system.

Such cells are being developed from embryonic stem cells and then assessed to see how well they function. For example, does the cultured heart muscle tissue beat as effectively as that which works automatically from birth?

BLOOD

Patients needing bone marrow transplants or blood transfusions could eventually be treated with blood stem cells grown in a laboratory.

Scientists and medical researchers at Edinburgh University have been able to multiply blood stem cells taken from mice and other rodents 150 times in the lab. They ultimately hope human blood cells for transplant could be produced in a similar way as is being used to treat patients with cancers such as leukaemia and lymphoma, genetic blood diseases and patients who have lost a lot of blood through injury. This could reduce pressure on blood donor supplies.

Meanwhile, colleagues at Glasgow University are attempting to generate blood by using embryonic stem cells to make red blood cells. If they succeed in creating large quantities it could also help preserve donor blood reserves. Researchers hope to start early clinical tests within the next year or so.

DIABETES

Using stem cells to help patients with diabetes produce insulin is an area of research being explored around the world.

In Aberdeen, though, scientists are currently trying to understand which stem cells give rise to insulin-producing cells in the pancreas. By knowing this, they hope to throw light on how diabetes can be tackled using stem cell technology.

NERVES

Treatment to reverse the effects of the neurological condition multiple sclerosis are being explored at the MS research centre set-up using a very kind donation from JK Rowling (the author of Harry Potter). In MS myelin, the sheath that protects nerve fibres becomes damaged causing the transfer of neurological messages from the brain to be disrupted.

At the moment doctors can offer patients little to reverse the growing damage so most sufferers become increasingly debilitated.

Earlier, Professor Charles ffrench-Constant, director of the Edinburgh-based centre, said he wanted to find a way to make the body rebuild damaged myelin using stem cells and biotechnology.

Ostensibly, there are a surprisingly high number of stem cells in the brain and his centre hopes to recruit them in an attempt to repair the myelin.

Professor ffrench-Constant said that he envisages patients receiving drugs to activate the process in 10 to 15 years.

CANCER

There is a relatively new theory that cancers themselves grow out of a specific population of cancer stem cells. If these could be identified, there is hope doctors could stop cancers from even developing in the first place.

A team at Dundee University are investigating the possibility that some forms of colon cancer develop from malfunctioning stem cells in the gut. Studying gut stem cells in normal and cancerous conditions may tell us how the disease might be treated.

IN PRAISE OF ADVANCING SCIENTIFIC RESEARCH IN SCOTLAND

Scientists in Scotland are at the leading edge of stem-cell-research. Potentially, it could change the course of medicine.

We could be on the brink of discoveries that would allow far more effective treatments of conditions such as leukaemia, shattered bones, colon cancer, neurological conditions such as MS or the growing epidemic of diabetes.

The promise of life-saving and life-enhancing treatment for millions of people as a result of such breakthroughs, however, is posing a challenge almost as taxing as the scientific ones: how to ensure the researchers involved are not tapped by other academic institutions or commercial companies who may be able to offer far higher salaries and profit sharing schemes. Poaching certain individuals could stifle or even set-back promising initiatives once started.

Much of the research does remain theoretical. The dangers, though, are all too real. Edinburgh University, for instance, has already lost Professor Austin Smith, “the father of stem-cell research”, who was invited to set-up a new centre in Cambridge. The prospect of a team heading south in his wake was averted only by joint action by the then Scottish Executive and the combined research universities.

It is an inevitable fact that world-class scientists will be head-hunted by leading research institutions and global companies who have vast swaying power in terms of salaries offered. They can not only offer attractive salaries and inducement schemes but modern state-of-the-art research facilities, which, arguably, is what will swing the balance for scientists at such a level.

THE SUGGESTION from Sir Graeme Catto, president of the General Medical Council and a former chief scientist for Scotland, that a fund to prevent researchers being poached as soon as they make a breakthrough deserves to be thoroughly explored. One of the ways to ensure that the best scientists remain in Scotland is to establish a critical mass of genuine expertise. A vital beginning has been made with the Translational Medicine Research Collaboration, between the universities of Aberdeen, Dundee, Edinburgh and Glasgow, with Scottish Enterprise and the NHS in Scotland.

Translational medicine emboldens the desire in treating disease from laboratory findings, or, put simply, from ‘bench to bedside’. The essence of that concept must be encouraged if Scotland’s increasing number of biotech companies is to realise their full economic potential: already, major pharmaceutical companies, such as Wyeth, recognise the point. Recently, for instance, the company bought over Haptogen, a company established to prevent scientists at Aberdeen University being induced into the drain of scientific expertise from Scotland to Cambridge and London. Such commercial collaboration can help resist, or prevent, an exodus.

International academic exchanges can also help. Exchanges such as those established between Dundee and Singapore by Sir David Lane, the world-renowned expert who discovered one of the prominent genes behind cancer. The vital work of our scientists, at home, must be nurtured. But, with Government funding more tightly stretched than ever before, Sir Graeme’s plea to benefactors was a timely one. With continued uncertainty in the world’s financial and capital markets, a new investment perspective within medical research will produce no other satisfying results more than that to which leads to a cure for a disease.

Notes:

1. To date, scientists in Scotland have registered five stem-cell lines with the UK stem-cell bank. There are around 45 registrations in the bank and not all come from within the UK.
2. Sir Graeme predicts that over the next decade there will be sudden advances which make the prospects of treatment more tangible.
3. The ‘quick access cash pool’ which could start at around £250,000 need not be provided purely by the Scottish Government, but also from “benefactors”.
4. None of the potential treatments are available today and would need rigorous testing before being licensed for human use.
5. Scottish Enterprise funds the Scottish Stem Cell Network: in 2007 it launched a £5m Stem Cells Translational Fund.
6. In providing public funding for research there is a difficult balance to be struck between the need to ensure best use of funds, which is necessarily time consuming, and the pace of research.