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November 2003

Back to Immortality
The Opportunities and Challenges of Therapeutic Cloning
Michael D. West, Ph.D.

Embryonic Stem Cells
In the following years and through the hard work of collaborators such as Jamie Thomson of the University of Wisconsin at Madison and John Gearhart at Johns Hopkins School of Medicine, the cells were finally isolated. Called human embryonic stem cells because they come from human pre-implantation embryos (microscopic balls of cells that have not yet begun to develop and attach to the uterus to begin pregnancies), these cells have fulfilled their promise in displaying the awesome power of making any cell type in the human body. And as we hoped, they made young cells that could theoretically be used to repair or replace aged or diseased cells and tissues.

President George W. Bush addressed the American people on August 9, 2001, to describe his policy relating to human embryonic stem cell research. He suggested that all federal funding be limited to the number of cell lines that had been isolated as of that date. He expressed his moral concerns about further efforts to isolate the cells, stating his religious belief that the entities from which the cells were derived were not in fact simply a clump of unformed cells, but instead were in fact very small people.

There are several problems with the President’s position. The practical one is that even if federal funding led to our ability to efficiently manufacture some cells of great therapeutic value, they would not be available to you—that is, the body would in most cases reject the transplanted cells as being a foreign invader. The miracle in the laboratory could not easily lead to a comparable miracle in the hospital bed.

Therapeutic Cloning
And so in 1999, my colleagues and I proposed a controversial solution. We argued that the procedure called nuclear trans-fer—the transfer of a somatic cell into an enucleated egg cell—not only could produce embryos that when transferred into a uterus could produce a clone, but could also be harnessed to make embryonic stem cells as well. Such cells would be essentially identical to the patient’s cells. This could potentially solve the remaining problem of histocompatibility by creating human embryonic stem cells and then any cell in the body, all of which should never be rejected by the patient.

The use of somatic cell nuclear transfer for the purposes of reversing time’s arrow on a patient’s cells has been designated therapeutic cloning. This terminology is used to differentiate this clinical indication from the use of nuclear transfer for the cloning of a child, which in turn is often designated reproductive cloning.

Since the debate over thera-peutic cloning began, the power of the technique has become increasingly impressive. In April 2000, my colleagues and I reported evidence that the egg cell could act as a “cellular time machine,” not only reversing the arrow on differentiation (that is, not only converting a body cell like a skin cell into an embryonic stem cell), but also doing the unimaginable, returning the aged body cell to immortality and rewinding the clock of cellular aging as well. These results, now reported for multiple mammalian species, suggest that we may have the potential to reverse the aging of human cells in the same manner.

This would mean that we could make young cells of any kind for a patient of any age. While this “time machine” is expected only to be big enough to take on a single cell, the resulting regenerated cells could theoretically be expanded and turned into cells that repopulate our blood with young immune cells, or cells that can re-seed our blood vessels with fresh young cells, or indeed young cells of any kind to treat a vast array of currently untreatable diseases.

Heated Controversy
Despite the good intentions of researchers in this emerging field of regenerative medicine, these technologies have been at the center of one of the most heated controversies in the history of science. The raging controversy over embryonic stem cells and cloning has deeply divided our nation, and the stem cells’ profound implications for battling the manifestations of age-related degenerative disease have raised concerns that mankind may be meddling in technologies that will anger the gods themselves.

In the face of lives molded and bounded by death, we are forced to choose our own position on these new technologies. In the summer of 1999, as I stood with my mother in a small hospital room, I knew my position in the debate. I would do anything to save the life of my mother—anything, that is, short of harming an actual human being.

And I had strong reasons to believe that therapeutic cloning would not have to create an individualized human being, even at the earliest states of development. I would risk my life, my finances, my reputation; I would give anything to help her.

Dr. Michael D. West (pictured above) is CEO of Advanced Cell Technology. In 1990 he founded Geron, the first prominent biotech-nology company to focus on human aging, where he served as a director and vice president until 1998.

Death Is the Enemy
My mother’s pulse continued its downward glide—90, 80, 20, 10, 8… I thought to myself, her heart was solid, I would never have worried that she would have died of heart failure. I saw in my mind the swelling imbalance in blood chemistry, the millions of cells in her body screaming for help, her precious mind being turned to chaos by anoxia. Finally her heart cells—facing, for the first time since the origin of life on earth, the abyss of death—gave up their valiant defense of life and fell into chaos and arrhythmia. They had accomplished their appointed goal; they had successfully passed on their genome into a son. Minutes passed. As successful as my mother’s life might have been in completing the job of reproduction, I found the strategy of the life cycle completely unacceptable. I stood there, hating death.

I walked to my car later that night, wandering aimlessly into the darkness. I had no itinerary, no plane reservations; I felt like driving randomly into the night. I looked overhead in that warm summer sky and stared at a bright but waning moon and I recognized its significance. The moon has for millennia been a source of encouragement to mankind facing the bleak realities of death and of loss. In 14 days, it is cut into pieces like the death of Osiris, but it always regenerates in an eternal fugue.

In the years to come, science and medicine will deliver on the promise of regenerative medicine. It is inevitable that the immortal cell, which can do so much to alleviate human suffering, will find its way to the hospital bed. But when these new therapies are available for our loved ones entirely depends on how we as a society grapple with these important issues.

The United States has a proud history of leading the world in boldly exploring new tech-nologies. We did not hesitate to apply our best minds in an effort to enable a man to walk on the moon. We were not paralyzed by the fear that we would anger the gods by reaching for the heavens. But a far greater challenge stands before us now. We have been given two talents of gold. The first, the root of immortal human life, is the human embryonic stem cell. The second is nuclear transfer technology. Shall we, like the good steward of the Bible, take these gifts to mankind and courageously use them to the best of our abilities to alleviate the suffering of our fellow human beings, or will we fail most miserably and bury these gifts in the earth?

I am confident that the United States, which historically has led the way in advancing technology, will find the courage to lead in regenerative medicine as well. I only hope we will do so quickly; time is not on our side.