Fetal Tissue Research Uncertainties Foster Confusion Among Many Bioscience Workers

The United States government's four-year ban on federal financing for human fetal tissue transplantation research directly affects only those scientists who would transplant fetal tissue from induced abortions into human patients. But both the ban and the controversy and confusion surrounding it also affect the working lives of other U.S. scientists with an interest in tissue repair and transplantation, researchers say. Thousands of investigators worldwide-a large proportion of whom are from the U.S.-have a primary research interest in tissue transplantation and cellular replacement, according to observers of the field. A meeting on neural tissue transplantation this summer in Washington, D.C., drew 1,000 abstracts, meeting organizers say. Over the past 20 years, research teams at medical schools, university brain science and neurobiology departments, and biomedical research laboratories worldwide have studied transplantation as a means of tissue repair. By the mid-1980s, animal research in the U.S. and elsewhere showed that fetal tissue was a promising transplant candidate in humans, and the National Institutes of Health had awarded an extramural grant to a university laboratory to study transplantation of human fetal pancreatic cells into patients with diabetes. But in 1987, an intramural NIH investigative team's proposal to transplant fetal neural tissue from elective abortions into human patients led to the moratorium on federal funding for such transplants by NIH's parent agency, the Department of Health and Human Services. Early this summer, the House of Representatives voted to overturn the ban, but in late June, the measure failed to gain enough congressional support to override President Bush's veto. Other nations, including Sweden, Great Britain, and Canada, continue to provide government support for the research. The lack of public funding has led to a near-total shutdown of human fetal tissue transplant research in the U.S. Many investigators worry that curtailment of the research has put U.S. scientists well outside the mainstream of international tissue transplant science. Paul Carvey, director of neuropharmacology research at Rush-Presbyterian-St. Luke's Medical Center in Chicago, cites a recent international meeting at which a paper by Swedish researchers raised some new questions and possibilities in his mind. "Had I had the opportunity, I would have come right back to the lab to try to replicate their results. That's the way one is used to doing science," he says. "But in our lab, our hands are completely tied. We are doing all our Work dancing around the core issue." Tissue transplantation research teams are typically large and represent such basic science disciplines as molecular biology, morphology, cell biology, immunology, neurophysiology, tissue culture, and neurology, plus clinical science specialties, such as Parkinson's and Alzheimer's diseases and diabetes. Many U.S. laboratories that might otherwise have studied human fetal tissue transplants have switched their research focuses to alternative tissues or concentrated solely on preliminary basic research on fetal tissue transplantation in animals. Federal funding is still available for Such studies. For these labs, many scientists say, uncertainty about the ultimate fate of fetal tissue research has created difficulties in planning and conducting long-term research programs and has compromised their ability to test and develop alternatives to fetal tissue. In a handful of U.S. labs, however, transplantation of fetal tissue into human patients is going forward, supported by private funds. For scientists in these labs, the federal funding moratorium means coping with new logistical and ethical dilemmas raised by the scramble for scarce private money. Yale University's Neural Transplant Center has conducted fetal tissue transplants inhuman patients using funds from private foundations, the patients who are serving as research subjects, their families, individuals suffering from Parkinson's disease, and other individuals interested in therapies for neurological diseases. According to center director Eugene Redmond and other scientists, being forced to turn to private funding sources alone can give a research program some of the elements of a cliffhanger, particularly in tough economic times. Although Redmond's research team members work as volunteers, receiving no salaries from project funds, "one day last month we were down to our very last dime," Redmond says. Besides a scarcity of funds, conducting research with private money means scientists need to learn about a new kind of grant-getting process. According to Redmond, that may present a special challenge to top-ranked scientists. "In general, the better you have been careerwise [as a biomedical scientist], the more likely you are to have held mostly federal grants in the past," he says. "That means extra time spent learning a process you're largely unfamiliar with." C. Warren Olanow, a professor of neurology, psychology, pharmacology, and experimental therapeutics at the University of South Florida in Tampa, says that confusion and suspicion surrounding the federal ban may complicate the private funding process even further. Scientists as well as private funding agencies have been confused about what kinds of research are eligible for federal funding and what kinds are not, Olanow says, adding that "the government didn't go out of its way to clear up anyone's confusion." In addition, say many scientists, some individuals and organizations are afraid to aid or sponsor fetal tissue research, either because they believe the federal moratorium bans human fetal tissue research itself and not just federal funding for studies of human transplantation of fetal tissue, or because they fear that government disapproval of the research might lead to federal retaliation against anyone involved with it. After working with adrenal tissue transplants as an alternative to fetal tissue, Olanow's lab is now ready to raise funds for a fetal tissue program, but Olanow doesn't expect it to be easy. "Some private institutions are influenced by whether government funding is available, and many people have false notions about what the ban means," he says. "One gets the sense the government may be trying to create an atmosphere of confusion and mistrust." Redmond contends that, in contrast to the peer-reviewed federal funding process, obtaining private funds can sometimes "be more like selling toothpaste" and can make scientists feel pressured to compromise their personal research ethics. As an example, he cites a media request for an interview with one of his transplant patients. "I simply won't do that," he says. "But then you may get to the interview and find that someone competing with you for funds has been less scrupulous. If that person gets more coverage, pretty soon you might be an also-ran." The complexity of tissue transplantation research often requires labs to obtain cooperation from other institutions to provide tissue or equipment and expertise—in areas such as brain imaging. The general murkiness surrounding the moratorium can make such cooperation hard to come by, according to Rush-Presbyterian's Carvey. "There's a feeling that the moratorium extends farther than it does," for example, to federal funding for basic research on human fetal tissue or to the research itself, he says. "That feeling of disapproval has spilled over onto public perception of fetal tissue research generally, and can make people reluctant to cooperate." Some scientists say the funding ban .and uncertainty about if and when it will lead to a ban on the research itself makes it much more difficult to plan the long-term programs of basic research and experimentation with animal subjects that are a necessary preliminary to research with human patients. University of Rochester neurobiology professor Manuel del Cerro has repaired retinal blindness in rats by transplanting rat fetal tissue. He says the ban "has hampered the ability to plan the next steps. We're talking about experimental periods of six months for rats, over a year for each group of monkeys," he says. "One is reluctant to try to make the next big jump if an actual ban on the research is going to come. It would be a tremendous waste of energy and time." Other scientists envision a brighter future, saying that technological developments are likely to change the field of tissue transplantation so radically that the fetal cell question will become irrelevant. In particular, many point to the potential for engineering and culturing in vitro lines of cells that will perform the same functions as fetal cells. "When this whole technology is developed, you'll have a situation that does not require constant harvesting of primary human tissue as a therapy. Then everyone will understand that this is a technology that can be regulated, and that will be far less controversial," says Ronald McKay, an associate professor of neurobiology at the Massachusetts Institute of Technology. "I think it's a mistake to hold this discussion as it's being held now-with the mindset that says there won't be radical technical developments that will change the entire question." But other scientists are not so sure. They point to the necessity of fully studying fetal tissue in order to test it against alternative transplant tissues as well as to learn enough about how it works to use it as a model for genetically engineered cell lines. "When the ban came, we did not have enough basic research on fetal tissue to decide for or against using it on that basis, but because of the ban we went with [transplanting] alternative tissue [instead]," says Roy Bakay, an associate professor of neurological surgery at Emory University in Atlanta. "But now we feel we've gone about as far as we can go in understanding the alternatives without seeing a side-by-side comparison with fetal tissue." Says Yale's Redmond: "I'm all for developing the potential of cell lines [as alternatives to fetal tissue] as fast as possible. Everybody's in favor of researching the alternatives. But without adequate fetal tissue research, we won't ever know what kind of cell lines we ultimately want to develop." Marcia Clemmitt is a freelance science writer based in Washington, D. C.

Fetal Tissue Research Uncertainties Foster Confusion Among Many Bioscience Workers

Interested in reading more?

Become a Member of