Synthetic Drugs and Stem Cells: Comparing Apples to Oranges

notEqual

Science, academia, and government have failed to properly translate stem cell research into practice. Conventional drugs are regularly pushed through the clinical trial system that currently favours chemical compounds over biological products. This inconsistency is never more evident than when one reads about stem cells in research and in the news: one lauds them as a powerful, regenerative innovation that could change the field of medicine; the other airs a sentiment of caution and wariness towards the legitimacy of these “sham” treatments. Sure, there are a number of stem cell clinics in less developed countries that offer treatments entrenched in quackery, but a cursory look at the situation would reveal that the clinics were established through exploiting legislative loopholes. While this contributes to the hurdles towards legitimate stem cell treatments, a more significant reason would lie in the paradigm that dictates the clinical trial system itself1.

Stem cell treatments are not the first to fall victim to academic scrutiny and public stigmatisation. Alternative medicine such as acupunture has largely been disregarded by “true medicine” proponents as pseudoscience. Stem cell treatments suffer from being placed in the middle of this spectrum when cogent research becomes conflated with unscrupulous practices. This happens despite the wealth of existing and emerging stem cell literature due to the lack of a standardised regulatory testing system for stem cells. Even the FDA concedes to the lack of a gold standard of testing parameters, as the source and mechanism of stem cells differ greatly among stem cell types and necessitate a case-by-case basis of assessment2.

This becomes the main issue that confounds the general public. When faced with the choice between conventional drugs that are limited in efficacy and stem cell treatments that sound too good to be true, we go with the option that’s perceived to be safer. The norm of arthritis treatments, for example, involves drugs that slow disease deterioration or procedures for joint replacements; but stem cell treatments that address the root problem of arthritis by regenerating the cushioning cartilage are forgone in the name of notoriety. Yet the similarity between the two begins and ends with arthritis: comparing their effects, mechanism of action, toxicity, and safety would be akin to comparing apples to oranges.

Drugs are synthesised from chemicals to ameliorate symptoms of acute diseases (sudden onset of symptoms usually caused by infection). In the 21st century, high public health standards mean that we are relatively free from acute diseases but regularly suffer from chronic, long-lasting ones where drugs show much less promise3. Rarely do they work without side effects, and rarer still that they can address the cause of chronic diseases. To be commercialised, drugs have to be rigorously tested for toxicity, unintended side effects, interactions in the body, and other parameters; but most drugs for chronic symptom relief provide only that—symptom relief.

Steroidal drugs, for example, are used in arthritis treatments to reduce inflammation in joints, but inflammation is your body’s—albeit painful—way of indicating where healing factors are most needed. The drug is a double-edged sword that stops the pain, but also hinders natural healing. One could argue that arthritic joints cannot heal naturally, so why not try and ease the pain? But that leaves another rather awkward question to be answered: if these drugs can’t treat arthritis then what can? The answer is not a solution: healthcare providers are pouring money into painkillers that leave the joint to deteriorate until an artificial joint takes its place.

The irony then is found in critics of stem cell treatments who wax lyrical about the unverified dangers of stem cells. In reality, many stem cells, particularly those sourced from the patient’s own bodies, have shown promising results in treating arthritis. A localised injection into the arthritic joint have elicited regeneration of cartilage that cushions the bones between joints, thereby restoring the joint to its pre-arthritic state. Notice how the treatment directly addresses the root cause of arthritis—the grinding of bones due to loss of cartilage cushioning. In fact, those who have sought legitimate stem cell treatments for arthritis have reported dramatic improvements in joint function, mobility, and pain.

So then is the wariness towards stem cell treatments baseless? Not entirely. As for every legitimate stem cell practice, there are many more offering sham treatments; but when cogent research is applied into practice, stem cell treatments may prove to be the safer, more effective option for arthritis treatment. Stem cells extracted from the recipient’s own body, or autologous stem cells, are one of the safest type of stem cells used for treatment. Digressing back to inflammation, where hormones and chemical signals are released by the injured site to attract healing factors, stem cells are among one of the factors that contribute to regeneration and repair of injury. Autologous stem cells are particularly efficient at picking up and responding to the body’s native signals as they are of the same genetic makeup—after all, no one knows you better than you know yourself.

Even discounting their autologous nature, solace can be found in the fact that stem cells are the natural building blocks that make up each human being. At one stage of our lives, we were amorphous congregations of stem cells that replicate and transform into recognisable organs and features, and eventually into complete human individuals. They are the building blocks to our bodies, and in adulthood when their numbers are scarce, stem cells are used for bodily maintenance and healing. Emerging technology has simply allowed us to harness these cells for their regenerative potential.

It is ineffable then, that when put under the lens, synthetic drugs are more readily commercialised than the naturally occurring stem cells. There is still hope however, as governments have begun to recognise their potential. Japan has recently launched a program that fast tracks stem cell treatments from clinical trials into commercialisation, as will the American FDA if legislations are passed. Stem cell treatments for arthritis have been recognised as the superior treatment option and public distrust towards legitimate treatments are beginning to lift. That isn’t to say that conventional medicine has held back the progression of healthcare; but that equal, unbiased scrutiny must be placed upon both types of medicine in order to truly benefit public health.


1 Derkatch, C. 2008. Method as Argument: Boundary Work in Evidence-Based Medicine. Social Epistemology, 22 (4): 371-388.
2 U.S FDA. Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy Products.
3 Jonas, W.B. 1998. Alternative Medicine—Learning from the Past, Examining the Present, Advancing to the Future. JAMA: The Journal of the American Medical Association. 280 (18): 1616-18.
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