. Sujata Kelkar Shetty.
Sunday, September 10, 2006.
Research and development of stem cells holds tremendous promise. Stem cells are in use in clinical trials to treat diseases as diverse as heart disease, diabetes, and Parkinson's. They are also being used in the process of drug discovery and in understanding fundamental cellular developmental processes.
Stem cells that are put under the research lens are of two types, embryonic and adult. While both of these have their uses, it is for embryonic stem cells that certain ethical considerations are necessary.
The Indian Council of Medical Research (ICMR) and the Department of Biotechnology (DBT) have jointly issued a set of comprehensive guidelines that are comparable to those in the UK. In this environment of sensible ethical regulation there is a strong interest in the Indian public research institutes for the pursuit of stem cell research, both fundamental and clinical.
The interest is backed by funding from the Department of Biotechnology and some interest in the private sphere as well.
Fundamental research is being conducted by scientists at several institutions including Dr Panicker, at the National Center of Biological Sciences, Dr Rangarajan, at the Indian Institute of Science and Dr Maneesha Inamdar at JNC to name but a few.
Before the stem cells can be used to treat diseases however, clinical trials need to be conducted to determine safety, feasibility and effectiveness of these stem cell transfers. We have several clinical trials running in the India right now.
Most of these trials are via autologous transfer, or those that use adult stem cells taken from the patients themselves. This is the safest way to use stem cells as there is no worry of rejection, an adverse immune reaction that can potentially be life threatening depending on the condition. Interestingly, embryonic stem cells are currently only used in fundamental research and it will be 5-8 years at the very least, before they can be put to use in clinical trials.
Dr Satish Totey, Director of Stem Cell and Regenerative Institute, Manipal Hospital is running stem cell trials that started January, 2006 for the treatment of stroke, spinal cord injury, leg ischemia and myocardial infarction. Since the start of these trials, many patients have already been treated for these conditions using bone marrow derived stem cells. His dream is to make stem cell treatment affordable and effective for diseases where patients have lost all other hope.
The LV Prasad Eye Institute, in Hyderabad has been very successful in using stem cells to treat corneal opacity and blindness caused by damage to the limbus region of the eye. They have already passed the clinical trail stage and treated over 250 patients with a 70 per cent success rate. For this procedure, they use limbal stem cells, from the good eye of the patients to reconstruct damaged regions, including the retina and the cornea. This institute has achieved the largest success rate for this procedure than any other research institute in the world.
We certainly have our bright spots when it comes to research and clinical use of stem cells. However, we also have our limitations that need to be addressed if India is to be become a powerhouse of stem cell research. We lack the necessary pool of well trained biomedical manpower to perform the specialised tissue culture and transplant medicine. While these skills can be learned, training requires money. While public funding is present, it is by no means sufficient. Also there are but a few private players willing to take the financial risks necessary for conducting research and development of stem cells. If the government were to provide tax and other benefits to biotech companies and private hospitals pursuing stem cell research, then that would promote a greater involvement. A focus on stem cell research by the ICMR and DBT could result in larger funds being allocated to stem cell research in public institutions.
If the environment is more encouraging India could certainly become one of the strongest players in stem cell research.
The author has done research in biochemistry and has worked for a multinational pharmaceutical company
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