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KLMNO THE WORLD
On the frontiers of stem cell treatment With therapies limited in the United States, other countries offer the ailing new hope — and risks
by Ariana Eunjung Cha in beijing
D
isillusioned by U.S. doctors who could not help their daughter with cerebral palsy, Ka- ra Anderson’s parents
did something they could not have imagined a few years ago: They took her to China. Specialists in the Chicago area, where the family lives, said that Kara’s brain injury was perma- nent and that the 9-year-old would probably end up in a wheelchair because of severe twisting in her leg muscles. But then her parents heard stories about children who had im- proved after receiving injections of stem cells. The treatment was not avail- able in the United States. It was only commercially available abroad. That’s how the Andersons joined the desperate people who are taking leaps of faith in seeking stem cell treatments in places as far away as China, India, Russia and Brazil. Western scientists worry that
patients are being taken in by slick marketing campaigns, wast- ing time, money and hope on un- proven therapies, and perhaps even putting themselves in dan- ger.
“Unregulated therapy in the ab- sence of any evidence that these cells are going to help patients is reckless. The potential to do harm is enormous,” said Arnold Kreig- stein, a neurologist who is direc- tor of stem cell research at the University of California at San Francisco.
Scientists hope various kinds of stem cells can eventually be used to treat devastating and common ailments: heart attack, stroke, Parkinson’s disease, diabetes, liv- er failure, even blindness. For now, there is scant evidence for the benefits of treatments such as the ones the Andersons sought. Most of the stem cells used in
Chinese clinics are obtained from fetuses from miscarriages. They thus fall somewhere between em- bryonic stem cells, which come from early-stage embryos — rais- ing ethical and religious ques- tions about their use — and adult stem cells, which are easier to ob- tain and are considered safer and less controversial. They are widely considered to be less versatile than embryonic stem cells, which can develop into almost every kind of cell in the body, but more so than adult stem cells, which are useful only to treat the tissues or organs from which they came. Fetal stem cells also have a downside: They can trigger im- mune-rejection responses or lead inadvertently to new or increased pain. They also have a tendency to clump together; one patient who sought treatments in Russia de- veloped multiple brain tumors af- ter undergoing experimental therapy with fetal stem cells, sci- entists reported in the journal PLoS Medicine.
Stem cell research is an area in which the United States faces new rivals — and ones willing to move quickly from experimental re- search to treatment. A January re- port by the National Science Board warned that the U.S. posi-
Israeli navy boards aid ship bound for Gaza This time, on an Irish
vessel, commandos greeted peacefully
by Janine Zacharia
jerusalem — Israeli naval commandos boarded an Irish hu- manitarian aid ship bound for the blockaded Gaza Strip without incident Saturday and diverted it to an Israeli port, after a similar attempt earlier in the week to in- tercept a ship from Turkey ended in a deadly melee at sea. Unlike Monday, when Israeli commandos were violently beat- en by passengers as they boarded the Mavi Marmara, activists aboard the Rachel Corrie peace- fully greeted the commandos as they climbed aboard. In the in- cident Monday, Israeli comman- dos opened fire in self-defense, killing nine activists. Few had expected a confronta-
PHOTOS BY CARLOS JAVIER ORTIZ FOR THE WASHINGTON POST Therapist Tammy Paulowski works with Kara Anderson, 9, who has cerebral palsy. Kara was taken to China for stem cell treatments.
University of California at Irvine, who specializes in research on embryonic stem cells and spinal cord injury.
Variety of approaches
Stem cell treatment in China is both a government-sponsored and a commercial enterprise, with wildly varying methodolo- gies, facilities and prices. Chinese doctors consider the
Kara Anderson could not walk on her own for most of her life before the stem cell treatments. Now she can get around on crutches.
tion as the world’s innovation leader is declining and China’s in- fluence is increasing. The report said that is the result of a surge in government investment in sci- ence and technology education, infrastructure and research. In the United States, the use of
federal funding for new lines of embryonic stem cells was banned in George W. Bush’s administra- tion. President Obama reversed that decision when he took office, but China and other countries have had a years-long head start. Treatments using embryonic or
fetal stem cells are in the experi- mental stage in the United States and are not approved for com- mercial use by the Food and Drug Administration. But they remain in a regulatory gray area in China, neither sanctioned nor banned. The government allows 50 or so stem cell clinics to operate freely. Several Chinese health officials
have expressed concern about the lack of oversight. Scholars affiliat- ed with the government say they expect some regulations to be in- troduced soon. The one trial of fetal-derived stem cells that has been started in the United States has been lim- ited to a few patients, and none using embryonic stem cells has begun. In China, thousands have undergone treatment with em- bryonic, fetal, adult and cells tak- en from a newborn’s umbilical- cord blood, Chinese scientists say. But evidence that treatment is working is merely anecdotal. “People flock to the words ‘stem cells’ because they rightly feel that the potential is enormous. I’m right there with them, but there’s a misalignment of prog- ress in the scientific and medical communities with the public per- ception of the power of stem cells,” said Hans Keirstead of the
Wu Stem Cells Medical Center, where Kara was treated, among the country’s premier facilities for central nervous system illnesses. Located across from an amuse- ment park in Beijing and inside a traditional Chinese medicine hos- pital, it charges $30,000 for a five- week treatment. Cheng Bo, deputy director of the center, said doctors there offer potential patients realistic assess- ments of the risks and benefits. “We tell them it’s impossible to cure patients completely,” he said. “Our goal is to improve the qual- ity of their life or to extend their life.” Many patients — about a third are children — come from developed countries where med- ical treatment is in general con- sidered superior to China’s, al- though they may lag behind Chi- na in stem cell research.
‘It was unbelievable’ Kara managed the improbable
after the first two of four stem cell shots in January. She began limp- ing around on a crutch and walk- ing up to 15 minutes on a tread- mill with the support of a rail, ac- cording to her parents and doctors. She could lift pebbles with her left hand and raise it over her head, which she could never do before. Her father, Brian Anderson, who learned about the treatment from a relative who suggested he do research on the Internet, said recently Kara has retained these
DIGEST IRAQ
2 Sunni candidates are assassinated Two Sunni candidates from the
largely Sunni coalition that won the most seats in Iraq’s March elections were assassinated Sat- urday, police said. Members of secular Shiite Ayad Allawi’s polit- ical bloc said the killings of the candidates connected to their group were politically motivated assassinations. In Mosul, uniformed men stormed the home of Faris Jassim al-Jubouri and told him that they were there to search it, Mosul po- lice Capt. Omar Khalid al Badra- nee said. They entered the home, shot him and fled in the middle of the night. Al-Jubouri did not win a seat in the elections. In Anbar, Saleh Fayadh — also a candidate from Allawi’s Iraqiya bloc who did not win in the elections — was killed in a roadside bomb at- tack. Iraqis worry that bombings and assassinations will continue as politicians jockey for top jobs in Iraq’s next government. Nearly three months after the election, no government is in place, but
the parliament is expected to convene soon after the ratifica- tion of results. — Dlovan Brwari and Leila Fadel
ASIA
S. Korean leader rules out war South Korea’s leader ruled out
going to war with North Korea on Saturday, hours after his govern- ment asked the United Nations to punish the communist nation over the sinking of a warship. “There is absolutely no possi-
bility of a full-scale war on the Korean peninsula,” President Lee Myung-bak told a group of busi- nesspeople in Singapore. The meeting was closed to the media, and the comments were posted by Lee’s spokesman, Park Sun- kyu, on the presidential Web site. It was the first time since the ship sinking that Lee has cat- egorically ruled out war with North Korea. The North, how- ever, has warned that any move to punish it over the sinking could lead to war. Lee’s comments were aimed at assuaging prospective investors.
“Don’t worry about a war, invest,” he was quoted as telling the busi- nesspeople.
— Associated Press
G-20 leaders pledge increased reform
World financial leaders
pledged Saturday to push ahead on curbing deficits and crafting financial reforms to safeguard the global recovery, including making banks bear much of the burden for government bailouts. As expected, finance ministers and central banks gathered in the port city of Pusan, South Korea, finessed what some said were at times heated differences over how to reshape financial reg- ulation and build safety nets for countries stricken by debt crises. The Group of 20 welcomed measures taken by the European Union, the European Central Bank and the IMF, including a $1 trillion bailout, to help coun- tries cope with the fallout from unsustainably high debt. Long-term, sustainable growth will depend on rebalancing growth, U.S. Treasury Secretary
Europe’s sovereign debt crisis sharpened worries that the global economy could succumb to an- other downturn following the one sparked by the collapse of Lehman Brothers in 2008. — Associated Press
Court upholds sanctions for mar- rying Israelis: An Egyptian ap- peals court upheld a ruling that orders the country’s Interior Min- istry to strip the citizenship of Egyptians married to Israeli women. The Supreme Adminis- trative Court said that the min- istry should take into consider- ation whether a man married an Israeli Arab or a Jew when decid- ing to revoke citizenship.
OSSERVATORE ROMANO/ASSOCIATED PRESS
CYPRUS Sufi mystic Sheik Nazim, flanked by Muslim clergy, talks with Pope Benedict XVI before the pontiff led a mass in Nicosia.
Timothy F. Geithner told report- ers after the meetings. “The Unit- ed States is moving aggressively to fix things we got wrong and to strengthen our economic funda-
mentals,” Geithner said, noting that as Americans boost savings and investment and consume less, other countries will need to generate more growth.
2 Ugandan peacekeepers die in Somalia: Two Ugandan soldiers serving in the African Union’s peacekeeping force in Somalia (AMISOM) died in fighting with rebels for control of north Moga- dishu this week, an AMISOM spokesman said Saturday. At least 11 people died when al- Qaeda-linked al Shabaab rebels and government forces shelled each other in the north of the city. — From news services
on
washingtonpost.com
Stem cells in action
To see more photos of Kara Anderson after her therapy, go to
washingtonpost.com/world.
abilities since her treatment in December. He said he is also no- ticing improvement in her eye- sight. “We really weren’t sure what to expect, but she got better and better every day. It was unbe- lievable,” said Anderson, 41, a con- struction contractor, who funded the trip and treatment with mon- ey pooled from relatives, friend and their church. Doctors said the timing of Ka-
ra’s improvement may have been coincidental: Cerebral palsy symptoms periodically get better or worse for unknown reasons, but stories such as hers dissemi- nated on the Internet are attract- ing thousands of patients. In the United States, a trial in- volving infusions of embryonic stem cells for patients with spinal cord injury was delayed from Jan- uary until August to address safe- ty concerns raised by the FDA. Keirstead, whose work is the basis for that trial and in 2005 made headlines for getting injured ro- dents to walk again, said he is ea- ger to see the trial started. “I was jumping for joy to see those first rats walk again, thrilled when I saw the technol- ogy progress to the clinic, over- joyed to see FDA approve it,” Keir- stead said. “Now we are on the cusp of seeing this in humans, and I am dismayed and frustrated at how long it is taking because the need is so great.”
chaa@washpost.com
Researchers Liu Liu and Zhang Jie contributed to this report.
tion Saturday, in part because the Irish vessel included 11 passen- gers and eight crew members, far fewer than the 600 passengers aboard the Turkish vessel. Those aboard the Rachel Corrie includ- ed an Irish Nobel peace laureate, a former U.N. diplomat and a best-selling Malaysian author. The clash aboard the Mavi
Marmara brought renewed world attention to Israel’s closure of the Gaza Strip, designed to strangle the Hamas government, which is in armed conflict with Israel. Prime Minister Binyamin Ne-
tanyahu has rejected calls to lift the blockade. Still, in response to U.S. demands, Israel is consider- ing allowing more goods into Ga- za and exploring ways to avoid fu- ture confrontations by allowing ships to sail to Gaza after having their contents inspected. “We saw today the difference
between a ship of peace activists, with whom we don’t agree but re- spect their right to a different opinion from ours, and between a ship of hate organized by violent Turkish terror extremists,” Ne- tanyahu was quoted as saying Saturday.
Organizers of the Free Gaza
Movement flotilla promised to re- turn with reinforcements. “We are putting Mr. Netanyahu on no- tice that we are returning in the next couple of months with an- other flotilla, that his actions and the actions of his soldiers have energized thousands of people who have stepped forward with offers to help and participate on the next voyage,’’ the group said in a statement issued Saturday. The humanitarian aid aboard the Rachel Corrie was unloaded at Ashdod port, awaiting transfer to Gaza. As of Saturday, Hamas had not agreed to receive the aid from the six ships in the flotilla that arrived Monday. In Istanbul Saturday, demon-
strators chanted anti-Israel slo- gans, and Turkish media report- ed that Prime Minister Recep Tayyip Erdogan, riding high at home because of the Marmara in- cident, was considering partici- pating in an aid flotilla.
zachariaj@washpost.com
SUNDAY, JUNE 6, 2010
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