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October 2001

Red blood cell colony derived from human embryonic stem cells by scientists at the University of Wisconsin-Madison. These are the first specialized human cells to be coaxed down a specific developmental pathway and to be reported in the scientific literature.

Wisconsin Scientists Turn Stem Cells into Blood Cells
A study published on September 3 in the Proceedings of the National Academy of Sciences reported that a team of researchers at the University of Wisconsin-Madison has directed human embryonic stem cells to become blood cells.

The researchers demonstrated that undifferentiated stem cells can be coaxed to become primitive types of blood cells that later develop into more mature types of blood cells. In a release issued by the university, Dan Kaufman, a hematology fellow at the university's medical school and the lead author of the study, said that the "results [of the study] show an effective and efficient way to derive blood cells from these early precursors."

These more mature cells could one day be used to create blood supplies for transfusion or transplant therapies. Kaufman added, however, that this ability "is not something that's going to be available tomorrow or next year."

The feat was accomplished in tissue culture by exposing undifferentiated stem cells to bone marrow and other cells, as well as growth factors, to encourage the stem cells down the developmental pathway to becoming blood.

The possibility that stem cells can be manipulated in a laboratory to become other types of cells is the central reason why federally funded stem cell research is supported by many disability activists, such as Christopher Reeve. Directed stem cell development could one day lead to a cure for conditions such as Parkinson's and Alzheimer's diseases and spinal cord injuries. Many conservatives, however, oppose research conducted on human embryonic stem cells, as the harvesting of the cells results in the destruction of the embryo.

On August 9, the Bush administration announced that only stem cell lines already in existence can be used in federally funded research. To date, the National Institutes of Health has identified 64 existing lines, about 80% of which are in Sweden at the University of Goteberg's Sahlgrenska University Hospital. Not every line, however, may be viable for research purposes.

For the latest on the stem cell debate, visit www.healthbiznews.com.

Therapists Use the Body to Mold the Mind
The face of rehabilitation may be changing as those who treat patients with brain and spinal injuries use new techniques designed to coax the brain into healing itself, according to an article published in the August 28, 2001, New York Times. According to the article, new approaches to rehabilitation are taking shape based on the knowledge that an adult brain can generate new neurons and on observations from animal experiments that these cells can possibly migrate to damaged areas. In addition, medical researchers know that activity prevents neurons from decaying.

One such new therapy is constraint-induced movement therapy, which "rests on the principle that lots of practice can reorganize the brain," said Wolfgang Miltner, PhD, a neuroscientist at the Friedrich-Schiller University of Jena in Germany, in an interview with Times reporter Sandra Blakeslee.

Patients undergoing this therapy have healthy limbs immobilized and are forced to rely on bad limbs, using them for several hours a day. "You don't just repeat movements," Miltner said. "You have to shape them, which means thinking about the element of each movement." According to Edward Taub, PhD, a neuroscientist at the University of Alabama at Birmingham, more than 150 stroke patients have been successfully treated with this therapy, showing improvements that "appear to be permanent."

A different type of therapy is being used to treat patients with partial paralysis from spinal cord injuries. V. Reggie Edgerton, PhD, a neuroscientist at the University of California Los Angeles, told the Times that "the spinal cord is smart," and a damaged one can be retrained to perform functions it has lost, provided it is not severed. Retraining is accomplished by suspending patients over treadmills while therapists or machines manipulate their legs to imitate walking. Patients undergoing this therapy have reportedly shown a marked improvement in their ability to walk.

But while such therapies have shown potential, experts warn that there are limitations. For example, the viability of these treatments for everyone who needs therapy has yet to be proven. Pamela W. Duncan, PhD, director of the Center on Aging at the University of Kansas Medical Center in Kansas City, is quoted in the article as saying that "it is premature to know exactly how beneficial the therapies may be for most patients."

In addition, Anne Shumway-Cook, PhD, a rehabilitation therapist at the University of Washington, added that therapists may be under pressure from patients to provide treatments that they may not fully understand. When the desired results are not achieved, the article states, it is impossible to determine if it was the technique or its delivery that was flawed. Limitations of a different sort are being imposed by reductions in the amount of rehabilitation covered by Medicare and private medical insurance. Constraint-induced therapy, for example, will not work if it is "given 2 hours a day for 3 days a week for a couple of weeks," according to Taub, "which is what most medical insurance plans allow." And stroke patients undergoing constraint-induced therapy at the University of Alabama pay from $6,000 to $13,000, which is not paid by Medicare.

The full text of the article is available online at www.newyorktimes.com.

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October 2001