Greg Korbutt opens a freezer in his lab and takes out 10,000 points of life.
They don't look like much at first — just golden specks floating in a Petri dish. But each of those tiny specks is a living human stem cell, raised for weeks in an atmosphere and temperature-controlled fridge. Under the right conditions, they could become almost any human tissue.
"What we're trying to do is get them to turn into insulin-producing [or islet] cells," Korbutt says. If they succeed, the 10,000-odd cells in this dish could become a cure for diabetes, saving thousands of patients from blindness, amputation and kidney failure. "The impact on the health care system will be dramatic." And it could happen in as few as five years.
Korbutt, a St. Albert resident and professor of surgery at the University of Alberta, recently got a $21.2 million grant to build a stem-cell research centre, one that could create cures for diabetes, lung disease and other chronic illnesses. He's one of the many bright lights leading the way into a new world of regenerative medicine.
Looking for hope
Kuen Tang has been looking forward to that world for years. A 31-year-old quadriplegic living in Edmonton, she's a counsellor at the Canadian Paraplegic Association.
Tang says she got interested in this area about seven years ago after watching a show on a woman paralyzed in an auto accident. The woman paid $30,000 to go overseas for an experimental stem cell treatment. "The experience was fantastic and she was able to move her legs."
Now she's in regular contact with stem-cell researchers and is assembling a list of clients willing to take part in their research.
Kevin Perrott is another recent convert to stem cell advocacy. The owner of St. Albert's Riverside Honda, he was recently diagnosed with cancer. "There's nothing more focusing of the mind than learning you're diagnosed with a terminal disease," he says. He's now a stem-cell researcher at the University of Alberta, one that organized a public forum on the subject in Edmonton last November.
"These technologies are going to be bigger than computers because everyone needs them," he says, speaking at his office at the University of Alberta. It's most relevant to degenerative diseases, he continues, which will become more common as our population ages. "Six million people suffer from osteoarthritis. I'm one of them. The trajectory is clear: I will not be able to rock-climb in two to three years."
Alzheimer's already costs Canadians $5.5 billion a year in direct costs and research suggests it could hit $17 billion by 2031. Productivity losses are up to four times as much, he says, citing a 2007 study. "We have to find a better solution."
Points of life
Stem cells might be that solution, Perrott says. "A stem cell is often referred to as the master cell of life," he explains, as it can become any one of the 200-odd types of cell in your body. You can see them in action when your wounds heal or your hair grows.
Regular cells create two copies of themselves when they divide. Stem cells create one copy and one "daughter" cell of another type — skin, muscle, etc. Stem cells become more and more specialized as they divide. Embryonic stem cells can — and do — become every material in your body and are the most potent. Umbilical cord cells are a little less potent, while the ones in an adult are even less, often limited to one or two cell types.
Embryonic cells are the most valuable for medicine due to their potential, but up until recently were in short supply; you had to make and destroy embryos for them, which was expensive and morally questionable. But in 2007, Japanese researchers figured out how to use proteins to transform an adult stem cell into an embryonic one, essentially sidestepping this problem.
Almost every disease happens when a cell goes bad, Perrott says. Now that we have a reliable source of stem cells, doctors can go in and replace those cells instead of treating the problems caused by them.
Researchers from the University of Pittsburgh have helped a paralyzed mouse hobble around again by injecting stem cells into its spine, he notes as an example. University of Minnesota researchers have had success growing working hearts from stem cells and believe the same technique could eventually lead to lab-made organs. Over at the Northeast England Stem Cell Institute, doctors have reportedly restored vision in a man's eye by repairing his cornea using stem cells.
Perrott's work focuses on ways to make stem cells work better. He pulls out a photo from his work of a pig with an ugly red rash on its side. For reasons he and his fellows have yet to discover, nanocrystalline silver bandages seem to stimulate the pig's stem cells to heal, causing the rash to heal very quickly. "By the third day, it's like [the pig] was never given a rash at all," he says, showing a shot of a nearly rash-free pig.
Stephen Badylak at the University of Pittsburgh has had similar success with a substance dubbed pixie dust. Actually the powdered form of the extracellular matrix from a pig's bladder, he's been able to use it to re-grow the tip of a man's finger in about three weeks. The U.S. military is now testing the substance on maimed veterans. Badylak has speculated that it could eventually help re-grow lost limbs.
Cautious optimism
Although many of these treatments could be available within years, Perrott says, they still have some major challenges to overcome. One of the biggest is controlling the growth of stem cells. Cells that can become anything run the risk of becoming everything — including cancer.
That's the challenge Korbutt and his team now face. "We can turn [stem cells] into fat and cartilage, but we don't know how to turn them into islet cells." He and his team have spent most of the last 10 years adding different chemicals to their Petri dishes trying to trigger that transformation. "It's going to be at least another five years," he predicts.
There are also financial problems. It costs tens of millions of dollars to get a treatment from the lab to the market, Korbutt says, and researchers can struggle to attract investment during their early work. Patents, legal battles and scientific caution add even more time to the development process.
Some patients grow weary of delays and go overseas for treatments. Tang tells her clients to do their research before they open their wallets. Many of these nations have different safety standards than Canada, she notes, and might be allowing unsafe or ineffective treatment. "We really need to be cautious of the danger factor."
But the biggest problem might be the lack of public awareness, Korbutt says. "Patients need to become aware of the potential of these therapies and look at every way to facilitate in their delivery," he says.
Patient advocates (such as actor Michael J. Fox) can help fund and push therapies to market, counteracting the caution of scientists and the profit-seeking of investors. He himself has founded a non-profit group called the LifeStar Institute that aims to harness the power of patients and caregiver groups for this purpose.
Tang says she's hopeful that stem cells could help wheelchair users walk again, although she doubts it will happen during her lifetime. Still, she tells all her clients to keep their bodies fit, just in case. That way, "when the day of the miracle cure [comes], you'll be prepared to take that step."
