A promising start for new stem cell research

Stuart Brown wants to know: What is the current stem cell research funding position in money terms for the UK, Europe and the US?

Dr Richard Tiner said:

This is not any easy question to answer, as the funding for stem cell research is not completely clear. However, there is some Government funding in the UK for some academic units but I am not sure what is happening in the rest of Europe. In the United States stem cell research is not politically supported except for autologous, i.e. stem cells from the person who will personally be receiving them.

Timothy wants to know: How exactly will the research help in the fight against heart disease and other diseases?

Dr Richard Tiner said:

If you're referring to stem cell research, then its future is likely to be in repairing damaged tissue following a heart attack because the heart tissue in the area of the blocked coronary artery dies. There is now some evidence that taking the patients own cells from their bone marrow and injecting close to the site of the tissue damage leads to an improvement in function greater than the currently available best treatment. However this is still very experimental.

Lisa wants to know: How long do you think it will be before stem cell technology will be widespread in combating heart disease?

Dr Richard Tiner said:

At least ten years and possibly longer, but trials have been reported already this year. There was one in Lancet in July. If further trials are positive, it will still take several years to develop and then market the technology.

Anthony wants to know: What other options are there available to people with heart disease? Is this building people's hopes prematurely?

Dr Richard Tiner said:

There are currently lots of options open to people with heart disease, ranging from lifestyle changes right through to surgery and new medicines. The most important factor though is to not smoke, and for people who find it difficult to give up they should consult a health professional like their GP or pharmacist. There are medicines available both on prescription and over the counter for people who need them to help to give up smoking. Anthony, if you are a non-smoker a lot will depend on what type of heart disease you are inquiring about as there are several types and they all have different treatments. The good news is that the mortality rate from heart disease has been decreasing since the 1970s and over the last decade the decrease has been quite rapid.

Sally wants to know: How do the findings of your Target Heart report affect families with a history of heart disease? Are there preventative measures being looked into?

Dr Richard Tiner said:

The one thing in your life that you can't control is who your parents are and the biggest factor in heart disease is whether you have a positive family history. However, there is very early research being done on the genetics of heart disease and how gene therapy might play a part in the future. With regards to prevention, the most important factors are to not smoke, not to be overweight, not to have raised blood pressure and to exercise regularly.

Unfortunately, there will still be patients who do all of those things and still have heart disease. This is likely to be due to genetic factors. With regard to prevention, lipid lowering medicines like statins are playing a big part in reducing cholesterol levels, particularly what is called "bad" cholesterol (low density lipoprotein.)

MSegall wants to know: My father had a heart attack 15 years ago. He has subsequently had a triple bypass and is doing well. Would stem cell research ensure him to go longer without the need of medications or further treatment? Thank you.

Dr Richard Tiner said:

It is too early to tell at the moment and the fact that he is doing very well from his triple bypass is good news. In fact the blood flow to the heart muscle is clearly adequate so the damage to the heart from the heart attack does not seem to be playing a major part.

Kitty wants to know: Both my father and grandfather died of heart disease - I'm obviously doing everything in my power to stave off the condition through exercise, giving up smoking etc. Am I less likely to get it being a women though?

Dr Richard Tiner said:

Yes, until you reach your 70’s and then the incidence of heart disease is about the same for males and females.

Stuart Brown wants to know: What excites you about stem cell research? Why should we be excited?

Dr Richard Tiner said:

I think the exciting thing about stem cell research in heart disease is that it really is a natural treatment. By that, I mean it is possible to take cells from the patients own bone marrow, culture them and inject them back into the blood stream where they migrate to the area of damage and become heart cells. This seems amazing to me. As yet we don't know how this happens but early evidence gives us a lot of hope for the future. Using the patient’s own body to repair a damaged part of their heart seems very exciting to me.

Nicki M wants to know: How has Christopher Reeve helped the profile of stem cell research?

Dr Richard Tiner said:

Very positively, and particularly in America. However, there are ethical issues about using embryonic stem cells and it is that issue which means that the UK leads the world in stem cell research...

Adrian wants to know: What are your thoughts on the controversy surrounding stem cell research? Christopher Reeve's death seems to have brought the debate to life.

Dr Richard Tiner said:

My personal thoughts, and I emphasise that these are personal thoughts, is that it is ethical and reasonable to use undifferentiated cells from an embryo that is no more than 8 or 16 cells in size. These embryos become available as a result of fertility treatment for infertile couples and essentially are being donated for potentially improving the quality of life for people with often severe disabilities. The overall research project is to develop the use of patients’ own stem cells from their bone marrow. The trial on heart disease reported in The Lancet in July did just that.

Simon wants to know: Is there a Frankenstein scenario to stem cell research? Is this the short end of a very long wedge that leads to human cloning and designer babies?

Dr Richard Tiner said:

Absolutely not! The stem cell researchers that I have met have absolutely no desire to develop human cloning. In any case cloning and stem cell research are completely different.

1stScientist wants to know: Has adult stem cell research reached as developed a stage now as embryonic stem cell research?

Dr Richard Tiner said:

I'm not sure of the answer. However, the trial reported in The Lancet in July was about the use of adult stem cells in heart disease with significant results.

Andy wants to know: What new legislation (if any) or funding do you believe is required to advance the industry? Should this be government or private sector led?

Dr Richard Tiner said:

With regard to stem cell research, the funding is likely to be mixed with some public funding through the Medicine Research Council (MRC) and some from industry. If the research leads to commercialisation of the technique then that will require private sector funding, as the cost of bringing in new technology to the market is several hundred million dollars.

Pete wants to know: Can you explain how the new funding in California will affect the future of stem cell research?

Dr Richard Tiner said:

I am sorry, I do not know have any information about funding in California.

Eamonn wants to know: What is the next big breakthrough? Stem cell research seemed to come from out of the blue. What else is there that is just out of site of public consciousness?

Dr Richard Tiner said:

In the future, gene therapy is a possibility with the repair of defective genes in blood vessel cells, for instance in the coronary arteries. Another possible development would be a vaccine for atherosclerosis. These are very much in the future but are already being tested in clinical trials are new medicines for treating heart failure by affecting potassium and calcium channels in the cells. When fatty plaques are formed in blood vessels they often have areas of inflammation around them and trials are underway to reduce this inflammation and therefore reduce the likelihood of a heart attack. There is a lot of research into prevention looking at other ways of reducing blood lipid levels.

Jay wants to know: What do you say to people who are opposed to stem cell research?

Dr Richard Tiner said:

They are of course entitled to their view but I personally cannot see any problems in using adult stem cells from patients' own bone marrow. The issue is around embryonic stem cells and when life begins. I fully respect the opinion of those people who believe that life begins at conception rather than a little later in the development of the embryo/foetus. However, I wouldn't want that opinion to prevent potentially life saving cures which will have to have rigorous ethical approval involving both scientific and public representatives.

Carolyn wants to know: Why are men more at risk of heart disease than women?

Dr Richard Tiner said:

There are a number of factors. These include the fact that women appear to be protected from heart disease until they reach their menopause. The incidence in women then gradually increases and reaches that of men around the age of 70. Also, the current generation of heart disease sufferers are paying for the fact that more men smoked in the recent past than women.

Guy wants to know: Is it true that one glass of red wine a day will prevent heart disease???

Dr Richard Tiner said:

Well it won't prevent it but it will reduce the risks. In fact there was a very interesting lecture at the Royal Society of Medicine earlier this year on what were the best red wines to drink. Those from the French region between Bordeaux and Toulouse were considered the best. Unfortunately the wine itself is not one of most people’s favourites. A lot of this is anecdotal but some research is being done into the benefit of the affects of red wine.

Jim wants to know: Where can I hold of a copy of the report? Thanks.

Dr Richard Tiner said:

You can get free copies of the Target Heart report from the ABPI Publications Dept., 12 Whitehall, London SW1A 2DY or call 0207 747 1446. It can also be viewed online at www.abpi.org.uk