August 3, 2015--The Case for Fetal-Cell Research

I rarely, very rarely reprint articles from the New York Times or any other source. This op ed piece from last Thursday is an exception. 

It was written by Nathalia Holt, a microbiologist and author of Cured: The People Who Defeated HIV.

At a time when both sides in the agonizing debate about abortion, particularly the sale and use of fetal cells and organs for research and those who oppose it are heating their rhetoric to white hot, this sane piece provides a much-needed perspective. Among many things, what is at stake and how emotionally complicated the issues are. Even for those, like Holt, who support fetal-cell research.

The Case for Fetal-Cell Research

We first acquired the stem cells from the red receptacles of a local hospital's labor and delivery ward, delivered to our lab at the University of Southern California. I would reach into the large medical waste containers and pull out the tree-like branches of the placenta, discarded after a baby had been born. Squeezing the umbilical cord that had so recently been attached to a new life, the blood, ladened with stem cells, would come dripping out.

But sometimes a different package would arrive at our lab. Despite my distaste for wringing placentas, I felt more squeamish about what lay inside the unassuming white box. Packed in the ice was a crescent-shaped liver of dark red tissue: a human liver. Just like the placentas that were discarded after birth, this tissue was originally destined for medical waste following an abortion.

Although their fates were similar, their origins couldn't be more different. One source was the byproduct of celebrations, the other a procedure often marked with stigma and shame. While under the bright focus of the microscope the cells we isolated were indistinguishable, in our minds there was a significant difference.

Stem cell research is a big deal in California, thanks to the Institute for Regenerative Medicine, a state agency that has allocated almost $2 billion in research grants since 2004 (federal funding is still highly restricted). To meet the demand for cells, researchers turned to a procedure protected by federal law: abortions. The discarded tissues from terminated pregnancies, performed up to 24 weeks in California, is a rich source of stem cells.

But only certain fetal cells are useful. While embryonic stem cells, derived from fertilized eggs, can give rise to any cell that makes up the body, as fetal cells develop from the embryo they become committed to specific cell lineages. The liver and thymus, for instance, are packed with the precursor cells to the immune system, while the brain contains neural cells that form the nervous system.

To meet the need for these precursor cells, biotech companies form an essential middleman between tissues donated from abortion clinics and the research labs that need it. They insure that informed consent is obtained, harvest the organs, in some cases isolate and purify the cells, and then ship them out to laboratories. There are profits to be made by such middlemen in what critics call the abortion industry. I fetus runs upwards of $850, not including testing, cleaning, or shipping charges, while a vial packed with pure stem cells can fetch more than $20,000.

The use of fetal tissue in research is not new. Fetal cells extracted from the lungs of two aborted fetuses from Europe in the 1960s are still being propagated in cell culture. They're so successful that today we we still use them to produce vaccines for hepatitis A, rubella, chickenpox, and shingles. From two terminated pregnancies, countless lives have been spared.

It isn't just vaccines. Scientists at the University of California, San Diego, have injected neural stem cells into two patients to treat their spinal cord injuries. And progress is being made in the use of stem-dell therapies against cancer, blindness, Alzheimer's , heart disease, H.I.V., and diabetes.

As impressive as this is, for critics the lives saved cannot make up for those that have been lost. And as important as I believe the research was, I sympathize with the sense of loss, even after leaving the [USC] lab for Boston. 

Every week when the plain white FedEx box was delivered, uneasiness permitted the lab. We all knew that the tissues contained within were precious. We planned our experiments meticulously, trying not to waste a single drop. We rationalized using the cells by telling one another that the abortions would happen regardless of whether we used the tissue for research. And we knew that if we didn't use the tissue it was bound for the trash.

Still, even with our preparations, justification, and sheer excitement that accompanied our research, the fetal cells brought sadness. We wished we didn't have them, despite the breakthroughs.

This is why it was difficult to hear Dr. Deborah Nucatola, Planned Parenthood's senior director of medical service, discuss the organs of aborted fetuses so casually in surreptitiously recorded conversations with anti-abortion activists posing as fetal-tissue buyers. It's understandable that politicians, angered by her callous tone, are investigating how fetal tissue is handled and how research is conducted, despite the strict institutional review that governs the use of anatomical tissue donated to research.

Politicians aren't the only ones looking for answers. Scientists are searching for alternatives to fetal cells. One solution may lie in reprogramming adult cells, creating what researchers call induced pluriponent stem cells. These cells share the ancestral adaptability of embryonic stem cells, yet can also be manipulated to look and act like fetal stem cells.

And yet, every time I worked with a fetal liver, I imagined that somewhere in California a woman had made an agonizing, heartbreaking decision to end her pregnancy. Yet she had also donated her aborted fetus to medical research. I thought of this as I isolated the golden-tinged cells inside the vent hood. A promise had been made; these cells were not simply trash.

The choice I made is repeated every day, in labs all over the world, Researchers have no say in whether a fetus is aborted or developed into a human body; those decisions are made by women and shaped by politicians. Yet their science, performed on discarded tissue, has the ability to save lives. It already has.