Stem Cell Research: Advantage India

Lakshmi, a 28-year-old woman from Guntur finds it hard to forget June 19, 2009. That was the day she became a victim of an acid attack. Her face was burnt and the eye damaged. Unless she manages a cornea donation, her loss is likely to be permanent. For Lakshmi and others like her, the work that is being done in L.V. Prasad Eye Institute, Hyderabad, can mean a rescue from blindness. If the Eye Institute keeps to its path of progress in stem cell research, Lakshmi could grow her cornea back. “We have tackled almost 600 such cases using stem cells from corneal epithelium,” says D. Balasubramanian, director of research, L.V. Prasad Eye Institute. A combination of factors have made India one of the hotbeds of stem cell research in the world, with both the government and private firms working in very interesting areas to win the sweepstakes of life as it were.

The world over, stem cells have been touted as the new medical technology with potential to change the way healing happens in a human body. The human body is made of cells which carry genes. Genes are the carriers of inheritance (curly hair), and all characteristics (deep baritone voice, pouted lips) that make a human being distinct. Stem cells are specialised cells found in certain parts of the body — umbilical cord, bone marrow, embryo and even teeth — that have the capacity to become like any other cell in the body. If stem cell technology develops fully you would be able to grow back a malfunctioning lung, atrophied heart muscle, burnt skin or failing kidney.

In the US, the Obama Administration has announced an increase in government funding for stem cell research. South Korea has a stem cell programme that is now eight years old and has provided close to $150 million dollars to develop stem cell lines that can be used in a variety of therapies. The most heartening thing is that India has got into researching stem cells very aggressively.

Stem cells are the Holy Grail of medicine and no country has a clear advantage as yet. USA could have had the lead but the Bush administration delayed research into stem cells on ethical grounds. South Korea looked like it had a lead when a Korean scientist Hwang Woo Suk claimed that he developed medically useful embryonic stem cells. Unfortunately, his claim was false. That set South Korea’s stem cell research back. India therefore has a chance to be one of the first to understand and use this technology.

Government of India realises this and the Department of Biotechnology has allocated more than Rs. 300 crore over the last five years towards basic and applied research in stem cell technology. Since the programme is government funded, it focusses on diseases that affect millions of Indians rather than exotic diseases and reminds one of its vaccine programme.

The entire government directed effort is in understanding the fundamentals of how stem cells work and conducting clinical trials to gauge the effectiveness of the therapy. The leading organisation doing the fundamental work is the National Centre for Biological Sciences (NCBS) in Bangalore. “We are developing model systems, for example planaria or hydra to understand how stem cells work,” says S. Ramaswamy, Dean, InStem, NCBS. Model systems are simple systems that scientists study to derive principles that can be applied to more complex systems. For instance, bacteria and yeast are model systems to understand molecular biology.

Flanking InStem at NCBS are a variety of institutes like AIIMS, L.V. Prasad Eye Institute, Center for Stem Cell Research at CMC Vellore and National Centre for Cell Sciences (NCCS) at Pune University. Most of these institutes are focussing on applied part of the research. They are trying to focus on three areas: Regeneration of damaged muscles due to heart attack, stroke or cornea damage. Given the prevalence of heart attacks, blindness and strokes, this seems a sensible strategy.

The task of these institutes is to locate promising sources of stem cells, apply stem cell therapy to cure patients and verify if the procedure is stable enough for wider applcation.

This is exactly the area where private effort too has come to the fore. Dr. Satish Patki, along with Dr. Ramesh Bhonde of NCCS, have shown that the female genital tract (endometrium) is a rich source of stem cells. Dr. Patki is now trying to see whether these stem cells can be used to generate blood flow to the foetus. “Without this therapy the blood pressure of the mother can rise to extremely abnormal levels and a doctor may have to abort the pregnancy to save the mother,” he says. As of now, he has only been able to use the tried and trusted bone marrow stem cells to do this. Now he is beginning trials to see if he can use source stem cells. Dr. Naresh Trehan at Medanta Hospital in Gurgaon has used bone marrow stem cells to grow capillaries in patients who don’t have alternate blood vessels for a by-pass operation. Reliance Life Sciences has just been given the go ahead for using stem cells sourced from one’s own body for therapy on a large scale.

If stem cells are going to be needed then someone will have to store them. Companies like Reliance Life Sciences and Lifecell have created facility to store stem cells from umbilical cord. Stemade is trying to store stem-cells from milk-teeth.

All this explosion of enterprise in stem cells is not without worries. There are reports of people being given “stem cell” injections for Rs. 80,000 a pop! There are ethical worries on the side-effect of such treatment. “Experimentation is good but having regulatory framework is absolutely essential. Right now we only have guidelines,” says Ramaswamy of NCBS.