A Defense of Donated Fetal Tissue in Scientific Research

Let me introduce this by saying that this article is super late to the party, but I still believe it’s important for me to say something on behalf of the scientific community. At least, on behalf of my own research and research being done in my field.

The subject is donated fetal tissue for use in scientific research. This subject induces a lot of passion in people- probably all of you saw your pro-life family members writing about how this disgusted them, or your pro-choice friends were desperately trying to keep this subject separate from the ongoing battle for reproductive freedom.

It has been covered ad nauseum, but let me begin by giving a quick overview. Three sting videos (so far) have been released by the pro-life group Center for Medical Progress wherein the undercover person poses as a biotech company representative meeting with a medical director of Planned Parenthood. The videos are highly edited and leave out very important details. One claim made is that Planned Parenthood is breaking the law by selling the fetal organs for profit — the claim that the entire sting video in essence rests upon. This is not true, a fact revealed when the unedited, full length videos were released. The medical directors of Planned Parenthood clearly state that they only collect money for shipping and handling fees. As a graduate student in Biological Sciences, I have also been a research technician. From my experience, I can say that the range given is entirely reasonable for shipping fees.

My work is a combination of stem cell biology and reproductive biology, in particular the development of the placenta. It fascinates me that there is so little known about the placenta. It’s a very tough organ to study in humans since ethically it’s not good to do experiments on pregnant women. It’s extremely vital to life and could be responsible for many early human gestational problems that result in pregnancy demises of causes yet unknown. Just knowing what predisposes a woman to a certain pregnancy complication would be a huge step forward in a field that is filled with more uncertainty than almost every other medical field.

As part of my research, I get to think of creative and interesting methods to study the placenta in more ethically sound ways in the lab. Our lab utilizes human embryonic stem cells and induced pluripotent stem cells, turning them into trophoblast cells which are the invasive cells of the placenta. Yes, placentas have to obtain that blood and nourishment from someplace, so they must invade the maternal endometrium to tap into those sources.

Stem cells are fascinating. Here we have a cell that has the potential to give rise to any other type of cell if given the right environment. One aspect of that environment is the composition of the extracellular matrix, which is what I study. Trophoblast cells need to invade through a variety of matrix materials in order to access the blood supply. Sometimes, this invasion is not deep enough, and complications such as Intrauterine Growth Restriction (small baby) of the fetus or Preeclampsia (high blood pressure, deadly in severe cases) in the mother can occur. Stem cells have so much potential to help scientists study the development of such complications. But it is also very valuable to have the actual cell type you’re trying to replicate as a reference.

This is where donated fetal tissue comes in to play.

I guess you could say I’m lucky in that I study the placenta. Because it is already seen as a disposable organ, it promotes less of an ick-reaction when I think about using it for my experiments. But fetal neurons, muscles, lungs, or hearts are somehow different in our minds, and it is uncomfortable to think about, particularly when these cells are obtained from an elective abortion. I think we can all admit that. But is that momentary discomfort reason enough to outlaw the progression of this type of research? I think a thorough investigation into the benefits of these cells is warranted before making sweeping decisions on their use in medical research and -probably more impactful- the proposed defunding of Planned Parenthood (in which taxpayers’ money is not used for abortion services).

It is important to understand that much of the research being done using donated fetal organs is actually based on eventually phasing-out their use. Similar to what my lab does with taking stem cells and turning them into trophoblasts, many labs are working on how to make a neuron or muscle or lung from stem cells. In order to get there, we’ll need to use embryonic stem cells that we KNOW can give rise to any tissue and reference that to the organ we’re trying to replicate in the fetus. Once we’re confident in that system, we can take induced pluripotent stem cells -cells harvested from the adult and taken back to a more plastic state using genetic modification to give rise to any cell type in the body- and try replicating in those cells what we see in the stem cells turned into your organ of choice.

It’s a long, hard, annoying, satisfying, interesting, and hopefully in the end fulfilling journey to this end-goal of helping people recover from debilitating diseases or injuries. It will take YEARS, LIFETIMES to figure out how to take skin cells from your arm and turn it into a new heart.

To be clear, research with embryonic tissues is not like the episode of South Park where Christopher Reeve eats fetuses like potato chips (or slurpies?) to cure his paralysis. It’s regulated and peer-reviewed. We are excited about the potential of the cells to help people. We hope one day to not need donated tissue at all, but there has to be steps of verification along the way. Otherwise, you’re not doing science.

Something I haven’t seen stressed enough in the media coverage of this story is that we scientists have immense respect for the tissues or cells that are donated. We optimally preserve the samples or freeze away numerous vials of cells so that we can get the most out of each experiment and prolong their usage. We try our hardest to plan experiments in advance so that nothing goes to waste. This extra work is essential, and wasteful science will inevitably sink. It is not just essential to survival in science — it is also most ethical.

This argument inevitably leads to whether abortion should be legal or illegal. I don’t want to discuss the right of women to have an abortion. That has already been decided by SCOTUS to be legal. So, while we have safe, elective abortions occurring in this country, early fetal tissue will be thrown away as medical waste if researchers are barred from its use. Ick-factor and ensoulment arguments aside, wouldn’t we rather make some use of this tissue and turn it into knowledge that will help many more people right now and in the future? In my case, we could gain huge leaps in understanding preeclampsia and an abundance of other complications of the placenta that will go insufficiently studied should this tissue be barred from our use.

Or, do we throw it all away?

A popular defense of fetal tissue research is the use of human fetal kidney cells in curing polio. From my online research, the polio virus and vaccines were tested on monkeys in the 1950s, while the embryonic kidney cells weren’t isolated and propagated until 1970. So, the cells weren’t used initially to study polio, but they have been used since the 1970s to amplify lots of viruses, including new strains of polio, that can then be studied. This is certainly a great innovation resulting from using donated fetal tissue.

But the science doesn’t stop at polio. Much more knowledge has been gained from these cells, called HEK293 cells. Just a quick search of “HEK293” on PubMed, a search engine for biomedical research articles, brings up 28,015 different published papers using this cell line (assuming each paper is about 10 pages long, this is a stack of papers measuring 46 feet, 10 feet longer than a school bus). Using Google Scholar, which searches a broader range of published academic articles, brings up 116,000 results. Nearly every cell, cancer, developmental, and molecular biology lab uses this cell line. One of the most important utilizations is their high efficiency in making viruses. Viruses can work in our favor in science since they are very good at injecting DNA into other cells, such as cancer cells, and this alters the gene expression of those cells. The viruses can contain whatever DNA sequences we like, having broad affects on the cells by modulating genomes in ways of our choosing. The resulting behaviors (such as cell division rate or invasiveness) can then be analyzed and finally, we learn a little something about what certain genes do in cells and we cure stuff! (Or at least learn how to treat it) Altering genes is just one use of the viruses provided by HEK293- we can also use these viruses to make cells fluorescent so they can then be measured by tracking their movements; the possibilities are endless. So in conclusion of this fetal kidney cell controversy-yes, we can cure polio with it, but we’re still propagating the same cells isolated way back in 1970 and they have proven to be an extremely useful scientific tool that have surely made a large impact on human health and wellbeing.

Senator Ted Cruz has written to the director of the NIH (National Institute of Health) Francis Collins calling for an investigation into NIH-funded research utilizing donated fetal tissue in order to confirm that no principal investigator (fancy name for head researcher on a grant) has purchased fetal tissue from for-profit distributors. He highlights a company called StemExpress which do appear to distribute cells from fetal liver. He sites that he has found a purchase of $25,000 from this company and wants to confirm that this was not fetal tissue purchased for profit with NIH money. I don’t think this investigation will come up with anything criminalizing- the accusation seems very vague to me. However, with this issue being raised in the public consciousness, what I am afraid of is that Francis Collins may not fight on behalf of this research. He has historically been against all research involving human embryos. Collins has not released any statements I could find on this issue but he has shown to be against the use of human embryos for research. Of recent note, he condemned a lab from China for their use of polyspermic, (too much DNA to thrive) non viable human zygotes (single cell embryo) for research using gene-editing tools such as CRISPR/Cas9 stating that this research will never occur in the US. These gene-editing tools are new, but show great promise in preventing disease in humans from the very, very beginning and are already widely used among numerous labs for gene editing in existing cell lines or whole animal models. I would not be surprised if Collins doesn’t defend this research should there be legislative action against it. I hope senior members of my research community will act should these issues surface.

In the sensational nature of political campaigns mixed with scientific ignorance, these topics are going to be misrepresented, exaggerated and used as political ammunition in a desperate attempt for republican candidates to stand out as being the most pro-life. Already, we’re seeing fast-tracked legislation to de-fund important healthcare programs provided by Planned Parenthood.  I look forward to the conclusions of the investigation of the NIH and hope that this issue is resolved without taking away the healthcare that thousands of women in this country depend upon. A great op-ed (http://www.nytimes.com/2015/07/30/opinion/the-case-for-fetal-cell-research.html?_r=0) has been written by Dr. Nathalia Holt on many of the topics covered above, articulated beautifully and said with much sensitivity which is very much appreciated. My hope is that more scientists will speak up and tell their stories in defense of stem cell research.

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