Cell therapy – medicine of the future
Gennady Sukhoi: "Medicine of the future requires courage"
Tatiana Guryanova, AIF Health, 28.01.2009
Cell therapy is a young field for our medicine. Although our scientists have been developing this promising area for fifteen years. Among those who stood at the origins of cellular technologies in Russia is Academician of the Russian Academy of Medical Sciences, Doctor of Medical Sciences, Professor, Director of the Scientific Center of Obstetrics, Gynecology and Perinatology Gennady SUKHOI.
Medicine of the future– Gennady Tikhonovich, there are legends about your works aimed at combating serious ailments.
Having headed a large scientific center, have you continued to develop fundamental research in the field of cellular technologies?
– Absolutely. We have organized two very powerful laboratories in our Center – cellular and molecular biology. Although this topic is quite seriously dealt with not only here, but also at the RAMS Surgery Center, at the Russian State Medical University, at the I. M. Sechenov Moscow Medical Academy.
– When they talk about cellular technologies, first of all they mean stem cells. Is this the main direction of your work?
– In fact, cellular technologies are a broader concept, which includes not only work with stem cells. One of the examples of such work can be considered the immunization of women with husband's or donor's lymphocytes practiced in our center, who, due to immunological problems, lost three or more pregnancies in the early stages. By restoring the natural defense mechanism that these couples do not develop, we managed to give the desired child to many dozens, hundreds of families.
Speaking of stem cells, you need to understand that this is a family of different types of cells. Moreover, there are two fundamentally different groups in this family: donor cells, which are obtained from the blastocyst (the early stage of embryo development), and our own cells (adult stem cells), which we can receive from a variety of sources.
An ordinary miracle– And yet a significant part of your research is related to fetal (germ) cells.
Why?
– This is a unique biological material. These cells have a fantastic ability to grow and immunological neutrality, so when injected into another organism, they are not rejected. The fact is that in the prenatal period, all cells are relatives, there are no enemies, there are no borders. In addition, embryonic cells have a universal mechanism for instant killing of "disobedient" cells that have gone out of control. These unique properties of embryonic cells initially guaranteed their success in the fight against the most severe ailments.
"Like what?"
– With the help of cell transplantation, it is possible to treat cirrhosis of the liver, kidney diseases, diseases of the central nervous system (Down, Parkinson's, Alzheimer's), prevent the most severe, fatal complications of type I and II diabetes mellitus, and other endocrine disorders. Our center is currently conducting very interesting work together with the Scientific Center of Cardiovascular Surgery named after A. N. Bakulev and with cardiologists from the I. M. Sechenov MMA on the restoration of myocardial tissue in patients after extensive heart attacks.
And recently, a significant event took place in our center: after undergoing stem cell treatment, for the first time in the world, a young woman with depleted ovary syndrome (when menopause occurs in women aged 26-32 and no hormonal treatment helps) became pregnant and gave birth to a healthy child.
The production of embryonic stem cells from umbilical cord blood is also developing intensively in our center. These are also very interesting cells, with which, if necessary, we can already treat an unborn child from various pathologies in utero.
Arguments against ignorance– I have heard about your interesting work with children suffering from Down syndrome.
What is her fate?
– We were forced to stop these studies. Although the first results were very encouraging. We tried to preserve the brain in children with Down syndrome, try to develop it as much as possible so that these children would be socially adapted so that they could learn. But, in order to talk seriously about this work, you need to have a large evidence base based on statistics from several dozen, or maybe hundreds of such children, whose fate we would trace to 5-7 years. But due to misunderstanding on the part of society, or even some of our colleagues, we were forced to interrupt these studies.
– As far as I know, the same sad fate befell another, very promising and important area of your work – with traumatic brain injuries in children on the basis of the children's Hospital No. 9 in Moscow...
– Alas. The fact is that research in the field of embryonic stem cells is associated with something controversial. The keyword "abortion" immediately comes to mind. But these cells are obtained not only from abortive material, but also from in vitro fertilization programs, which are popularly called "test tube babies". Formally, this is a failed life, the extra cells left over from the program. The biggest ethical debate in the world is unfolding around them.
And when it comes to the use of fetal cells obtained from the remains of abortive tissue, there are much fewer ethical problems in the Western world.
- why?
– Because the right to decide whether this pregnancy will develop or not belongs to the woman herself. By the way, if we return to our work in the department of pediatric neurosurgery, its results were more than encouraging. And this work can be restored even tomorrow. What is missing is the strong-willed decision of medical officials. And while this is not happening, we are working on rats, on mice, and at this time someone's children are dying, who are not helped by classical methods of therapy. Tell me, where is the ethics here? Is it ethical to drain a biologically priceless material that can not only save, but also revive another life into the sewer?
Strength check– Is there a lot of material required for cell transplantation?
– A little. Tissues and cells obtained from 30 biological units are enough to treat 300 patients. The drug obtained from embryonic tissues is injected into the patient's body by injection. However, the path from the initial substance to the finished "medicine" is long and complicated. The tissues necessary for the preparation are isolated from the embryo. This process is time-consuming and requires jewelry precision and absolute sterility. The processed material enters a special laboratory, where it is thoroughly cleaned, tested and certified.
– And if the pregnancy was terminated naturally? Can this material be used for cell therapy?
– No way! Because if nature, evolution has stopped the development of this pregnancy, it means that these cells are potentially unhealthy initially. That's why my colleagues and I are categorically against the thoughtless, commercial use of stem cells. There should be no random people in this area. I am convinced that during the formation of cellular technologies in our country, it would be right to limit this area to the framework of large federal centers with scientific potential and state level of responsibility.
– Or maybe we need an appropriate law regulating this area?
– Work in this direction is underway: together with the State Duma committees, a large group of our colleagues is working under the leadership of Academician of the Russian Academy of Sciences and the Russian Academy of Medical Sciences, Rector of the I. M. Sechenov MMA Mikhail Alexandrovich Paltsev. But the process of lawmaking is slow. In the meantime, we are trying to solve this problem within the framework of the RAMS, ethical committees, academic councils. And I would like us to have the courage, and our leaders and colleagues the wisdom not to close this area, not to lose what we have gained. To slow down the development of this area means to slow down the development of medicine.
Portal "Eternal youth" www.vechnayamolodost.ru29.01.2009