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Originally published in “Tuttoscienze” of La Stampa, 20 April 2005

Diabetes, strokes, Alzheimers, Parkinsons, multiple sclerosis. Each year these illnesses doom millions of people and their loved ones to a difficult life. Currently there is hope, even if only a theoretical one, to treat, or even to fully heal, these illnesses using embryonic stem cells which are derived from human embryos. But since it is necessary to destroy embryos at a very early stage of development in order to obtain the stem cells, for years these cells have been at the core of a controversy which is basically centered around one single ethical dilemma: is it acceptable to destroy human embryos? Or, is a human embryo, regardless of its phase of development, always a baby and so by destroying it we destroy a human life? Roger Pedersen is one of the leading experts in human embryonic stem cells of the world. He spent 30 years doing research in the U.S., but when the Bush administration banned public research on embryonic stem cells in 2001, Pedersen left his country, his friends and whatever he had achieved over the 56 years of his life and went to Cambridge, England. Today he is the head of the biggest stem cell research centre of the world: the Cambridge Stem Cell Institute, a £ 16.5-million (24 million Euros) centre founded to bring stem cell research and medical applications together. We spoke with him about embryonic stem cells.

Professor Pedersen, are you satisfied with your choice to leave the U.S.?

I think it was the best career decision I have made in my life. Here, I can work on embryonic stem cells at the highest level; this kind of research is widely supported and well funded.

In any case, after the Bush administration banned embryonic stem cell research, you could have decided to change the focus of your research. And actually, as a researcher with your reputation in the U.S., you could certainly have obtained funds and recognition in other areas of science. Whereas, in order to pursue embryonic stem cell research, you left everything. I suppose you had strong motivations for studying those cells…

Personally, I think they offer great opportunities to humankind. And ,actually, we have already found proof of the benefits which human embryo research can offer us. Thanks to this research, we can treat infertility - those people who thirty years ago had no hopes of having a baby can now have babies. And we should not forget that everything began here in England: the first test-tube baby was born thanks to Professor Robert Edwards at Cambridge University.

Who is funding your research?

I don’t receive even a penny from pharmaceutical companies. All my funds come from the government; more precisely, from the Medical Research Council, from the Wellcome Trust, a not-for profit organisation, and from a studentship.

Let’s speak about the stem cell controversy. In an interview with a well-known Italian weekly magazine, a top level researcher on stem cells, Italian scientist Angelo Vescovi, declared that, according to biology, a seven-day-old embryo is a human being, as life starts at fertilisation. How do you comment on this?

I would comment by saying that this is a very arbitrary and misleading statement. Fertilisation is simply the fusion of two genomes together, the mother’s genome and the father’s, but that doesn’t mean we then have a human being who can be physically individuated. For example, every biologist knows that during the first two weeks after fertilisation, the fertilised egg can develop into twins. And, in fact, British regulations have been established according to this rationale: by limiting ourselves to conducting research on two-week-old embryos, we can be certain by a wide margin that they have not reached the point of becoming physically individuated human beings. This is what science dictates. The rest is religion or, in any case, metaphysics. Everyboby has his/her own right to believe in a religion, but he/she does not have the right to pass it off as science.

There is an aspect of embryo research which seems particularly disquieting to the public: the fear that, due to economic interests or scientific curiosity or madness, sooner or later scientists can arrive at the point of performing inhuman manipulations or experiments similar to those the Nazis carried out. Are you afraid of this?

I think that we should confront these kinds of fears much more rationally, since what happened during the Nazi regime happened under a regime of terror. In a democracy, science is very different, as there is room for public debate, dissent, rejection, democratic laws and controls. For example, here in Britain, whoever wants to do research on human embryos must apply to the HFEA, the governmental authority which controls and licenses all British reproductive medicine and embryo research. The HFEA examines all the research projects and decides which project should be licensed and which not. No license means no research and no money for research. Rules are very tight and straightforward and the HFEA can send inspectors into the labs. I can assure you that nobody wants to risk, as violations are not punished with a simple penalty but are punished with jail.

Some claim that there is no need to get involved in an ethical controversy in order to develop therapies; we could settle for adult stem cells, which are not ethically controversial. What do you think about this?

I think that, since we are at the beginning of our studies, it would be ridiculous to abandon embryonic stem cells. First of all, we are in the phase in which we must understand how stem cells work, both embryonic stem cells and adult ones. If we don’t understand, we go nowhere. And so, we need to study both of them - if you want to understand a pear, you have to also study an apple, or maybe an orange because that tells you what a pear is and what it isn't. In addition, since, as I've said, we are only at the beginning of our studies, nobody can say with certainty which direction the clinical applications will come from. So, if we abandon embryonic stem cell research, we risk cutting off an entire sector of clinical applications. It would be like saying, after the discovery of the first antibiotic, penicillin, that we didn’t want to know anything about other antibiotics, that penicillin was enough. We now know that bacteria can become penicillin-resistant and some people are allergic to penicillin. Had we abandoned the studies of antibiotics after penicillin discovery, how could we have treated infections resistant to penicillin and allergic patients?

People who oppose the research and use of embryonic stem cells sustain that all the stem cell treatments currently available are actually derived from adult stem cells and that no patient has so far been cured by embryonic stem cells. Is this true?

Yes, but we should add that therapies derived from adult stem cells use a particular set of stem cells - that is, blood stem cells - which have been known of and studied for twenty years, and in twenty years there has been enough time to derive treatment. Embryonic stem cells were only discovered in 1998. I think it is quite understandable that we don’t already have treatments from them, as six years are very few. However, even if we don’t have treatments yet, by using animal models – mice in particular - we have proof of the principle that they can have therapeutic applications.

Some claim that the huge economic interests of biotech companies searching for patents and so on are the real pressure for studying embryonic stem cells. What do you think of this?

It is true that therapeutic applications of embryonic stem cells can have economic value. Nonetheless, I think the perception in this is inaccurate. I have been working on embryo research for 30 years and, until I was 56 years old, I was doing research in the U.S. where, quite often, science means technology and therapy - that is, business. Do you know how many biotech companies working on stem cells I have known? Four. Two of them were working on adult stem cells and went bankrupt, as they were unable to make a profit due to the lack of demand for their therapy. The other two biotech companies were working on embryonic stem cells, but they weren't able to get investments from Big Pharma, the group of large multinational pharmaceutical companies.

How is this possible?

Big Pharma is not interested in investing in areas of research which probably will bear fruit in ten years time, as embryonic stem cells seem to promise. They have areas which can assure profits quite quickly and so they prefer to invest in those areas. And this is why embryonic stem cell research should be funded by public investments. Private firms invest according to a profit rationale and not because the research promises to revolutionise medicine.

In ten years time, what can we reasonably expect?

I think at that time we can expect to have understood how embryonic stem cells work, which properties they have in common with adult stem cells. And I am confident that this understanding will translate into applications which will have medical and social consequences of such proportions that maybe we cannot even imagine them now. In any case, even in a worst-case scenario that we will not derive any treatment or medical benefits, nonetheless I think that studying them will bring us to the most exciting discovery of our time: how human beings develop.

Don’t we already know this?

We know very little about the first stage of development of a human embryo, since in that phase the human embryo which develops inside a woman’s body attaches to the wall of the uterus and becomes “invisible” from studies. But now, by studying it in vitro, we will have access to that first stage. The same science which has investigated the origins of the universe and of our species now can investigate the Big Bang of human beings.

In conclusion, would you advise your American and European colleagues to do what you did: to quit everything?

It is a personal choice. I can just say that here in Cambridge we welcome prominent researchers who want to do research on embryonic stem cells. And, in fact, many of them are on their way here.