If there's any hope for a cure for Zucker and more than 1 million other Americans with Type 1 diabetes, the most debilitating form of the disease, it may lie in a revolutionary new field of research based on manipulating human embryonic stem cells. These building blocks of life, when isolated in a microscopic cluster of cells, can morph into any kind of tissue. (So-called adult stem cells, which can be harvested without sacrificing embryos, can turn into only a few tissue types.) One day, scientists hope, the entire genetic makeup of a patient like Zucker could be transferred into a cloned human egg that can produce the insulin-producing cells her body lacks.
But some religious groups believe the clumps of 100 to 200 cells from which embryonic stem cells are taken represent a potential human life as worthy of protection as any child's. Three years ago, President George W. Bush, under pressure from both sides, adopted a compromise that ended up choking off most federal research funds to the field. He said at the time that although the research offered "great promise" in saving lives, it could lead to "growing human beings for spare body parts."
Today a brush-fire challenge to Bush's stem-cell policy is spreading across the U.S., fueled by the frustration of such families as Zucker's who have allied themselves with patient activists for other diseases, major universities, several state legislatures and members of Congress. Last month 206 U.S. Representatives wrote to the President, calling on him to fund stem-cell research on spare embryos from a pool of some 400,000 stored in the freezers of in vitro fertilization clinics. These embryos, only a few days old and smaller than the head of a pin, will probably be discarded unless they are donated to science. Embryonic stem cells, the letter noted, can be used to treat "diseases that affect more than 100 million Americans, such as cancer, heart disease, diabetes, Parkinson's, Alzheimer's, multiple sclerosis, spinal cord injury ..." The signatories included two dozen pro-life Republicans.
Given the emotional nature of the debate, the Bush White House is unlikely to make any sudden moves before the November election. But in a startling rebellion against the federal biomedical establishment, several states are moving forcefully into the vacuum. California and New Jersey have passed laws specifically authorizing the cloning of human eggs to create stem cells (so-called therapeutic cloning), and the legislatures of seven other states, including Illinois and New York, are considering similar bills. This week New Jersey Governor James McGreevey, in a nod to the state's pharmaceutical industry, will inaugurate a $50 million stem-cell institute to be funded with state and private money. In California, activists last month submitted 1.1 million signatures nearly twice as many as necessary to launch a November ballot measure that would underwrite stem-cell research with $3 billion in state bonds over 10 years. The California funds would dwarf federal grants, which have stalled at about $17 million a year for human embryonic research since Bush restricted funding to a few dozen pre-existing stem-cell lines. Only 19 of those turned out to be available. Says Stanford Nobel prizewinner Paul Berg: "California is paving the way for a revolt in a lot of other states."
Meanwhile, universities are maneuvering for position, fearing that they could lose their brightest scientists to programs overseas. It was only six years ago that a biologist at the University of Wisconsin in Madison, James Thomson, isolated the first human stem cells from in vitro embryos. But in February, South Korean researchers stunned the scientific world by successfully harvesting stem cells from cloned human embryos considered the most promising avenue for treating disease. A prestigious American investigator moved to Britain, where the research is encouraged. Now Stanford and Harvard hope to raise at least $100 million each for new stem-cell institutes. The universities of Wisconsin and Minnesota are expanding their labs, and in March an anonymous donor gave $25 million to the University of Texas to boost its Houston program.
Billions of dollars are at stake in the race for medical cures. California boasts half of the nation's biomedical research capacity and one-third of its biotech companies. The bond initiative, if it passes, would pay to build 12 to 15 new stem-cell research centers, a massive magnet for scientific talent. "California will be the center of stem-cell research for the world," predicts Palo Alto real estate developer Robert Klein, co-chairman of the initiative campaign. Klein, who has contributed $1.4 million of his money toward the effort, touts the economic benefits, forecasting $70 million in tax revenues from new jobs even before any cures are discovered. And if cures are found, the profits would accrue to California companies, along with substantial savings on the state's $114 billion annual health-care bill.