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Deregulating stem cell quackery in Italy? A bad omen.

Stem cells are magical, mystical things that can’t be explained.

At least, if you listen to what docs and “practitioners” who run stem cell clinics in various parts of the world, usually where regulation is lax and money from First World clientele is much sought after, that’s what you could easily come to believe. Unfortunately, it’s not just Third World countries in which “stem cell clinics” have proliferated. For instance, they are not nearly uncommon enough in Europe. The example that is most troubling right now is Italy, and the reason is that there is currently a law being considered that would greatly weaken the regulation of stem cell therapies, so much so that on Friday I saw something that’s fairly rare: a major scientific journal published a pointed editorial about this new law, specifically EMBO Journal published a commentary by an international group of scientists warning about the path that the government of Italy is considering entitled Regulation of stem cell therapies under attack in Europe: for whom the bell tolls.

Stem cell quackery is a very popular form of quackery these days because, well, stem cells are so magical-seeming. You can now find stem cell treatments offered for autism (one of which, offered at a clinic in Costa Rica, I’ve discussed before and involves injecting “stem cells” into the cerebrospinal fluid of autistic children for a cool $15,000). Kent Heckenlively, the man who took his daughter to the aforementioned Costa Rica clinic for this treatment is not alone in subjecting his autistic child to such unproven uses of stem cells. Just a couple of months ago, a broadcast journalist in the Philippines named Karen Davila took her autistic son to the Villa Medica Clinic in Germany, which offers variants of stem cell therapy. One is known as “fresh cell therapy” and involves harvesting cells from lamb fetuses and injecting them into the patient. The other is called fat stem cell repair therapy, which is claimed to involve harvesting fat from the patient’s abdomen or thigh and then isolating “stem cells” from them to be injected back into the patient’s body.

There’s also a variation on this “stem cell” theme in China, discussed by Steve Novella a few years ago, in which Dr. Hongyun Huang runs a clinic in which he injects “stem cells” claimed to be derived from olfactory sheath cells taken from aborted fetuses into the cerebrospinal fluid of patients suffering from spinal cord injury or motor neuron disease like amyotropic lateral sclerosis (Lou Gehrig’s disease), claiming what can only be referred to as miraculous cures, sadly credulously reported by the press. He’s a little more expensive, in that he charges $20,000 (or at least he did back in 2008, when Steve wrote his post).

It’s not just neurological diseases and conditions for which stem cell treatments are offered, though. Dubious “stem cell” treatments can be easily found for virtually any disease that is currently incurable, chronic, or only treatable with great effort and not-so-great success. The list of diseases and conditions include, in addition to developmental disorders such as autism, neurological injury, and degenerative neurological diseases such as multiple sclerosis, diseases as diverse as heart disease, autoimmune diseases, respiratory disease, HIV/AIDS, diabetes, hypertension, cancer, and, of course, anti-aging. Truly, there is seemingly no disease for which some clinic, somewhere in the world (usually in Central America and China, but sometimes in Germany and the former Soviet Union) won’t be claiming miraculous cures with “stem cells.”

One example, a clinic in the Ukraine called EmCell, advertises its wares with slickly produced infomercials, chock full of impressive-appearing graphics and animations:

It’s hard not to note that 1994, the year that this clinic came into existence, was long before legitimate stem cell therapy, other than bone marrow transplantation, had progressed to anywhere near being a viable therapy. Notice the claims of patents, mostly in Russia and the Ukraine, but a few European patents and a couple of US patents as well. I looked at one of the US patents. All it is is a method to prepare a “cell suspension” from human embryo that, or so it is claimed, is suitable for treating HIV. You know what you don’t see on the website? Solid evidence from randomized clinical trials. There are, however, many testimonials. It doesn’t help that well-known antivaccinationist and autism quack (in my opinion) Jeff Bradstreet is apparently the U.S. contact for EmCell.

Of course, EmCell is far from alone; it’s just one of the older and slicker “stem cell” clinics. There are many others, such as the Stem Cell Institute in Panama, the Bio-Cellular Research Organization in Ireland, the Regenerative Medicine Institute in Tijuana, among many others. Astute readers might have noticed that I use scare quotes when I discuss stem cells in the context of these clinics. That’s because it’s very much in doubt in most of these clinics whether what is being administered actually consists of stem cells. That’s where the need for regulation comes in most acutely. It’s also why what is going on in Italy right now is of great concern.

Attacking regulation of stem cell therapies in Italy

It’s been a bad year for Italian science thus far. Just last month, animal rights activists broke into the animal facility at the University of Milan and occupied it. During the occupation, they stole animals and rearranged all the cage cards so that scientists didn’t know which group of animals were which anymore, rendering their work uninterpretable and ruining years of research. Now this. If you think that the “health freedom” movement is limited just to the U.S. and its more libertarian-leaning groups, think again. The EMBO article, by Bianco et al, starts out describing how this proposed law came to be. Noting that this is the first case in which unproven “stem cell” treatments are recognized as legitimate therapy without having been tested in rigorous clinical trials and based only upon flimsy preclinical evidence, “to be made part of a publicly funded, public health care system,: Bianco et al write (note that “MSC” = “mesenchymal stem cell”):

Patients with disparate, severe neurological diseases were and are being treated, and will continue to be treated in a major public hospital in Italy, by intravenous and intrathecal infusions of ‘MSCs’, purportedly prepared according to a unique, novel method of isolation in culture, and in vitro differentiation into neurons. This activity had previously been taking place in Trieste. In Brescia, an official agreement had been stipulated between the public hospital and a private foundation, whereby the foundation was granted permission to prepare cells with the purportedly proprietary method. Cells for infusion into patients were prepared within a GLP lab (not stringent enough for growing cells in culture before use in patients), intended for the handling of bone marrow and cord blood-derived haematopoietic cells. Patients were being treated in the hospital. Patient care in public hospitals in Italy is paid for by the Government.

More information can be found in these news reports in Nature from March and April. Here’s what happened. Apparently, Italy’s health minister, Renato Balduzzi, has been impressed by the blandishments and claims regarding adult stem cell therapy and on March 21 decreed that that a controversial (actually, let’s be honest, a quack) stem cell therapy can continue in 32 terminally ill patients, mostly children, even though the stem cells were not isolated according to Italy’s safety standards. This decision followed a prolonged campaign and media pressure to authorize the compassionate use of the therapy. As noted in this Nature report, hundreds of people protested in Rome on March 23, including a naked woman with pro-stem cell slogans painted on her body.

This particular therapy is marketed by the Stamina Foundation and has been banned multiple times. However, this time the Stamina Foundation has found a winning public relations message, pushing for “compassionate use” of its unproven therapies:

Stamina Foundation president Davide Vannoni, a psychologist at the University of Udine, says that the publicity around the treatment has won him 9,000 new patients. He hopes that further modifications to the law will allow him to expand the therapy.

A month ago, an investigatory television programme, The Hyena, reported that children with incurable diseases such as spinal muscular atrophy were being denied supposedly important treatment, and Italian show-business personalities joined the call to relax rules on stem-cell treatment.

As is my wont, I wandered over to the Stamina Foundation website. Unfortunately, it’s in Italian, and I don’t speak Italian. However, a little Google Translate allowed me to get the gist of what the Stamina Foundation is selling. For instance, this page touts mesenchymal stem cell therapy (MSC) for everything from heart disease, to Parkinson’s disease, to multiple sclerosis, to kidney damage, to type I diabetes, to Alzheimer’s disease, to Huntington’s chorea, to spinal injuries, and just about anything else you can think of. That, in and of itself, should be a massive red flag, of course, coupled with the fact that in the news reports Vannoni admits that he’s never published his outcomes. Moreover, the only published outcome, a small trial involving five babies with type I spinal muscular atrophy treated with Vannoni’s MSCs was published in October and was entirely negative, leading the authors to conclude:

More generally, our findings highlight the risk that the combination of newspaper ‘hype’ and parental ‘hope’, with the support of courts that are sympathetic to families with children with severe disorders, may produce shortcuts in the design of clinical studies that would need more rigorous preclinical information and more accurate safety and efficacy measures and may actually put patients at risk of potential side effects of therapy.

Vannoni’s response? He claimed that the therapy didn’t work because the clinicians did not use his exact cocktail of cells.

Indeed, I can’t help but compare Vannoni unfavorably to Stanislaw Burzynski, who at least has published a few papers and case reports. They might be crappy papers, case reports, and incomplete clinical trials that, when examined closely, don’t support his claims, but he has published. Vannoni, on the other hand, seems not to care about even the appearance of not being a quack.

One aspect that Vannoni does share with Burzynski, however, is his willingness to cynically use desperate patients to try to get approval for his unproven therapies. Indeed, public hospital Spedali Civili of Brescia has been permitting the Stamina Foundation to administer MSC treatment for various neurodegenerative treatments, despite its not being one of the 13 authorized Italian stem cell factories. After an inspection in 2012, the Italian version of the FDA ordered an immediate halt to these treatments, and that’s when the protests began:

But the halt sparked protests among patients’ families who believed the treatment was working. Some appealed to the courts, and as a result a few patients were allowed to go ahead with the therapy. On 15 March, a group of 13 Italian stem cell researchers published an open letter to the country’s Minister of Health, Renato Balduzzi, asking him to shut down all of the Stamina Foundation’s treatments at the hospital.

The open letter urged Balduzzi not to succumb to the wave of emotion and pointed out that there was no evidence that MSCs can do what Vannoni and his patients’ parents claim they can do. They also argued that “compassionate use” exemptions shouldn’t be used as a means of weakening regulation of completely unproven therapies. Indeed, it’s worth citing a couple of passages, conveniently translated into English here:

The decision seems to be dictated by emotions raised by public opinion rather than by scientifically based reasons. No scientific evidence whatsoever has been produced suggesting that mesenchymal cells may have any effect on those diseases for which it is claimed they could be employed. Moreover, no scientific description has been given of the method by which it is claimed these cells may be obtained. This seems a real subversion of the scientific and moral foundations of medicine, denying both the dignity and the traumatic experiences of patients and their relatives. We are aware of these issues and they profoundly motivate the scientific community to generate and guarantee accepted, visible and public data that will change any potential scientific hypothesis into an accepted curative procedure.

The scientists also addressed the health freedom issue head on:

The freedom of any citizen to adopt any personal health decision, including the wish to refuse any cure, does not imply that the Government is obliged to authorize all medical procedures that anyone may suggest as appropriate. In fact, although the individual choice to use an imaginary or inappropriate therapy complies with the rights of individual citizens, such therapies should not necessarily be approved by the Government and provided by public or private health structures. It is not the Government’s role to respond to pressure from patients to translate an individual choice into a therapeutic option for ready use in any health structure. Media campaigns should not become instrumental in adopting decisions on medical or health procedures. The right of single individuals to adopt snake oil as a freely chosen drug does not mean that snake oil has to be prepared in hospital pharmacies as a result of Government-authorized procedures.

In other words, the Italian government is on the brink of giving free rein to stem cell quacks, but it’s worse than that. This order, as the scientists point out, in essence allows government-funded facilities to collaborate with stem cell quacks and facilitate their treating patients.

One point that the scientists didn’t really nail, and that’s the issue of informed consent. One notes that Vannoni’s stem cell quackery has no evidence for it published in the peer-reviewed biomedical literature nor any compelling clinical trial results. Consequently, if claims are being made for this treatment it is impossible to give informed consent because there is no evidence upon which to base even a rough estimate of the chances for success are weighed against the risks of the treatment. Even worse, we don’t even know that these are really stem cells. Seriously. As the scientists point out, there is no transparency, and if there’s an area of clinical research where transparency is essential, it’s stem cell research.

Sadly, the scientists’ words fell on deaf ears. In fact, Balduzzi had called a scientific review committee to examine the cases and make recommendations. It recommended against authorizing further use of the Stamina Foundation’s stem cells in a public hospital, but Balduzzi ignored the recommendations of his own panel and permitted use of the Foundation’s procedure in a terminally ill three year-old. Indeed, not only did Balduzzi sign the order allowing the bogus MSC therapy to continue at a public hospital. On April 10, the Italian Senate amended Balduzzi’s ministerial decree with a clause that would redefine stem cell therapy as tissue transplantation, thereby releasing it from any regulatory oversight by the government. If this decree is passed by the other parliamentary chamber in Italy, the Camera dei Deputati, then dubious stem cell therapies will be out of reach of Italian drug regulators. One notes that this will be in marked contrast to European Union and U.S. standards, which treat cells removed, treated, and reinfused as drugs, although sadly one also has to note that the attempt to redefine cell therapies as not being drugs but surgical procedures or “tissue transplantation” is not unique to Italy. Regulations for stem cell therapies are in a perpetural state of catch-up.

It’s also hard not to note that the Catholic Church apparently played a role in this scientific debacle. As noted in Nature, Vannoni’s stem cell treatments are not embryonic stem cells; they are claimed to be MSCs; i.e., “adult stem cells.” Because of its opposition to the use of embryonic stem cells, the “scientifically naive” Vatican is enamored of the sorts of treatments offered by the Stamina Foundation, and indeed even held its Second International Vatican Adult Stem Cell meeting from April 11 to 13, described as “a shamelessly choreographed performance” in which “sick children were paraded for television, sharing the stage with stem-cell companies and scientists desperate to hawk a message that their therapies must be speeded to clinical use” and was framed as a “fight for reason and fairness against an uncaring and intransigent scientific community.”

If you go to the Stem For Life website, you’ll find a lot of anecdotes, some preclinical science described, but not a whole lot of actual compelling evidence. One anecdote in particular is as manipulative as any I’ve ever seen anywhere else. Don’t get me wrong. I do believe that eventually that stem cells, be they adult or embryonic, will be used for more and more therapies and that they will eventually allow the treatment of diseases that we currently cannot treat, but we have to be realistic and understand what is and is not known about adult and embryonic stem cells before they are used as therapies.

Why the Stamina Foundation’s stem cell treatment is highly dubious

All of this brings us back to the EMBO article. I really do have to give the authors credit for a well-written, clear explanation of why MSCs are not ready for prime time yet and therefore why deregulating them, as the Italian government appears to be on the verge of doing, is madness. They pull no punches. First, they argue in a manner that I approve of heartily (and paraphrasing Tim Minchin) that “regenerative medicine must be medicine.” In other words:

Stem cells are not a homogeneous class of cells; ‘stem cells’ are not one-size-fits-all cures. There are different kinds of stem cells in different tissues, and even when the appropriate stem cell is selected for an indication it takes years of research to learn how to administer the stem cell safely and effectively, as demonstrated by the decades of research that was required to transplant bone marrow safely and effectively. The use of stem cells in medicine must remain cognizant not only of the true biological nature of the type of cells considered for use, but also of the biology of the diseases being targeted. Treating patients with disparate neurological diseases with intravenous or intrathecal infusion of MSCs, which is being done in Italy, has no medical rationale.

You can tell a lot about a purported stem cell therapy by how the “stem cells” are isolated and administered. If the physician doing the therapy can’t tell you what specific kind of stem cells he’s using, give a good technical description of how they are isolated and purified, show preclinical evidence demonstrating that they are, in fact, stem cells, and describe how he is going to target them to the correct area, then chances are good that the therapy is dubious. As Bianco et al point out:

In the case of systemic administration of mesenchymal stem cells (MSCs), cells are introduced into the bloodstream, which is not their natural environment. They are infused in the hope that they will reach target organs that do not normally contain MSCs. There is a wealth of knowledge about their function in their natural site (the bone marrow) and a wealth of knowledge on the properties they exhibit in a tissue culture dish. But it is not clear how exogenous MSCs will behave in the brain, kidney, or the lung. As inherently osteogenic and adipogenic cells, MSCs could generate bone or fat in the wrong organs if transplanted in sufficient numbers (Breitbach et al, 2007). MSCs can also embolize in the lungs and damage the local microcirculation. Allogeneic MSCs can trigger an adverse reaction (instant blood mediated inflammatory reaction, IBMIR; Moll et al, 2012), which leads to activation of the coagulation and complement cascades, and to the death of the infused cells. IBMIR can result occasionally in thromboembolism, but we were unaware until recently that IBMIR could be triggered by MSCs. This exemplifies why infusion of MSCs must necessarily be studied in rigorously controlled and monitored clinical trials before such therapies can be considered safe in patients.

In other words, just inject the cells either into the bloodstream or the cerebrospinal fluid, and hope like hell that they “home” in to the right place and know what to do. It’s not that simple, unfortunately. Adult stem cell therapy works for bone marrow transplantation because progenitor cells are made in the bone marrow and they tend naturally to stay there when the circulation takes them through the marrow. We also have 30 years of experience using adult stem cell therapy for bone marrow transplantation. Bianco et al recount a little history about this pointing out that the first trial using bone marrow transplant between unrelated patients resulted in the deaths of all the recipients in the trial. Indeed, Donnell Thomas, we are told, spent 14 additional years in the laboratory figuring out why donors had to be matched to recipients before transplant, observing that “This illustrates how even the simplest and most promising cell therapies must be studied in depth to be delivered safely and effectively to patients.” He also notes that the situation becomes much more complex for cell therapies in which the scientific rationale for who they might work is not know, unclear, or unproven.

Basically, it turns out that to date there are very few examples of proven stem cell therapies. There is bone marrow transplantation, of course. there are also corneal resurfacing procedures with limbal stem cells and skin regeneration with epidermal stem cells. There is also decent preclinical evidence and a few case reports for bone regeneration, and it is not unreasonable to hypothesize the use of specific types of stem cells for cardiovascular disease, although progress in this area has been disappointing.

Then, as I’ve pointed out, there’s the whole issue of exactly what kind of cell is being used. Just because someone says they are isolating and using “stem cells” does not mean that what is being isolated and used are, in fact, stem cells. Indeed, Bianco et al get almost downright sarcastic (at least as sarcastic as I’ve seen in a scientific review article) and refer to mesenchymal stem cells as “most suspicious cells,” stating:

Cells that have become known as ‘MSCs’ are locally transplantable, system-specific and self-renewing perivascular progenitors of skeletal tissues, including the haematopoietic microenvironment (Sacchetti et al, 2007). They are found in the bone marrow and have significant potential in medicine and unique biological appeal. It is therefore perhaps not surprising that multiple cases of unauthorized stem cell treatments being offered directly to the public before any approval or evidence of efficacy are centred on the use of the so-called MSCs. Lack of scientific rigour, although not unique to the MSC subfield, has flourished therein. Loose definitions and poor assays have disseminated across the scientific community as ‘gold standards’ (Dominici et al, 2006), creating huge confusion and opening the way to the completely erroneous belief that any culture of cells from any kind of connective tissue is a culture of stem cells. The apparent ease of isolation and culture, and the conceptual confusion between a stem cell as a physical and functional entity, and a culture of cells originating from stem cells ex vivo (Caplan and Correa, 2011), have contributed to the widespread use of such cells worldwide. Their nature as ‘adult’ stem cells has granted license and exemption from unwanted ethical controversy. Pressure towards development of therapies from all funding bodies around the world, a general climate dominated by the need to develop treatments (‘translational medicine’, Zerhouni (2005)) and the very existence of multiple companies ready to commercialize ‘MSCs’ have contributed, in turn, to making this particular biological object prone to misuse in the clinic and user-friendly for ill-intentioned salesmen.

This cannot be repeated often enough. Whenever a stem cell clinic claims to be using “stem cells,” are they really? What is their scientific rationale? What are their preclinical data? Do they really support the use of these cells? In the vast majority of cases, including that of the Stamina Foundation, the answer is no.

Finally, we should think of these cells in the same way we think of any “complementary and alternative therapy”—or any therapy, that matter—and I have yet to find a better paragraph, even one of mine, arguing for the importance of there being at least a plausible mechanism:

Complementary to empirical clinical trials, a number of studies have been conducted, claiming ‘beneficial effects’ of systemically infused MSCs in animal models. The conceptual design of these studies as ‘clinical trials in a mouse’ is often flawed, detracting from the power of such studies to highlight a robust rationale for subsequent clinical use. Typically, a pharmacological effect is measured, without measuring the dose, kinetics and dynamics of the active principle, unknown at the outset. A putative active principle is often identified ex post through ex vivo reductionistic experiments. These arbitrarily single out a putative ad hoc molecular mechanism out of a maze of possible, pleiotropic, interlocking mechanisms. An arbitrary hypothesis that fits the results is pursued and alternative hypotheses are ignored. In vivo effects are often interpreted in a biased way (e.g., in studies on ischaemic heart disease, size of post-infarct scars is equated to extent of necrosis; effects of cardiac remodelling are ignored). Even though these studies sometimes specifically record the vanishing of infused cells, they fail to relate any claimed effect to kinetics of cell survival. ‘Clinical data in the mouse’ are descriptive and insufficient to offer mechanistic insight. Mechanistic insight is not a dispensable intellectual luxury. It is specifically required to develop effective therapies. It is to this end that we need mechanisms and rationale. MSCs are thought to have a role in treating GvHD and arthritis alike (Keating, 2012), owing to their generic ‘known immune modulatory effects’. The specific immune modulatory effects are not known. We have no way to model and measure them effectively in vitro or in vivo. We have, therefore, no way to distinguish those operating in GvHD from those operating in arthritis, or to tell whether they are the same or different. We have no way to tell whether these effects are unique to MSCs or shared with other kinds of cells, and which ones. While potentially crucial to advance therapies that harness immune modulation, these issues are mostly neglected. Meanwhile repetitive, expensive, small, uncontrolled phase I–II trials with i.v. infusions of MSCs continue to be pursued as useful.

I love two of the sentences in that paragraph; so I will repeat them again: Mechanistic insight is not a dispensable intellectual luxury. It is specifically required to develop effective therapies. Live them. Learn them. Love them. I do, and I try to live by them in my research.

The same admonition could be directed at, say, acupuncture, except that at least MSCs have more plausible mechanisms. However, as Bianco et al point out, preclinical data and understanding are critical to designing clinical trials that can actually give the answer that is being sought. Just taking a bunch of ill-defined cells and willy-nilly injecting them into small groups of patients with wildly disparate conditions with wildly differing mechanisms of disease is likely to be no more informative than taking some needles and sticking them willy-nilly into patients with wildly disparate conditions with wildly differing mechanisms of disease and hoping we’ll gain therapeutic insight.

There can be no compassion without safety and efficacy

One of the most potent arguments for Balduzzi’s decision in Italy is an emotional one: Look at the suffering children! They are dying! How can we possibly deny them this therapy? My response would be to rephrase that a bit by adding specific therapies other than stem cell therapies.

For example: Look at the suffering children! They are dying! How can we possibly deny them MMS enema (bleach enema) therapy?

Or: Look at the suffering children! They are dying! How can we possibly deny them homeopathy?

Or: Look at the suffering children! They are dying! How can we possibly deny them bloodletting?

Sounds ridiculous when put in those terms, doesn’t it? But, even though some day they might turn out to be wonderful treatments, right now stem cells are in the same boat. We do not know if they are effective and safe, and there is an incredible paucity of preclinical evidence to show that they do anything for the deadly diseases for which they are being used in Italy. The argument is that these severely ill children have nothing else going for them, no other therapeutic alternatives; so safety concerns can be thrown out the window. However, terminally ill patients need more safety and protection, and exposing them to unknown risks in a therapy with no evidence of efficacy is, as Bianco et al, put it, ethically unacceptable. Most people would accept the contention that someone who is severely or terminally ill has the right to take risks in search of treatment, but their willingness to take such risks because “they have nothing to lose” makes them vulnerable to any number of unproven treatments or even outright quackery. Without some sound evidence that a treatment might be effective, they are in essence taking all risk with at best an unknown and likely very small chance of benefit and at worst no benefit at all for all the risk. While personal freedom might give them the right to “roll the dice” and take large risks for minimal chance of benefit, neither physicians nor the government are obligated to facilitate their taking such risks. In fact, quite the contrary for physicians, who are ethically bound to give proper informed consent and obligated not to provide treatments without evidence of efficacy. As Bianco et al put it, “There can be no compassion without safety and efficacy.”

One can only hope that the Italian government figures that out before the Camera dei Deputati takes up the minister’s decree.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

178 replies on “Deregulating stem cell quackery in Italy? A bad omen.”

It’s good to see the Italian science community speaking out about this. I’d hate for Italy’s slogan to become something like:

Italy: Where science is settled by judges and legislators!
Italy: Science? We’ve got anecdotes!
Italy: Science? But think of the children!
Italy: Where the scientifical rules.

Dangerous Bacon

What do you mean with that It’s Italy???
Are Americans perfect???

I don’t understand why even a quack would do this:

One is known as “fresh cell therapy” and involves harvesting cells from lamb fetuses and injecting them into the patient.

Those cells aren’t “self”; they arent even human. Why would one expect the body to do anything other than kill them off as fast as possible, without giving them the opportunity to do whatever magic stem cells are supposed to do?

OT, but still legal, news: Wakefield’s Texas case is set for oral argument on May 22. Each side gets a total of 20 minutes.

@Narad

What? It’s actually moving forward? You mean he isn’t trying to stall again, or has he just run out of available stalling tactics?

@Todd- you didn’t see his latest “video” on AoA?

Back to the topic at hand, I think we’re seeing a version of the CSI effect here….that people have been shown the “miracle” of stem cells in various sci-fi drama, that they believe that injecting anything that says “stem” in the title will perform some type of magical mystery cure……regardless of the disease treated.

Just look at shows like Fringe, for example, that make “weird” science palatable….and for the gullible, raised expectations that this type of Science was real & could be utilized. Scary stuff that people can be so stupid.

The status of Vannoni’s therapy is even worse than Orac states in the post. From the March report in Nature:

Some of the compelled treatments led to the only publication of clinical results so far. Clinicians at the Burlo Garafalo Children’s Hospital in Trieste treated five babies with type I spinal muscular atrophy and published the results last October (M. Carrozzi et al. Neuromuscul. Disord. 22, 1032–1034; 2012). They found that “the treatment did not change the course of the disease”, says co-author Marco Carrozzi. Vannoni argues that the therapy failed because the clinicians did not use his exact cocktail of cells.

So there is a publication showing Vannoni’s therapy to be useless (at best), though Vannoni claims that it was the physicians rather than the treatment that failed.

Italy had parliamentary elections since Balduzzi issued his decree. He’s no longer Health Minister, and I haven’t heard whether he stood for election this time around. I also have heard (but haven’t been following this too closely) that there has been some difficulty forming a coalition government following the elections, which may be why the Camera dei Deputati has not taken up this legislation yet.

There’s a radiologist in Alabama purporting to “cure” ALS by harvesting and isolating MSCs from adipose tissue from the patient in question. These are then reinjected into the spine where they apparently go on to repair the degenerative motor neurons. Because…magic? Unfortunately I have a relative who fell under the spell of this junk and is now $20K poorer and in end-stage ALS. There isn’t an appropriate term I can use to express my disgust for people like this.

Have a looksy…
precisionstemcell(dot)com

Driving home yesterday I was surprised to see a local Hair Restoration Clinic now advertising (on a billboard) stem cell therapy. In the car we were joking how the doctor on the sign had missed the boat, here she’d make a breakthrough with stem cells and didn’t think to try to apply it to organ failure or Parkinson’s Disease.

But it was also kind of ominous. The words “stem cells” now have so much cache with the general public that anyone hawking a product of any sort is trying to work those words into their billboards. Quack heaven.

And of course, via Autism One, 2013:

James Jeffrey Bradstreet will present about his paper on GcMAF protein therapy and his ” research on stem cells in Europe and collaboration on enhanced neurophysics intervention for ASD”.

Neurophysics?

-btw- Narad:
What great timing for AJW!
Since he’ll also be at AutismOne that weekend.

That video is too much! His dire seriousness punctuated with studied eyeglass prop manipulation.

Yes, but are they QUANTUM Stem Cells? That would be doubly magical!

That video is too much!

Dachel well and truly shoots herself in the foot with this comment on the video. After offering the rhetorical question whether “Wakefield’s work stopped Hilleman from getting the Noble [sic] Prize for Medicine,” one finds in the NYT article that Hilleman “got hate mail and death threats instead.”

Little wonder she generally limits her “professional” public exposure to cut-and-paste spamming.

Two facts about Vannoni’s “therapy”:
1) The true, huge step for Stamina Foundation was to go to Spedali Civili in Brescia, one of the best public hospitals in Italy. There are rumors that the first name in the list of patients treated with stem cells wasn’t a child but a local politician. Put together with the fact that in Italy healthcare is supervised by regional (local) governments…. Sadly, privacy law doesn’t allow to know the name, so, take it as a mere rumor;
2) Vannoni has tried to patent his “therapy” in Usa (2) and in Italy (2), but his requests were rejected due to lack of “originality”, at least in Usa, with this words “The claimed invention, as a whole, is clearly prima facie obvious”.

Thank for the post. I hope that my country will not become the Land of Quackery….

Wow. Just wow. We need energy stem stem cells & magnetic stem cells surrounded by Baltic Amber.

Lola: DB means that Italy, as a whole, has become very anti-science lately. America ain’t perfect, but at least we don’t jail scientists (yet.)

I’d hesitate to generalize from the peculiarities of Italian jurisprudence to an entire country.

“Stem cells are magical, mystical things that can’t be explained” like magnets I guess. Did the Juggalo party recently get elected in Italy?

“prepared according to a unique, novel method of isolation in culture” anyone surprised if this method involves succussion?

I’d hesitate to generalize from the peculiarities of Italian jurisprudence to an entire country.

It’s not as if the phenomenon of “quacks drawing upon corruption and personal contacts to get their hands on a money stream” is confined to Italy.

Sitting here feeling like dog vomit because the fibromyalgia is playing up again (what is it with Tuesdays?) I can understand why people with chronic illnesses, or kids with chronic illnesses/disorders, fall for stuff like this. Which makes me all the more angry at the snake-oil salesmen who peddle this garbage.

#7 People also turn into porcupine monsters on Fringe.

Hoping nobody takes that as reality….

Ah more stem cell quackery. Seems to be the same old MO. Promise to cure a hard to treat condition with an unevidence-based treatment, claim that Big Phama or the Medical Establishment is trying to hide the evidence for the cure to protect their income streams, and watch the money roll in from desparate patients.

In other news Greg Beattie, new President of the AVN, has stated parents should not trust their doctors about vaccines, but get their information from “health professionals who maybe aren’t in the medical mainstream”

@Dangerous Bacon:
I would like to remember you that no-one from other countries has ever commented on any post on Burzynski with “Well, it is the US, what can you expect?”
Because most people understand that idiocy and greed are humans trait, same everywhere (and pretty much in the same percentage).

So please, avoid insulting my country. DB. Orac’s blog deserves better.
Thank you.

This said, I am kind of surprised. Italy has very restricted law on stem research. I suppose this is more politic than science *sigh*

“[I]t is not unreasonable to hypothesize the use of specific types of stem cells for cardiovascular disease, although progress in this area has been disappointing.”

Not sure what you mean by disappointing. There have been several small randomized trials, most of them positive. I found an Italian review from 2007 (Giordano et al., Journal of Cellular Physiology 211: 27-35) that cites three studies in which MSCs improved ejection fraction in people who had had myocardial infarctions. There’s been at least one more placebo-controlled study to report the same since, as well as a few studies comparing different methods, and an American study was being set up in 2011.

That’s critical, of course, because one of the tenets of American scientism is that everyone else is “behind” America, or at least behind the Anglophone world – sometimes, it’s hinted, so far “behind” that they should stop trying to innovate and just do what we say is good. Whenever others accept a practice that we do not, it’s got to be either obsolete or unproven, because we are always the most knowledgeable judges of what Science has to say. That was once true, I think, at the peak of our empire – but it’s not true anymore. Science as a body of knowledge is now too broad and deep for any one nation to dominate in every area of research, and America has not been pursuing advancement of knowledge as well as possible lately. In some fields, other nations have already surpassed us, and that will continue to happen in more and more fields.

The studies of MSCs for heart disease are still all too small to put much weight on, to be sure – but if this method did continue to show benefit in larger trials, it would go mainstream first not in the U.S., but in Europe, where far more relative effort is being put into this research. At that point American thanatophobes would have their choice of continuing to sneer at the benighted Eye-talians or going abroad, hat in hand, to buy treatments that America hasn’t gotten around to figuring out how to use yet. And that seems like just deserts for a scientific establishment that purports to be above culture yet refuses to accept or learn from any work done abroad that clashes with their cultural beliefs. (Like acupuncture studies – but that’s a different issue.)

@jane

That’s critical, of course, because one of the tenets of American scientism is that everyone else is “behind” America, or at least behind the Anglophone world – sometimes, it’s hinted, so far “behind” that they should stop trying to innovate and just do what we say is good. Whenever others accept a practice that we do not, it’s got to be either obsolete or unproven, because we are always the most knowledgeable judges of what Science has to say.

Ah. That must be why we don’t have the measles, mumps, rubella or varicella vaccines, which were developed in Japan. Oh, wait.

Careful about casting broad nets.

@Todd – I am leery of anyone that quotes the term “scientism.”

@Lawrence

Yeah, that too. But rather than focus on one’s use of crank words like scientism, I thought I’d just point out the error in the assumption.

Todd W – Nice, if slightly bizarre, try at using the MMR vaccines as a synecdoche for all medical innovation past, present, and future. Did I say America was never the world leader in medical science? No, at one point, indeed we were the tops – which does NOT mean that everything then being done in Russia or France, say, was automatically worthless. The MMR vaccines, all several decades old, come from that era. Now, sorry, those days are long gone. It is a multipolar world and you cannot sit on your butt and assume that the rest of the world is too culturally inferior to have and develop a genuinely valuable idea that one of our scientists or megacorps has not already had. Or rather, you can, but that will only hasten the decline of American dominance. The more groundbreaking work that is published by Italy – and yes, Japan! – the less foreign doctors and American patients will feel obliged to fawn over American opinion molders.

By the way, when Science is used as a sockpuppet to dictate that disliked results of actual scientific studies should be automatically ignored, I think it is entirely fair to say that what you have there falls into the category of a civil religion. In the mouths of its preachers, it presumes to dictate values, for one thing, which science-as-process can never do. It presumes to say not only that questions that can’t be answered by the scientific method have no value, but that some questions that could be answered should not be allowed to be asked. It presumes to say that published scientific data should be treated as garbage or fraud if they do not fit with certain pre-existing beliefs, or that certain beliefs must continue to be held as likely even as data to oppose them have been amassed. These are dogmas. Just as for theistic religions, there are different branches of scientism that vary in the breadth and stringency of their doctrinal requirements. (For example,a few people on other blogs seem to think Science demands that we continue to assume that animals are automata who do not think or feel, never mind all that silly neuroscience and animal behavior research. People around here seem to emphasize mostly that any medicine not recently invented in the Anglophone West must be worthless, so shut up about those clinical trials.)

@Jane – you missed Todd’s point that plenty of drugs and treatments from overseas are currently in use, not just here, but worldwide…..what counts is the actual scientific backing of whatever is being presented. In this case, in Italy, the science is very lacking.

It has nothing to do where a particular treatment originated, but if it is actually effective.

@jane

you cannot sit on your butt and assume that the rest of the world is too culturally inferior to have and develop a genuinely valuable idea that one of our scientists or megacorps has not already had.

Perhaps you missed the point of my comment. I was illustrating that we do not assume scientists from other countries are inferior.

As for the rest of your comment, wow! What a massive flaming pile of strawmen. You have some citations to support your wild claims that scientists think anything not from the “Anglophone West” must be worthless or that results of studies are automatically ignored simply because the results are not liked?

The more groundbreaking work that is published by Italy – and yes, Japan! – the less foreign doctors and American patients will feel obliged to fawn over American opinion molders.

Perhaps the fact that Vannoni doesn’t do this eluded you in your zeal to start rambling about “scientism.”

Todd W.:

You have some citations to support your wild claims that scientists think anything not from the “Anglophone West” must be worthless or that results of studies are automatically ignored simply because the results are not liked?

Because if that were really true we would not have either the varicella or DTaP vaccines, plus some other treatments.

Lawrence – Since I was quite sure that at least two of the measles, mumps and rubella combo were invented by Americans, I presumed he was being sarcastic in saying they were Japanese. He indicates below your comment that he was serious. Chris adds that the DTaP vaccines (what we used to call DPT) are also of foreign origin. Checking Wikipedia, I find:

Measles – first vaccine 1963, US
Mumps – Currently used Urabe strain is of Japanese origin (and associated with higher meningitis risk, hence already abandoned in some other countries). But the U.S. had a killed vaccine version starting in 1950, and then a Merck-made Mumpsvax.
Rubella – Seems to have been first used as part of the MMR combo created by an American working for Merck.
Tetanus – First tetanus toxoid put into use by a French scientist, following early basic research by Italian and Japanese scientists. Since superseded.
Diphtheria – Pioneering work in 1890 by the same Japanese guy and a German guy; only the German got a Nobel out of it. Americans started producing antitoxin within a few years based on his work.
Pertussis – First vaccine developed by an American, followed quickly by a Dane; DPT mixture created by an American woman; safety was improved by a Japanese scientist in 1981 (in Japan, approved in the US 11 years later).

So maybe we can give Todd W. half credit. When he listed off a bunch of vaccines that were not made in Japan he mightsimply have been thinking of the wrong acronym, MMR vs DPT, since Japanese science did in some way influence all three vaccines in the latter. One does get the impression that the early work would have been done here not much later if necessary, since back around 1900 there was considerable research interest in vaccines. So it might be a stretch to say “we would not have” tetanus vaccine.

As for whether the science on stem cells is lacking now, yes. I sure wouldn’t pay money for them. But! It seems that there’s now more European science of the randomized human study sort and *published in journals* to back the use of these adult stem cells for a couple of conditions than there was American (or phonied-up South African) science in favor of bone marrow transplants for breast cancer, which some emdees (not, glad to say, our host) got quite rich dishing out. I doubt that the stem cell treatments can be killing so high a percentage of patients as that treatment did. Traditionally, the introduction of novel procedures has been done with far less regulation than the introduction of new drugs, which is ethically questionable since a patient has no power to reverse a procedure with unacceptable side effects. (Google “endometriosis” and “rectal pull-through” if you want to ensure that you never consider consulting an allopath for a gynecological problem again.) Orac implies not just that the institutions offering stem cells in Italy are using inadequately strict ethics, but that the government should shut them down. Should the U.S. government have shut down the whole bone-marrow transplant catastrophe at the beginning? If we are to prate of ethics, there must be universal standards.

jane:

Mumps – Currently used Urabe strain is of Japanese origin (and associated with higher meningitis risk, hence already abandoned in some other countries). But the U.S. had a killed vaccine version starting in 1950, and then a Merck-made Mumpsvax.

No. The one used in the USA is the Jeryl Lynn mumps strain that became available in late 1960s. The story is in the New York Times today.

Jane –

Quickly as I haven’t time to be involved in this: no-one is suggesting shutting down all of stem cell research or all stem cell-related businesses.

It is unethical and poor practice to allow people to tout and sell things that have not (yet) being shown to work, especially if they might adversely affect others.

There are a number of ‘clinics’ making what to be polite are rather unlikely claims about treatment using ‘stem cells’. It’s fair and sensible to ask that those ‘clinics’ show their claims have substance before offering their products. Aside from the science aspects, there’s the issue of unsubstantiated claims in advertising.

That’s critical, of course, because one of the tenets of American scientism is that everyone else is “behind” America, or at least behind the Anglophone world

For anyone with training in the physical sciences or mathematics, this statement is a knee-slapper. Not too ago, reading competence in German, Russian, or French was mandatory for completion of a Ph.D. in such fields. But…

Now, sorry, those days are long gone.

Amazingly, there is a whole field of scientometrics. I quick survey does not suggest that the broad brush of “scientism” is much in evidence (for a look at Russia, see here [PDF]; following the references to Zitt is of some interest). Indeed, what do people who use this word with some care think it means? Here (PDF) we find an epistemological quarrel over a critique of the term. Jane’s “American ‘scientism'” is nowhere in sight. The question to my mind is where this novelty comes from.

Yep, I was going from memory and got my Japanese-developed vaccines wrong. My point, however, was that there are medical products and procedures that have been developed by non-Western scientists that are very well-accepted in the U.S.

Jane, your blanket statement that American scientists dismiss anything that isn’t “Western” is false. (By the bye, I believe that Italy is considered to be part of “Western” culture, so your argument makes even less sense.)

You’re also engaging in a tu quoque fallacy by bringing in the bone marrow transplant stuff.

Back briefly to the Wakefield video comments, Slivermaven has checked in with this compound factual error:

The only fraud ever conducted was by phamaceuticals who failed to tell you that HeLa cells came from a woman who had Syphilis, and that spirochetal prion proteins cannot be killed. They recombine with what ever junk DNA they want to survive. SHAME is upon the medical mafia killing the public on purpose for lies of protection that never worked and only destroyed our immune systems forever more! Because they refuse to stop adding to the mix!

.[redacted]/releases/2013/5/prw­eb10694837.htm

This press release is gone, but it lives on in the Google cache. Too bad that Charles E. Holman Foundation failed to note that F1000 Research isn’t a journal, much less “prestigious.”

HeLa cells came from a woman who had Syphilis, and that spirochetal prion proteins cannot be killed

That Silvermaven is nothing but class.

Sorry, link works, but should have been closed after “antibiotics”.

Narad and Todd W – You keep on conflating science and scientism; I suppose that I should have stepped on that right away when you started mentioning vaccine science. I never said that practicing American scientists rejected research published by foreigners. In my field, as in many others, workers from any country are given equal respect for similar work. My impression is that those online proponents of scientism who claim that Science requires us to hold certain beliefs, and immediately reject studies that question those beliefs, are usually NOT professional scientists. Those people have never spent much time at international meetings listening to presentations of significant work by nonwhite people with funny accents, so it is easy for them to say “Oh well, that’s Chinese; you can’t trust anything that’s done in China.” (Or “It’s Italy, Orac.”)

Todd W – No, asking about bone marrow transplantation is not the tu quoque fallacy. One of the things that annoys me most about the high-school debate model is that people think they can say “Oooh, you said a Fallacy!” and they have won the entire argument without even needing to demonstrate that their charge is true. Better yet, you can put the name of the alleged fallacy in Latin to better cudgel the lower orders into submission; they can’t point out that your charge is false if they aren’t sure what it means. While most real fallacies can be shown to be such as a matter of objective logic, the “tu quoque fallacy” seems to me almost uniquely vulnerable to selective usage based on status and group affiliation. To say “It’s okay for Sue to do X because everyone agrees it’s okay for Fred to do X” is not obviously false, except perhaps to Fred; it deserves an answer, not a sneer. As it happens, I didn’t say that; what I said was more like “If it’s wrong for Sue to do X, wasn’t it also wrong for Fred to do X but even worse?” If you agree, all you have to do is say “Yes, and Fred shouldn’t have gotten away with that, but now both Fred and Sue should be discouraged from further such acts.” If you don’t agree, then there is a very substantive question – in this case, how one can decide which novel invasive procedures should be illegal for clinical use, which should be legal but called unethical, and which are just peachy; whether the rules should be the same everywhere; whose values should be used in setting the boundaries – that would be worth discussing.

@jane

You keep on conflating science and scientism; I suppose that I should have stepped on that right away when you started mentioning vaccine science. I never said that practicing American scientists rejected research published by foreigners.

You did come in with vague accusations of scientism. One could easily assume you were painting with a broad brush and accusing people of scientism who were not engaged in any such thing. Now, you have narrowed your focus (slightly), but you still suggest that certain commenters are worshippers of scientism based on one or two comments, rather than looking at their overall behavior.

As for the bone marrow example, to me, it read as if you were saying that we should go easy on the Italian stem cell clinics because bone marrow transplants were so poorly regulated when they were introduced. I don’t know if I was alone in that reading of your comment, but that’s how it sounded to me.

Finally, you take one person’s comment that was, admittedly, very vague and could be taken in multiple ways, as evidence of scientism, suggesting that things are being dismissed simply because “It’s Italy”. Here’s another interpretation: based on the current scientific and political climate in Italy (i.e., active hostility toward actual science), we should not be surprised that there is more anti-science or pseudoscience coming out of there; certainly look at it, but look with a grain of salt and additional scrutiny.

Similarly, people do not dismiss out of hand research out of China. Rather, based on past evidence of research misconduct, studies are looked at more closely and critically, because there is valid reason to be concerned there may be additional fraud. The same applies to research coming out of American or Western European labs that have a less than stellar reputation. If these studies were simply dismissed without any other consideration, then Orac and others here wouldn’t even bother reading and analyzing the studies.

Getting back to your accusations of scientism: Who is engaged in that? What is your evidence to support your claims?

@jane – I don’t see anyone making blanket statements that “research done around the world is garbage & shouldn’t be trusted.” What I see if a desire that all research, regardless of where is comes from, should meet the same high standards of peer-review and replication – and in areas where there have been legitimate areas of concern (like China, for example, where rampant publishing fraud has been proven), extra scrutiny is necessary.

For the post above, there isn’t even published Science to show that this particular treatment is effective (and what little is known, it is completely ineffective) – that isn’t because it is coming out of Italy, it is because it is junk science coming from a Quack. I don’t care where the quack lives – bad science is bad science.

Lawrence – I don’t know anything about the quality of that one clinician’s care. Most of the guys who gave bone marrow transplants weren’t publishing any research on it, so his failure to publish in itself doesn’t make him a Quack. However, I have no opinion as to that guy’s competence or ethics. As for the quality of the science that is being published, well, it’s not my field so I can’t be sure. However, I would not a priori assume that Italian science was of worse quality than American science, where the biggest of the big money reigns supreme. Orac’s statement that research on stem cells for heart disease has been “disappointing” specifically does not seem supportable so far, unless you assume that published postive results from multiple researchers must be of such bad quality as to be worthy of rejection. And that is a belief that requires an explanation.

jane – I don’t speak for Orac, but “disappointing” is a relative term. Perhaps he hoped for stronger positive results earlier. He may interpret the results differently than you do. Maybe the most recent data he reviewed didn’t include some of the studies you list. Why do you assume he meant that the studies were worthless because they were not done by English speakers?

I can’t assume that he means that, though he’s not immune to the attitude that foreign work may be regarded with extra suspicion to a degree correlated with his dislike of the results. But it’s not clear what he does mean. To me, when most studies of a treatment for a given use, including the apparently “best”, give favorable results, this might be better described as “promising” than “disappointing”. Stem cells are a recently invented, hi-tech modality; if enough evidence is amassed for their use to make that use mainstream, they will be solidly within the scope of conventional medicine, not traditional nor alternative medicine. It is thus a little funny to see favorable studies being dismissed as if some people “just know” that stem cells can’t really work in the same way they “just know” no traditional modalities can really work. And that is what makes me wonder whether those people would have had a more favorable attitude if it were American research teams making most of the progress. The most obvious alternative explanation is that, as for the hostility a few people seem to have towards research on gut flora, they just don’t like to see anything gaining attention that they weren’t taught in school. Or possibly these people have such a deep understanding that they know why all the favorable studies will prove to have been wrong, but they can’t explain it to the rest of us.

@jane – how about letting up with the strawman arguments. You are articulating opposition to a view that hasn’t been stated by anyone here.

I never said that practicing American scientists rejected research published by foreigners.

Well, you did say this: “By the way, when Science is used as a sockpuppet to dictate that disliked results of actual scientific studies should be automatically ignored, I think it is entirely fair to say that what you have there falls into the category of a civil religion. In the mouths of its preachers, it presumes to dictate values, for one thing, which science-as-process can never do.”

Which is to say that scientists, who you are claiming not to be guilty of the “scientism” that you are apparently reporting from a disadvantageous orientation in Plato’s cave, are nonetheless its high priests.

However, I would not a priori assume that Italian science was of worse quality than American science, where the biggest of the big money reigns supreme.

Aside from one flippant comment, nobody here is doing that. Perhaps you’d also like to quantify “the biggest of the big money reigns supreme.” Are you referring to the split between governmental and private-sector funding? You could have made that case (but didn’t bother to), and you would still have been stuck with the “reigns supreme” part.

Instead, we get this low signal-to-noise ratio rambling about an increasing idiosyncratic version of “scientism” — which, apparently, is now down to “American lay ‘scientism'” or something — that has very little bearing that I can see on thoughtful uses of the term.

jane,
I can’t assume that he means that…Yet that is what your messages, including this last one, says you do. If you really hadn’t assumed that Orac (and others) were dismissing foreign research out of hand, I’d like to think your message would have been more along the lines of “I have to disagree that the current research on treating heart disease with stem cells is disappointing. If you look at study a, b, and c you’ll find …”.

But no. You decided to use the term “scientism” (I’m unclear on what that is supposed to mean, but I presume it’s not complimentary) and to accuse people of attitudes that you can’t reasonably prove they hold.

You decided to use the term “scientism” (I’m unclear on what that is supposed to mean, but I presume it’s not complimentary) and to accuse people of attitudes that you can’t reasonably prove they hold.

She sets it out here. It’s a mishmash that never seems to get provided any sort of philosophical grounding. She’s been trotting this out at SB since at least 2010, always with same result: that she has nothing but vague complaints and never seems to tie them to anything in particular, even though she presents herself (vaguely, again) as a scientist and probably has “more of a clue about how to conduct research than you do.”

Heh! I will just offer one more short response to all the personal comments at once, viz: People who are actually doing [most kinds of] scientific research, are in my observation, usually not the people who serve as aggressive proponents of the sort of worldview that many term scientism. I think this may be because most of us comprehend the limitations of our own fields well enough to see the wisdom of humility on the broader scale.

Jane –

I’m with Lawrence at #54 – ease up on the strawmen.

I find it hard to reconcile your remarks about ‘non-white’ or ‘foreign’ scientists and biological research (or for that matter research in any area of science): so-called ‘Western’ research labs are full of people from all over the world, with different cultural backgrounds too.

I never said that practicing American scientists rejected research published by foreigners.

“Never said” is a strong claim that invites us to look back at earlier threads:

And finally, there certainly is a pro-Western (or pro-American) and anti-Asian bias among some followers of scientism – it has shown up nicely in the tai chi thread. […] But when Asian results conflict with American results, or when Asians study something Americans haven’t studied and the results don’t fit with the dogmas of scientism, they are often immediately dismissed as being presumably of low quality.

Perhaps the intended inference here that the unnamed anti-Asian scientismists cannot be true Scotsmen practicing American scientists, by dint of their bias.

Jane –

#59 crossed over #58. #58 is a little better, but then why all the earlier stuff? (Perhaps you set aside your comments for a few minutes before posting them, so that you might see how they read to others.)

Consider if scientism is largely a strawman created by those that oppose science as a device to foist onto and frame those they oppose. By contrast at different points you have scientism as not real (not how science is) and also real.

People who are actually doing [most kinds of] scientific research, are in my observation, usually not the people who serve as aggressive proponents of the sort of worldview that many term scientism.

Yet even this — that your version is held by “many” — you can’t be bothered to demonstrate.

Jane: Stem cells are a recently invented, hi-tech modality..

Ha-ha-hah, hah-let me get my breath.
Take a biology course, ma’am. Stem cells are not a recent invention-using them is-, but they’ve always been around. (Seriously, are babies, as a whole, a recent invention?) They are not more high-tech than any other kind of cell. The only thing that is different about them, as far as I understand, is that they can, eventually, become another form of cell. Like for instance, you can turn a stem cell into a liver cell, but you can’t turn a lever cell into, say a lung cell. Capiche?

The thing I find most interesting about stem cells is that they appear to be part of an innate repair mechanism that doesn’t work as well as it might. Our bodies apparently have the required mechanisms to repair a heart damaged by ischemia, or to regrow a severed limb, so why don’t they? Or is that a dumb question?

Krebozien: My personal theory is that it might have to do with the energy cost. Perhaps a vertebrate burns too much energy regrowing a limb or organ to make it worth the trouble? I think the only vertebrate that grows back something are certain sorts of lizards, and even then tail regrowth is very slow. (But it presumably is worth it to the lizard.)

#59 These days, many teams of scientists are made up of people from different nationalities. The Internet has made that much easier.

Almost forgot:

And that seems like just deserts for a scientific establishment that purports to be above culture yet refuses to accept or learn from any work done abroad that clashes with their cultural beliefs. (Like acupuncture studies – but that’s a different issue.)

I’d say that the delicious irony is pretty much the exact same issue, given that acupuncture was only saved from the honey wagon by means of a “Western” importation.

Khani –

I suspect you mean #67 (your comment) for #54 or #58, i.e. Jane 😉

(I agree with what you said.)

The whole conversation, really. I spoke with a scientist recently who was collaborating with a person in Russia–he’d even spent some time in Siberia with the other scientist.

I don’t think I care overmuch where a scientist comes from, provided the science is good. And I’m pretty sure most people here feel the same way.

I’ve been to a scientific conference in SIberia, for what little it’s worth. (I’ll avoid regaling on my various Asia/Central Asia trips…)

I think the only vertebrate that grows back something are certain sorts of lizards

Salamanders and other amphibia are the experts. Of course amphibia have to rebuild their bodies completely with the whole metamorphosis thing, so they *have* to be good at it.
Tuatara — who are not lizards — can also regenerate tails.

Speculating wildly, I imagine that a mammal that loses a limb is very likely to be eaten by a predator during the regeneration period, which would dramatically reduce the evolutionary advantage that such an ability would endow. A lizard sans tail would still be able to run away from something trying to eat it.

Sorry, an amphibian sans tail
I think they’re called “frogs”.

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