Scientists Say Placenta May Ease Stem Cell Debate

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c. 2007 Religion News Service

CEDAR KNOLLS, N.J. _ It’s early afternoon in the labor and delivery room at Morristown Memorial Hospital, where Didi Bogert, 36, is sprawled in bed. She’s exhausted and pale, and her voice is a whisper.

Her obstetrician, Craig Bissinger, is starting to think C-section. Her equally exhausted husband, Greg, is growing quiet.

The arrival of baby Bogert is taking longer than expected. But once it happens, Didi and Greg not only will become first-time parents, they also will become pioneers in the fledgling science of stem cell technology.

The couple are part of a small group nationwide choosing to store stem cells extracted from the placenta, an organ that traditionally is discarded after delivery. The placenta, scientists are now discovering, contains “adult” stem cells that, much like embryonic ones, can be coaxed to transform into a variety of cells.

While much of the country has been mired in controversy over the promise and ethical cost of embryonic stem cells, a tiny band of scientists at a Cedar Knolls firm has stayed quietly under the radar for years, searching for a way to stage their own version of an end run. They may have pulled it off.

A specialized kind of stem cell they have found to exist only in the placenta may help bypass moral objections and fulfill the amazing promise of these strange cellular chameleons.

The stem cells will be stored at LifebankUSA, a biotechnology firm founded by Robert Hariri, 47, a neurosurgeon who discovered how to harvest stem cells from placentas in the late 1990s. Hariri’s company was the first in the country last May to offer placental stem cell banking.

The Bogerts are paying $2,395, plus a $225-a-year storage fee, to have their baby’s stem cells placed in a cryogenic freezer at the facility.

“We’re not really expecting something to happen so that we would need to resort to using the stem cells, but you never know,” said Greg Bogert, a 33-year-old police sergeant in Riverdale, N.J. “Who knows how far science will have advanced by the time our child is older? There may be cures we couldn’t dream of today. To us, it’s worth taking the chance.”

About the time Didi’s doctor is considering surgical delivery, LifebankUSA employee Magdalena Reyes phones the maternity ward from her office two miles away. Reyes needs to know the time of delivery so she can send a courier to pick up the placenta for processing at the firm, located in a nondescript office park.

At 3:50 p.m., Bissinger assembles his team in an operating room. He makes the first cut at 4:23 p.m. Six minutes later, Bissinger reaches into Bogert’s womb and pulls out a slick, reddish, dark-haired baby girl. She squawks.

“Awwwww,” someone says, as 7-pound, 2-ounce Brianna enters the world.

Bissinger massages Bogert’s abdomen and then extracts the placenta. He places the one-pound organ in a white plastic tray and puts it aside. The intricate process of sewing up Bogert consumes the team for the next 23 minutes. After Didi is taken to recovery, Bissinger stabs a needle into the umbilical cord, extracts its blood and injects it into a plastic container provided by LifebankUSA.

Then Bissinger turns his attention to the placenta. He tips the tray’s contents into a plastic bag provided by Lifebank. He places that in another bag and packs it into a Styrofoam box the size of a bowling bag. He also places the cord blood container and a vial of Bogert’s blood into the case, following company instructions.

“It’s easy, no problem,” says Bissinger.

The field of stem cell research has been hampered by a long-running controversy over the ethics of using embryonic stem cells, because the embryos that produce them must be destroyed in the process.

Their use has been severely restricted in the U.S. since 2001, when President Bush limited federally funded work to only a few lines of embryonic stem cells. The House passed a bill Thursday (Jan. 11) that would lift those restrictions, but Bush has promised to veto the bill.

Adult stem cells appear to offer better commercial prospects _ with less controversy.

These cells, for now donated primarily by grown men and women after being extracting from bone marrow, fat cells or nasal tissue, raise no ethical quandaries. Researchers have found the cells can renew themselves and differentiate into different types of cells, though probably not to the extent of the embryonic variety. This power of renewal, many researchers believe, will help in treatments for damaged heart muscles, kidneys, tendons and brain cells.

Contrary to reports that only embryonic stem cells are flexible enough to morph into all kinds of tissue, Hariri found that placental stem cells were far more flexible than anyone had thought and produced 10 times more stem cells than the umbilical cord. Like many of Hariri’s patients, the Bogerts also banked these cells, extracted from a cord blood sample in a now-common procedure.

Hariri’s company presented research in 2005 showing placental stem cells morphing into cartilage and fat-like cells. LifebankUSA researchers also have been able to coax placental stem cells to develop into nerve, skin and muscle cells.

Hariri, who figured out stem cells could be extracted from the placenta by infusing the organ with fluid, has refrained from publishing extensively in scientific literature because his methods are proprietary.

However, he has proven them to the federal Food and Drug Administration, which has cleared the company to do preliminary work, leading to clinical tests using placental stem cells to treat diseases such as coronary heart disease and diabetes.

At LifebankUSA, mailroom employees register receipt of the box from the hospital. The Bogerts’ kit goes to Mike Solas, who starts what will be a long paper trail accompanying the samples through the lab. If the samples are ever needed, the lab will have to prove they are from the Bogert baby and must verify the chain of custody.

For privacy purposes, the samples are assigned codes so that basic information, including blood type and medical history, is shielded from workers.

The samples are now ready for physical processing to remove the stem cells and render the material capable of being stored safely for decades. The placenta is removed from the box and wheeled into the placenta perfusion laboratory. The cord blood is sent to separate quarters where it will undergo parallel procedures.

Jennifer Vincente, a technician, dons hospital scrubs and two pairs of latex surgical gloves. Before she places the placenta on a hooded lab table, she sprays it thoroughly with alcohol. She discards the gloves, pulls on another set of doubles and starts working on the placenta.

Using a scalpel, Vincente cuts off some of the amnion, the placental sac, and clears off some excess tissue.

The placenta is then taken to a part of the lab off-limits to visitors. For 51/2 hours, the placenta will be infused with liquid to draw out the organ’s stem cells. Hariri designed the proprietary process.

“What I found out is that the placenta is a living thing,” he says. By running fluids through it, the technique is simulating what happens in the uterus before birth when the placenta is thriving and producing stem cells.

The placenta emerges from the infusion as a solution composed mainly of pinkish blood. Over several steps that last about two hours, technicians separate its components.

After separation, the solution has various layers. The bottom one is red, composed of blood cells. It is topped by a thin white line, which contains the stem cells, and then a layer of yellowish solution, which is plasma. Technicians add some dimethylsulfixide, a cryoprotectant so that the cells will stay resilient when frozen and not shatter into crystals.

A multi-step process is used to lower the temperature of the sample, and then it is locked in a liquid nitrogen-cooled cryogenic freezer, where the interior temperature is minus 122 degrees Fahrenheit.

The process of donating the placenta, Didi said, was painless. Behind the drape of the surgical sheets, they say, they didn’t even know what was happening.

Last month, the couple received a letter from LifebankUSA stating that the baby’s placenta and umbilical cord successfully yielded a robust quantity of stem cells numbering in the millions.

“We don’t have any regrets,” Greg Bogert says. “And we hope we never have to use them.”

(Kitta MacPherson writes for The Star-Ledger of Newark, N.J.)

KRE/PH END MACPHERSONEditors: To obtain photos of the Bogerts, Bissinger and Hariri, go to the RNS Web site at https://religionnews.com. On the lower right, click on “photos,” then search by subject or slug.

See related story, RNS-STEM-CELLS, transmitted Jan. 12, 2007.

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