An American Vaccine Disaster 65 Years Ago: Lessons for Today

"Remember the Cutter Incident!" The phrase is not exactly the same sort of watch word as "Remember the Alamo." 

But it does have fresh resonance today. The Cutter Incident was a vaccine disaster in America 65 years ago. The case is the keystone of a column yesterday in the Los Angeles Times that said, "History tells us that speed kills."

The comment came from Arthur Caplan, a bioethicist at NYU Langone Medical Center and a co-author of an article this week in the Journal of the American Medical Association (JAMA) that sounded a warning in the rush for a Covid-19 vaccine. 

Caplan spoke about the matter with Michael Hiltzik, a business columnist at the Times and author of "Big Science." Hiltzik's column appeared one day before the California stem cell agency is set this afternoon to consider more applications in its $5 million Covid-19 funding round. (Vaccines also came up at last Friday's meeting of the agency's governing board.)

Hiltzik wrote, 

"If anything is known for sure about the scientific battle against the novel coronavirus, it’s that the quest for a vaccine has been unprecedentedly intense, with rapid development and speedy production the paramount goals."

The Cutter Incident, Hiltzik said, is example of the perils of speed. It involved errors in a polio vaccine produced in 1955 by Cutter Laboratories. An estimated 40,000 children contracted polio from the vaccine. About 200 were permanently paralyzed. Ten died. 

Hiltzik wrote, 

"The so-called Cutter incident was 'one of the worst biological disasters in American history, exploded the myth of the invulnerability of science and destroyed faith in the vaccine enterprise,' observed Paul Offit, a vaccine expert at the University of Pennsylvania whose 2005 book is the definitive account of the episode."

The polio vaccine was halted in its tracks during the summer of 1955. Hiltzik wrote, 

"Public confidence in the vaccine was shattered. 'The summer of 1955 came and went with few children getting their shots,' historian David Oshinsky, a co-author of the JAMA article, recounted in his 2005 history of the epidemic. Major outbreaks occurred in Boston and Chicago. 'It seemed like old times, with beaches and movie theaters once again deserted and people fleeing the cities to escape the evil germs.'"

Hiltzik concluded, 

"Clinical trials won’t be the final hurdle in bringing vaccines to the world. Managing the public’s expectations will be crucial, since no vaccine for anything is 100% effective. So will ensuring that the manufacturing process is airtight.

"With anti-vaxxers and conspiracy theorists already spreading wild stories about the coronavirus, it would be a shame to give them more ammunition.

"'In this world, where there’s so much vaccine hesitancy and doubt,' Caplan said, 'you better get it right, out of the box. You can’t afford a failure. Even knowing that we’re in desperate need of a vaccine and the deaths are happening, I worry that if we don’t do it right, it’s going to be worse.'"

Pressures for Stem Cell Profits and Cures: A Case from Japan with Implications for California

A stem cell treatment in Japan for spinal cord injury is raising a ruckus about ethics, efficacy and billion-dollar searches for cures and profits.

The matter involves a therapy called Stemirac and Sapporo Medical University. The treatment is now available to the public in Japan with most of its $140,000 cost covered by Japan's national health insurance program. 

The most recent overview of Stemirac came yesterday on a site called "Undark" in an article written by Amos Zeeberg. In the piece, Arnold Kriegstein, director of the stem cell program at UC San Francisco, called Stemirac  "essentially an unproven therapy."  Bruce Dobkin, a UCLA neurologist, was reported as saying "the results briefly reported in the media may suggest the treatment doesn’t even work."

(Undark's site says it is a "is a non-profit, editorially independent digital magazine exploring the intersection of science and society."  Its publisher is Deborah Blum, a former colleague of this writer at The Sacramento Bee. Blum is now director of the Knight Science Journalism Program at MIT.) 

In the piece yesterday about Stemirac, Zeeberg wrote, 

"It’s arguably the world’s most ambitious approved stem cell treatment and should have been a cause for celebration: a long-awaited breakthrough for the field of regenerative medicine — using modern biological tools to repair the body — and a harbinger of more impressive medicines."

He continued, 

Arnold Kriegstein
UCSF photo

"Instead, the therapy has been met with a heated debate. On one side, many experts have slammed Stemirac’s approval in uncommonly direct terms, saying there isn’t enough evidence to show it is effective or even safe. The treatment went through an expedited approval unique to Japan: After short, small clinical trials that suggest safety and efficacy, regulators can approve stem cell treatments on a conditional basis — allowing use of the treatments for seven years, while sponsors gather additional evidence to support a full approval.

"Critics also say Japan’s approach is far too soft — that early approvals allow patients to take experimental therapies that could be ineffective or dangerous, at a high cost to both patients and insurance providers. 'This is essentially an unproven therapy,' said Arnold Kriegstein, a stem cell researcher at the University of California, San Francisco. 'I’m very surprised this is happening in a country like Japan.'..."

The Undark article continued, 

Bruce Dobkin
UCLA photo

"What’s more, UCLA neurologist Bruce Dobkin told Undark, the results briefly reported in the media may suggest the treatment doesn’t even work. Dobkin pointed to previous trials testing other potential treatments for spinal cord injuries, and the Stemirac findings 'are exactly the results we found in patients in randomized controlled trials — in the control groups,' he said. That is, patients injected with Stemirac seemed to do as well as patients who got placebos in these earlier trials. He says people who have recently suffered spinal cord injuries, like Kusachi, the injured high diver (mentioned in Zeeberg's piece), and the others in the Stemirac trial, often have significant natural improvement over the next several months — exactly the period covered by the trial. It’s possible the patients were simply healing naturally, he says, but without a control group and double-blinding, it is hard to tell."

Undark's article captures many of the issues surrounding the development of stem cell therapies including the pressure to generate results for patients and profits for companies -- not to mention prestige and praise for researchers.

California's $3 billion stem cell program feels that pressure as well. It is running out of cash and would more than welcome a breakthrough in one of its 56 clinical trials -- one that would stimulate California voters to provide more billions for the state's nearly 15-year-old stem cell research effort.

Stem Cell Video Flap: A Look at the California Firm Backing the 'Docu-Series'

A California physician deeply enmeshed in the national ruckus over a controversial, stem cell video has -- according to his web site -- "achieved world-renown as a pioneer in the area of stem cell research."

He is Mark Berman, one of the co-founders of Cell Surgical Network (CSN), which partly financed the lengthy, online video, "Healthcare Revolution." At least 12 scientists, other experts and institutions reacted with shock last week when they became fully aware of its approach and financing. They asked that they be removed from the film.

Mark Berman,  photo from Berman web site

One researcher called the video an "infomercial." Another said she was placed with "charlatans and thieves."

Berman's firm has been sued by the Food and Drug Administration as part of an effort to curb untested and potentially dangerous stem cell treatments. The number of dubious stem cell clinics has grown sharply in recent years. Estimates are that 1,000 exist nationally, with the highest percentage in California.

On Sunday he emailed the irate scientists and asked them to reconsider their requests for removal. None apparently did. 

What follows is a brief look at Berman's history and that of his firm, which has offices in Beverly Hills and Rancho Mirage, Ca., and about 100 affiliates nationwide and more abroad. 

But first, the text of his response to questions from the California Stem Cell Report about the video and its financing. The "docu-series" was produced by Bobby and Sara Sheehan and their firm, Working Pictures.

"I met Bobby and Sara when they came to interview me at my office for another project they were working on a couple years ago. We were commenting on all the amazing work being done in the field of cell therapy and stem cell research, yet all the surrounding controversy. A lot of this was due to people putting random unmatched cells into patients for a whole host of conditions and not adequately tracking the follow up. We thought it would be really important to show some of the world’s greatest minds, who have devoted, in some cases, decades to advancing this field, and highlight all the great work that’s currently being done to advance healthcare.

"I’m not sure what the entire series cost. We were just a tiny part of this film. Bobby and Sara spent over a year flying around the world to get this project done. they worked completely independently from us. Neither I, nor anyone in CSN, paid anyone that was interviewed or promised them compensation. We have zero financial interest in Working Pictures, nor do they have any financial interest in CSN. 

"This whole project is about educating people on the work being done to advance healthcare and we think it’s important that the word gets out."

Berman's website says he has practiced cosmetic surgery since 1983 and started his stem cell practice in 2010.  He is co-founder of Cell Surgical Network and the California Stem Cell Treatment Center. 

Erin Allday of the San Francisco Chronicle reported last year: 

"For more than three decades, Berman’s focus was breast augmentations and face-lifts. He invented a pocket-like device that can be implanted into the breast to produce better-looking, safer results from augmentation procedures. He calls it his “Sistine Chapel.”

With his business partner, Rancho Mirage (Riverside County) urologist Elliot Lander, Berman has built the largest chain of stem cell clinics in the country. Their Cell Surgical Network has more than a hundred affiliates in 33 states — including 38 clinics in California alone — selling treatments they claim will fix everything from knee pain to symptoms of multiple sclerosis.But over the past eight years, Berman has reached far past his specialty into a realm of highly sophisticated, still-nascent medicine. He’s become one of the country’s most outspoken and notorious providers of so-called consumer stem cell therapies: using human stem cells to treat a wide variety of ailments despite little or no scientific proof that they work.

“As a cosmetic surgeon, it’s kind of a joke that I’m at the center of this universe,” Berman said in an interview last fall (2017). “But I’m kind of ground zero.”

"Seven months later, his words became darkly prophetic: In May, Berman and his partner were targeted by the U.S. Food and Drug Administration. The FDA requested an injunction that, if approved by a federal judge, would stop them from selling stem cell therapies. 

"The FDA issued a similar request against a separate operation in Florida, U.S. Stem Cell Clinic.

"Their clinics, though, are just some among several hundred that have popped up across the country in recent years. They are renegade outposts operating with little legitimacy and oversight at the frontier of what is otherwise a highly promising field of medicine."

Here is a short list of other sources of information involving Berman, his treatments and  enterprises: 

• Stem cell scientist Paul Knoepfler of UC Davis has written extensively about Berman and Cell Surgical Network, going back to 2013 when Knoepfler published this Q&A.
• Vox recently carried an overview of unregulated stem cell treatments, including Berman's firm. 
• A Washington Post story about the 2018 FDA filing against Cell Surgical Network.

Stem Cell Video Flap: A Look at the Firm that Produced the "Docu-Series"

Bobby Sheehan discusses his personal and professional background in this YouTube clip.

Who are Bobby and Sara Sheehan, not to mention Working Pictures? 

It is a question that arises from their controversial "docu-series" that raised a ruckus this week in the small world of stem cell science.

Their online video, "Healthcare Revolution," was an unpleasant surprise for at least 12 scientists and other experts who learned only a few days ago they were appearing in the production. All of them asked to be removed.

They believed that they had been misled about how interviews that they had given many months ago were going to be used. 

They objected to sharing an electronic platform with dubious enterprises that are current targets of the federal government's actions to shut down dangerous and unproven stem cell treatments. 

Executives of those firms also appeared in the video in a manner that was considered a case of "false equivalency."

Earllier this week, the California Stem Cell Report queried Sara Sheehan about the video and their links to a California stem cell firm, Cell Surgical Network, with 100 national affiliates that the Food and Drug Administration is suing. 

The full text of her response runs below. But first a little background drawn from the Internet.

Sara Sheehan is executive producer for Working Pictures, according to its web site.  Her husband, Bobby, is producer, director, writer and cameraman. Their web site says Bobby had a "nomadic and slightly feral" upbringing. It also said, 

Sara Sheehan
 Working Pictures photo

"Collectively, they have produced well over a hundred hours of content in the form of online and conventional TV series, documentaries, and narrative films. Bobby has directed and lensed over 300 commercials…and they have produced three talented children."

The Sheehans are also associated with another enterprise called "Mortal," which deals with death and spiritual awareness. 

The California Stem Cell Report asked Sara Sheehan about the cost of the stem cell docu-series, which was partly financed by Cell Surgical Network, and any other financial ties with that firm.  Here is the verbatim text of her reply.

"I appreciate your asking us to provide additional information and I have answered your questions below: 

"We set out to produce a documentary series about the very complex regenerative medicine landscape. There is a lot of information out there and consumers are faced with a daunting amount of opposing opinions and concerns. We felt that by showing the entire landscape - including advances in research that will be providing hope to patients years down the line, the fact that many consumers are going overseas for treatments, the legislation that has been enacted in this country, patients who have gotten treatments in this country and other countries and their outcomes, and the lawsuits- we would educate the consumers who would see this and allow them to make the best decisions for themselves and their loved ones. 

"We looked for financing for the series, which took a year to make. We had investors, Drs. Berman and Landers (of Cell Surgical Network) were part of that team. Never did they ask to see edits, to control the content or interfere with the story in any way. That was the deal. The rest of the costs we bootstrapped ourselves: our investors did not pay us for our time and we covered many costs ourselves. We are not connected in any other way to Cell Surgical Network or any other regenerative medicine provider, nor do we stand to benefit financially from any procedures or products being marketed. We have no family members connected to Cell Surgical Network or any other regenerative medicine providers. The bottom line is that we are filmmakers who attempted to outline what is clearly a heated and emotionally charged environment. Ironically, Cell Surgical Network is featured most prominently in an episode entitled The Lawsuits, outlining the cases against US Stem Cell and Cell Surgical Network. We had updated that episode to reflect the decision against US Stem Cell. 

"We never paid anyone to be interviewed. In fact I have NEVER paid anyone to be interviewed for this project or any other project.

"After a year of interviewing and editing as many and as varied voices as possible, the resulting series is 12 episodes long. We organized the information by subject and feel we had a comprehensive product that provided a good, basic overview of the field that included many opposing points of view. There is a tremendous amount of information contained in the series that we felt showed as much of the landscape as we were allowed to capture.

"Unfortunately, a number of people expressed concern about being included in the project and we immediately responded that we would honor their wishes to be removed."

LA Times on Stem Cell Video Flap: 'Infomercial,' Hype and How the Hooha All Began

The Los Angeles Times this afternoon reported on the uproar over a stem cell video has left some researchers across the nation incensed and calling the film an "infomercial" that ballyhooed unproven therapies.

Twelve scientists and other experts have asked to be removed from the video that was partly financed by a California firm that is being sued federal regulators to halt the potentially dangerous treatments.

The Times piece was authored by Pulitzer Prize-winning columnist Michael Hiltzik who has written previously about the unregulated stem cell industry. He said,

"If there’s anything that drives legitimate stem cell scientists up a wall, it’s their being lumped in with clinics offering unwary customers supposedly effective disease treatments through stem cell injections."

The firm that helped fund the "Healthcare Revolution" is Cell Surgical Network, which is based in Southern California but has 100 affiliates across the country and more overseas. The Food and Drug Administration has sued the firm to halt the use of what it calls unproven and potentially dangerous treatments. 

The film was produced by Bobby and Sara Sheehan over the period of about a year. Hiltzik wrote,

“'It’s a package that’s very misleading and not balanced,' says Evan Snyder of Sanford Burnham Prebys Medical Discovery Institute. 'It was pitched like it would be a ‘Nova,’' he said, referring to the scientific series produced for the Public Broadcasting System, 'but it came out like an infomercial.' 

"Lawrence S.B. Goldstein of UC San Diego says he was led to believe the producers were making a 'balanced, sober documentary.' The trailer for the series posted on its website, however, was infused with hype—'It sounded like miracle cures from stem cells are here today—‘Give us your money and we’ll fix you up,’ giving false hope to people suffering from terrible diseases.'”

The Times piece laid out how the flap erupted just days before the video was to begin today. Hiltzik wrote,

"It was only last week that the true nature of the project emerged. That’s when Cell Surgical Network sent customers and former customers an email announcing the documentary’s upcoming premiere. The email landed in the in-box of Doris Tyler, a Florida resident who is suing Cell Surgical Network and affiliates for allegedly leaving her blind via a stem cell treatment for an eye condition.

"Tyler alerted her attorney, Andrew Yaffa, who passed the alarm on to Loring at Scripps. Loring scanned the documentary’s website and noticed that she and numerous academic colleagues were featured along with purveyors of unproven treatments. On June 13, she says, “I sent messages to everyone I knew” on the roster of participants.

"Subsequently, Sheehan disclosed that Cell Surgical Network had partially funded the series, deepening the alarm and prompting most, if not all, the academic participants to withdraw. 

“That was the kiss of death for me,” Loring told me. “I do not want to be associated with those guys at all.'”

Loring said in a letter to the Sheehans,

 "You have placed my interview among those of people who are charlatans and thieves...."

Stem Cell Video Flap: CEO of California Stem Cell Agency Backs Out of Internet 'Docu-Series'

The president of the $3 billion California stem cell agency has removed herself from a controversial online video that placed her in the electronic company of leaders of firms targeted by federal regulators.

In an email early today to the producers of the lengthy video, Maria Millan referred to an appeal for her to reconsider her previous request to back out of the "docu-series."

"I am not swayed by the letter from Mark Berman of Cell Surgical Network and, in fact, it deepens my concern. I maintain the same position and concerns expressed in my note dated June 15. Please remove my interview from the documentary and my picture and name from any associated materials —including this link- please remove me as an “episode expert” on https://www.healthcarerev.org/?inf_contact_key=efe318f527b6ecd43046adebf597cfd9."

The video, titled the "Healthcare Revolution" was partly financed by Cell Surgical Network, which has offices in Beverly Hills and Rancho Mirage, Ca., plus about 100 affiliates nationwide. The Food and Drug Administration(FDA)has sued the firm to halt what the FDA says are unproven and potentially dangerous treatments.

A number of researchers and others pictured in the video have also asked to be removed, saying they were misled about how their interviews would be used. San Diego-area stem cell researcher Jeanne Loring declared that being in the video placed her among "charlatans and thieves" who prey on desperate patients.

Kevin McCormack, senior director of communications for the California Institute for Regenerative Medicine (CIRM), as the stem cell agency is formally known, explained what led to the agency's involvement with the video producers, Bobby and Sara Sheehan. In response to questions from the California Stem Cell Report, McCormack said, 

"When the Sheehans asked us to be part of the series we looked at previous work they had done and reviewed the questions they wanted to ask. We knew they were going to talk to a wide range of people for the series but we were sufficiently reassured that we initially agreed to the interviews feeling it was important to have our voice heard.

"However, once we learned who was partially funding the project and saw the trailer we felt it risked giving a distorted view for anyone who saw it and that it inadvertently legitimized opportunistic, bad actors. It’s unfortunate these so-called 'clinics' are trying to hijack the reputation of legitimate stem cell therapies and cash in on scientists who are doing serious, scientifically sound research....

"I think the fact that virtually all of the highly regarded scientists interviewed for the series have withdrawn from it, people like UC San Diego’s Larry Goldstein and Scripps Jeanne Loring, says everything that needs to be said. None of us who have spent years warning the public about the dangers of going to clinics offering unproven and unapproved stem cell therapies want anything to do with something that equates FDA-sanctioned clinical trials with unsanctioned and unregulated stem cell therapies."

The flap over the video comes as the number of dubious stem cell clinics is estimated to exceed 1,000 nationally, with the highest percentage in California. The state has been slow to regulate the clinics whose treatments have reportedly led to illness and blindness. Legislation aimed at the clinics is all but dead in the legislature, leaving the regulation solely in the hands of the state Medical Board. 

The board said today that it has no authority over clinics -- only physicians. The board has been mulling over the matter for about 11 months. But its two-person "task force" has yet to schedule a public meeting.  

California State Medical Board Says it Has No Authority to Regulate Dubious Medical Clinics

The California state Medical Board wants to make it clear that it does not regulate stem cell clinics -- only physicians. 

An email from its spokesman this morning said it is concerned that readers might misunderstand an item on the California Stem Cell Report last week dealing with the pace of state regulation of "snake oil" enterprises.

Carlos Villatoro said,

"I would like to request a correction/clarification in your story. The Board does NOT regulate stem cell clinics and has no authority take ANY action against stem cell clinics. "The Board’s sole jurisdiction lies in the physicians who work at the clinics, who may or may not be performing stem cell procedures.   The statement in your story,  'A spokesman for the California Medical Board, Carlos Villatoro, said this week that a task force of the board is expected to hold its first meeting this summer to deal with stem cell clinics,' is inaccurate and we are concerned that your readers will think that we regulate stem cell clinics, which we do not. "The Board would appreciate a correction/clarification. Please let me know if you have any further questions."

In a response to Villatoro, David Jensen, publisher of the California Stem Cell Report said, 

"Thank you. I will run a separate item containing your email comments. The board's position is important and significant. However, I do not think a correction is necessary. The clinics are mostly run by physicians. 'Dealing' with clinics means dealing with those who run them, i.e., physicians. I would glad to discuss this with your executive director or the chair of the board if you wish. Thanks."

Stem Cell Video Flap: California Firm Asks Concerned Scientists to Reconsider Requests for Removal

This is a clip from the web site for the video "The Healthcare Revolution."

More details emerged late today about a controversial Internet video backed by a California stem cell firm that is being sued by federal government to halt what allegedly are "unproven and potentially dangerous treatments."

The video features the CEO of the $3 billion stem cell agency, Maria Millan, and more than 80 other researchers and academics. The video website displays logos of academic institutions ranging from Stanford to the University of Cambridge. The site says the video will reveal that "stem cell technology that is said to be 10, 20, years down the road is actually here – NOW!"

Some of the researchers who appear in the video have asked to be removed because of its connection to Cell Surgical Network(CSN), which has offices in Beverly Hills and Rancho Mirage, Ca. The firm said it has funded a portion of what it called "this important docuseries." CSN today asked concerned scientists to reconsider their requests. 

CSN has been sued by the Food and Drug Administration to  halt its treatment practices.

Jeanne Loring, professor emeritus from Scripps Research, is one of those scientists whose remarks were carried in the video. In an email, she said she only learned that she was in the video last week. The recording of her came from an interview that she did at the World Stem Cell Summit. 

Loring has been a longstanding foe of unregulated stem cell clinics. She wrote the producers of the video, Sara and Bobby Sheehan:

"As I have explained many times, to print reporters, community groups, and in video interviews, as a scientist with a moral compass, I cannot condone exploitation of desperate people who are led to believe that they will be cured or even helped by a clinic or a pill or any purported therapy that is not based in science.... 

"You have placed my interview among those of people who are charlatans and thieves, and I request that you remove all reference to me in the video and on your website." 

(See here for the full text of Loring's letter.)

The firm initially granted Loring's request but then late today appealed to her to change her mind. Loring refused. 

In her email today to Loring, Sara Sheehan cited a letter sent out today to "concerned stem cell scientists and doctors" by Mark Berman, co-founder of Cell Surgical Network. It appeared to be addressed to other researchers filmed for the video. 

Berman said his firm made "no effort to control (the) production" of the video. 

Berman told the researchers,

"Personally, I think a lot of the participants who want to drop out know little and/or nothing about the work CSN has been doing worldwide. They do not know about some of the amazing basic science research we have funded, nor do they know about the hundreds of patients that we have treated at no cost and hundreds at markedly reduced rates including dozens of patients that have had multiple deployments at no cost."

(The full text of Berman's letter can be found here.)

Text of Loring Letter Asking to be Removed from Stem Cell Video

Here is the text of email that stem cell scientist Jeanne Loring sent to Sara Sheehan in connection with the controversial "HealthRevolution" documentary. 

​"Dear Sara:
"When I was interviewed at the World Stem Cell Summit, I was misled about the context in which my interview would be placed. I was told that it would be an educational video about the progress of legitimate stem cell therapies.

"I am a staunch and outspoken opponent of clinics that flout the FDA regulations for stem cell treatments, and have met many people who have paid many thousands of dollars to obtain unregulated (and therefore unsafe) treatments that claim that stem cells will magically cure any disease.

"As I have explained many times, to print reporters, community groups, and in video interviews, as a scientist with a moral compass, I cannot condone exploitation of desperate people who are led to believe that they will be cured or even helped by a clinic or a pill or any purported therapy that is not based in science.

"I know you are young, but this is equivalent in history to the Laetrile scam of the 1970s. Thousands of desperate people emptied their wallets and obtained this alleged therapy before the FDA stepped in and banned it. Many were crushed and bankrupt; some died.

"'Stem cell' clinics are worse, because they can market their useless and dangerous products to a far larger audience.

"FDA leaders Scott Gottlieb and Peter Marks have denounced these unregulated clinics as “bad actors”, and I would go further - I think they are criminals.

"I use pluripotent stem cells to generate real cell types to replace cells that have died in disease. I have not seen any evidence that extracts from fat, or bone marrow, or products derived from placentas and umbilical cords have any medical value.

"You have placed my interview among those of people who are charlatans and thieves, and I request that you remove all reference to me in the video and on your website.

"I understand that you are good and honest film makers, so this should not be a difficult request. Please respond that you have removed me and I will not trouble you further."

"Sincerely,
"Jeanne Loring"

Stanford Exonerates Researchers Who Had Ties to Scientist in Gene-edited Babies Experiment

Stanford University this afternoon cleared three professors of any wrongdoing in connection with their ties to a Chinese scientist who said his research had led to the world's first gene-edited babies.

Pam Belluck of the New York Times broke the story after obtaining a letter that cleared scientist Stephen Quake in connection with the research, which stirred a global controversy. 

Belluck wrote,

“'In evaluating evidence and witness statements, we found that Quake observed proper scientific protocol,' said a letter from the university to Dr. Quake, obtained by The New York Times on Tuesday.

"Referring to the Chinese scientist, He Jiankui, by his nickname, JK, the letter said that Stanford’s investigators concluded that Dr. Quake did not 'directly participate in any way in JK’s research, including in the conception or performance of the work.'

"In fact, the letter said, Dr. Quake discouraged Dr. He from pursuing the project and urged him to follow proper scientific practices after he insisted on going ahead."

The Times ran a front page story on Sunday focusing on Quake's email communications with He. Belluck wrote today,

"On Tuesday, Dr. Quake, who turned 50 this week, said: 'I’m pleased this inquiry is over and its conclusion is consistent with what I knew to be true: that I had urged Dr. He not to pursue this path and when it became clear he wouldn’t listen to me, to adhere to high scientific and ethical standards in his research.'"

Quake is involved in a $40 million program financed by the $3 billion California stem cell agency. 

The other two researchers are Matthew Porteus, a genetics researcher, and William Hurlbut, an ethicist.

As of this afternoon, the Times story on Sunday had generated 329 comments in the Times from readers, covering the full gamut of reaction.

One reader, only identified as JHP, had only this to say,

"For such an intelligent and accomplished person, Dr. Quake comes across as breathtakingly obtuse."

The Times said 134 readers "recommended" the remark.

Another reader, Robert Speth of Fort Lauderdale, said,

"Dr. Quake’s actions appear to be that of a dedicated mentor who encourages their students to be successful, but to do so while conducting themselves in an ethical manner. While the investigation by Stanford is warranted, from the information presented in this article, I cannot see even a hint of misconduct by Dr. Quake."

The Times said 175 readers "recommended" the remark.

The Times also makes its own judgment about comments and labels some as a "Times Pick," It also has a category called "Reader Picks" in addition to "All." The Times moderates its comments for civility.

The reader comments can be found by going to the story and clicking on a small box to the right of the reporter's byline.

Going Slow in California on Stem Cell "Snake Oil"

California Attorney General Xavier Becerra is remaining mum on regulation of "snake oil," stem cell clinics as the Golden State pursues a go-slow approach to cracking down on the dubious treatments.

More than 100 such clinics are operating in California, the most of any state in the nation. New York state earlier this month took the lead among states in attempting to regulate the clinics, which the chairman of California's $3 billion stem cell agency, Jonathan Thomas, has described as peddling "snake oil."

New York Attorney General Letitia James filed a lawsuit earlier

Letitia James
NY Department of Justice photo

this month charging that the treatments at one clinic amounted to fraud. She said in a news release,

“Misleading vulnerable consumers who are desperate to find a treatment for serious and painful medical conditions is unacceptable, unlawful, and immoral. 

“We will continue to investigate these types of clinics that shamelessly add to the suffering of these consumers by charging them thousands of dollars for treatments that they know are unproven.”

The businesses number more than 700 nationwide and have treated an estimated 20,000 persons. The clinics sell products that they say are stem cells for use as treatments for problems ranging from erectile dysfunction to cancer. The treatments lack rigorous scientific testing and cost thousands of dollars. In some cases in Florida, they have resulted in blindness. Other serious injuries have been reported elsewhere.

In the wake of the New York action, the California Stem Cell Report, on April 5 and again on April 11, queried the California attorney general's office about his position on the dubious clinics. However, Becerra's office has failed to respond.

The web site of the state Department of Justice, which is headed by Becerra, says, however,

"The Department of Justice will put patients first in a more quality health care system. We achieve this by protecting patients from bad actors...."

Other California state entities have expressed concern about the unregulated clinics but also offer only a slow schedule for action, if any.

Six months ago, the state Medical Board, which regulates physicians, created a task force to look into problem. Asked recently about the task force's progress since October, Carlos Villatoro, spokesman for the board, responded briefly,

"The board is gathering information for the Stem Cell and Regenerative Therapy Task Force and has set a goal to have its first meeting in late May, early June."

In the legislature, Assemblyman Kevin Mullin, D-San Mateo, has introduced a measure to deal with the clinics. His bill, if it is passed and signed into law, would not take effect until next January. It would direct the state Department of Public Health to hold hearings sometime next next year in order to craft possible legislation to directly regulate the clinics. 

A new regulatory panel called the Stem Cell Clinic Regulation Advisory Group would be created. After members are named and organized, it would have the ability to enact "emergency" regulations on a 90-day notice after it has consulted with "the medical community, bioethicists, legal scholars, and patient advocacy groups."

The legislation (AB617) is scheduled to receive its first hearing in the Assembly Health Committee April 23.

The unregulated stem cell clinics have been in business for years. Their dubious treatments and sales pitches have been well documented. UC Davis stem cell scientist Paul Knoepfler has been particularly active. He and Leigh Turner of the University of Minnesota were the first to document the full scope of the clinics in a groundbreaking study in 2016.

In recent years, the Food and Drug Administration (FDA) has become more active. In the case of one California firm, Cell Surgical Network, which has been in business since 2010, the FDA sued the firm last May alleging that it had, among other things, used a smallpox vaccine to create an unapproved stem cell product. The product was injected directly into tumors in persons with potentially compromised immune systems, the FDA said.

The NY Times Details Stanford Scientist's Communications in the Gene-Edited Babies Controversy

The New York Times this morning carried a front page story dealing with Stanford University, scientist Stephen Quake and gene-edited babies in China. 

Stephen Quake
Chan Zuckerberg Biohub photo

The story appears to the first time that Quake, who is the Lee Otterson professor of bioengineering and professor of applied physics at Stanford as well as co-president of the Chan Zuckerberg Biohub, has spoken at length publicly about his role in the matter of the Chinese children, who are the first gene-edited babies to be born. 

Their announcement last fall created an international brouhaha about the ethics and science of the work by He Jiankui, who once worked in Quake's Stanford lab. 

Times reporter Pam Belluck began her story like this

"'Success!' read the subject line of the email. The text, in imperfect English, began: “Good News! The women is pregnant, the genome editing success!' 
"The sender was He Jiankui, an ambitious, young Chinese scientist. The recipient was his former academic adviser, Stephen Quake, a star Stanford bioengineer and inventor. 
"'Wow, that’s quite an achievement!' Dr. Quake wrote back. 'Hopefully she will carry to term...'"

Stanford is investigating Quake's ties and communication with He. The Times reported that the school has received a complaint from the president of He's Chinese university, alleging that Quake “violated the internationally recognized academic ethics and codes of conduct, and must be condemned.”

In the Times article, Quake, who is participating in a $40 million genomics program backed by the $3 billion California stem cell agency, denied the allegations. Quake said his interactions with He have been misinterpreted. 

The Times wrote, 

"'I had nothing to do with this, and I wasn’t involved,' Dr. Quake said. 'I hold myself to high ethical standards.'

"Dr. Quake showed The Times what he said were the last few years of his email communication with Dr. He. The correspondence provides a revealing window into the informal way researchers navigate a fast-moving, ethically controversial field."

Stem Cell Hype: The Latest Warning from Researchers

The Scientist journal last week carried a cautionary note concerning iPS cell therapies, particularly a recent, "exciting" announcement concerning their use for treatment of spinal paralysis.

"Ethical Challenges in Using iPS Cells to Treat Paralysis," was the headline on the opinion piece. It carried a subheading that said,

"Uncertainties about the cells’ risk profiles and the potential for hyping unproven therapies mean scientists and the media must tread carefully."

The article dealt primarily with what it termed "exciting" news about an experiment in Japan. But the article has broader implications for the entire field including in California, where the state stem cell agency is currently helping to fund 46 research projects involving iPS, induced pluripotent stem cells. 

The piece was written by John D. Loike, a professor of biology at Touro College and University Systems in Brooklyn and who has a regular column on bioethics in The Scientist, and Martin Grumet, a professor of cell biology and neuroscience at Rutgers.

Writing about the Japanese research, they said, 

"Caution is warranted here, for at least three reasons: the uncertainty of the stem cell type to be used in their clinical trial, the safety of transplanting stem cells into humans, and the responsibility of scientists and the press to communicate clearly the benefits and risks of the stem cell treatments, especially to desperate patients who would seek such unproven treatments."

They continued.

"The excitement of the press release may be misinterpreted by patients, who may think that now is the time to treat human spinal cord injury with stem cell transplants. With difficulties getting admitted to legitimate sub-clinical trials, could this hype for hope lead poorly informed patients to seek out other “stem cells” to treat their spinal cord injuries or other conditions? We must avoid anything that may promote “medical tourism” to unapproved interventions.

"The fact that there are more than 700 'stem cell clinics' advertised in the United States alone highlights the desperation of so many patients with terminal illnesses seeking unapproved or unproven therapies. There are no studies documenting the therapeutic successes of these clinics and some of their patients have developed serious side effects. Scientists and the press must ensure an ethical and realistic presentation and communication of new and potentially exciting discoveries and caution readers about the realities of initial clinical trials.

Shilling for Stem Cell Treatments? A Look at the Journal Nature and an Advertising Matter

For UC Davis scientist, Paul Knoepfler it was something "very strange." For Pulitzer Prize-winning Los Angeles Times columnist Michael Hiltzik, it had the earmarks of a "race to the bottom."

And it all involved a stem cell matter published by the prestigious journal Nature.

The headline on Hiltzik's column yesterday summarized the case like this. 

"Did a world-famous science journal become a shill for a questionable stem cell claim?"

Hiltzik wrote,

"Readers of Nature, one of the world’s most important scientific journals, might have been struck recently by an audacious claim appearing on its website about a possible stem cell treatment for heart attacks.

"The published item asserted that MUSE cells, a subset of stem cells, could regenerate heart tissue after acute myocardial infarctions, which are deadly sudden heart attacks. This could be a significant advance in both cardiac treatment and the use of stem cells.

"Here’s the problem. The published item wasn’t a peer-reviewed article subject to Nature’s rigorous professional vetting procedure. It was an advertisement placed by the Translational Research Center for Medical Innovation, the Japanese research lab that says it performed the reported study on MUSE cells using white rabbits.

"It looked like a Nature article, however, at least to Paul Knoepfler, a stem cell expert at UC Davis who has become one of our most assiduous debunkers of stem-cell quackery. Knoepfler thought the layout of the item might cause some readers to mistake it for a peer-reviewed paper, and promptly queried Nature. The journal responded by taking the advertisement offline Feb. 22. Knoepfler’s brief chronicle of the affair can be found on his website here."

Hiltzik concluded:

"The Food and Drug Administration has its hands full monitoring these claims and treatments. The agency has issued multiple warnings to steer the public away from such clinics and has taken administrative and legal action against some of them. The signs point to more exploitation and more danger to the public health. Important journals such as Nature shouldn’t be participating in a race to the bottom."

For the record, Knoepfler has been critical in the past about some of Hiltzik's commentary, including the columnist's views about the state stem cell agency.  

Position of the California Stem Cell Agency on Gene-Edited Babies? No Go.

California's $3 billion stem cell agency may be on the leading edge of regenerative medical research, but it is clearly opposed to the type of work that has led to the international flap over the gene-edited babies in China. 

Its regulations have long barred that sort of experimentation. In 2016, the agency, known formally as the California Institute for Regenerative Medicine (CIRM), convened an international conference to discuss the issues involved.

The session in Los Angeles went on for hours, generating a 223-page transcript touching on the difficulty of regulating gene editing, among a host of other difficult issues. 

One patient advocate in the audience, Adrienne Bell Cors Shapiro, noted that it is nearly impossible to control all that might happen. She said,  

"People are messy. And if you develop this technology, somebody is going to find a way to use it."

Last week the MIT Technology Review published an article about a Stanford University investigation into what two of its researchers knew about the Chinese research. The scientists also have received CIRM funds for research unrelated to the Chinese work. 

Asked for a comment, a spokeswoman for the state stem cell agency said in an email:

"CIRM’s regulations prohibit nuclear genome editing for reproductive purposes. In February 2016, CIRM convened the Scientific and Medical Accountability Standards Working Group (SWG) for a workshop on Human Gene Editing. The SWG subsequently recommended that no changes be made to CIRM’s existing prohibition on nuclear genome editing for reproductive purposes."

In 2016, Hank Greely, a law professor at Stanford who deals with bioethical issues, told the gene editing conference:

"CIRM is in the human embryo experimentation world. It funds research as long as the embryos are not implanted. It funds it with special protections and special review considerations and special informed consent considerations. I don't think CRISPR-cas9 changes that."

The controversial research in China triggered a global uproar in the scientific community. The leading stem cell research organization, the International Society for Stem Cell Research, issued a statement opposing such experimentation. 

He Jiankui, the Chinese scientist who performed the experiment, has lost his job in that country, according to news reports, and may be facing criminal charges. His work has not been confirmed by an independent review. 

Hype and Fraud and Their Impact on the California Stem Cell Program

Cartoon by Johan Thyberg from "For Better Science"

The New York Times this week published a piece about how the lust for success could be corrupting science in a greater way. 

The questions it raises have particular relevance in the stem cell field, which is still very much in a formative stage. 

Aaron Carroll, a professor of pediatrics at the University of Indiana, produced the opinion piece for the Times. He wrote, 

"How might grant funding and career advancement — even the potential for fame — be biasing researchers? How might the desire to protect reputations affect the willingness to accept new information that reverses prior findings?"

He also said, 

"Moves toward open science, and for a change in the academic environment that currently incentivizes secrecy and the hoarding of data, are perhaps our best chance to improve research reproducibility Recent studies have found that an alarmingly high share of experiments that have been rerun have not produced results in line with the original research."

Questions arise with some regularity about hype and fraud in stem cell research. Back in 2014, bioethicist Art Caplan asked, “Why so Much Fake, Unduplicable Stem Cell Research?”

Just this past fall, a multimillion-dollar stem cell research scandal involving Harvard surfaced once again in the news.

Credibility, of course, is everything in science. For the California stem cell agency, it is a matter of survival. It will be out of cash for new awards in less than 12 months and is hoping voters will then give it an additional $5 billion.  More news about stem cell hanky panky, wherever it occurs, will not serve the agency well when it makes its pitch once again to the people of the Golden State.  

A Deep Probe by STAT into the Man Behind the CRISPR Babies

Want to know more about the researcher who spawned what are now known as the CRISPR babies? 

STAT published a cracker jack of a piece this morning about He Jiankui, including details about his life and his pathway into the gene editing game.

STAT promoted the article this morning in a newsletter with this squib:

"Every superhero, and antagonist, has his own origin story. He Jiankui, the scientist who stunned the world with a claim that he had already gene-edited two baby girls, has one too." 

The lengthy article was written by Sharon Begley and Andrew Joseph and covers He's path from physics to biology. They quoted UC Berkeley scientist Jennifer Doudna as saying, 

“His demeanor was an odd combination of hubris and naivete. He was very confident in his work, and not totally understanding what an explosion he had caused.

The STAT piece is based on extensive reporting. Its authors wrote,

"With details reported for the first time, it describes the many times He met with and spoke before some of the world’s leading genome-editing experts, the low opinion they had of his research, and the hints he dropped about his grandiose aspirations. It is based on interviews in Hong Kong and with experts on four continents, with scientists and others who have crossed paths with He, as well as on documents and published accounts. He did not reply to requests for an interview."

The article's final paragraph ends like this:

"Even those who condemn his experiment doubt it will be more than a speed bump on the road to editing of embryos to prevent severe inherited diseases. 'We have to acknowledge there is interest in using [CRISPR] clinically,' Doudna said. To those calling for a moratorium or an outright ban on such research, she has one response: 'It’s too late.'"

The Genetically Altered Babies Story: More Information Surfaces on Researcher's California Links

More details are emerging this week concerning the California connections of the man behind what are being described as the world's first gene-edited babies. 

The scientist is He Jiankui, who spent two years in a lab at Stanford University, according to the lab's web site.

Lisa Krieger of the San Jose Mercury News has produced a roundup of the information about the researcher's activities in the Golden State. They include the connections with Stephen Quake of Stanford, who heads the lab where He Jiankui worked from 2010 to 2012.

She reported that Quake is declining any comment on He Jiankui.

Also mentioned in Krieger's piece are Mark Dewitt of UC Berkeley, William Hurlburt of Stanford and Jennifer Doudna, also of Berkeley.

Another useful piece exploring He Jiankui's training was produced by Sharon Begley, Andrew Joseph and Rebecca Robbins at STAT. The article takes a broad look at the researcher's training and background.

One cautionary note: The "facts" in this ongoing tale sometimes seem in conflict and sometimes murky. UC Davis' Paul Knoepfler raised the matter on his blog yesterday in an item headlined, 

"Trying to connect the dots on CRISPR baby story paints a dark, cloudy picture."

Even determining the number of years He Jiankui worked at Stanford is in question. Quake's lab clearly reports two years. STAT reports that it was "about a year" without identifying a source. A relatively minor point, but if that can't be nailed down, what else is missing? As Knoepfler wrote, much murkiness exists in the morass of stories and commentary that has emerged this week.

The caveat for those who follow this matter? As the old adage goes,

"Even if your mother says it's true, check it out."