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a bit more on cell cultures, cell mortality and patients’ rights

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Human connective tissue in culture, 500x. Image courtesy of Dr. Cecil Fox (photographer)/National Cancer Institute.

Canto: Well, we’ve followed up Meredith Wadman’s The vaccine race with Rebecca Skloot’s The immortal life of Henrietta Lacks, which intersects with Wadman’s book in describing cell cultures and their value in modern medicine and genetics. So are ready to talk about all this again?

Jacinta: Yes, this book tells a compelling history of the Lacks family as well as a story of the ethics around human cell cultures, based on the HeLa cell line taken from the cervix of Henrietta Lacks in 1951, shortly before she died of cervical cancer.

Canto: A very aggressive adenocarcinoma of the cervix, to be precise, though the tumour was misdiagnosed at the time.

Jacinta: Yes, her bodily state and her sufferings make for grim reading. And the cells were taken sans permission, in a pioneering era of almost no regulation and a great deal of dubious practice.

Canto: The wild west of cell and tissue culturology.

Jacinta: George Gey, the guy who ordered these cells to be taken, was a great pioneer in cancer and cell culture research, but he and others found it very difficult to keep human cells alive in vitro, so he was much surprised and delighted at his success with Henrietta’s tumour cells.

Canto: They were the first ever cells to live beyond the Hayflick limit, though that limit wasn’t spelt out by Hayflick until 1961.

Jacinta: And wasn’t accepted for decades after that. And the reason for their apparent immortality, a rare thing in untreated cells, was their cancerous nature. Human cancer cells contain an enzyme known as telomerase, which rebuilds the telomeres at the ends of chromosomes. Normally these telomeres, often described as like the protective caps at the ends of shoelaces, shorten and so become less protective with each cell division.

Canto: So if we could stop cancer cells from producing telomerase, you’d stop all that metastasising…

Jacinta: Sounds easy-peasy. And if we could introduce telomerase into non-cancerous cells we could all live forever.

Canto: Bet they haven’t thought of that one. So if this cell line was cancerous, how could they be of so much value? How could they be of any use at all, since the aim, I thought, was to produce ‘clean’ cells, like the WI-38 cells Hayflick produced ten years later? Remember how they had so many problems with monkey cells, which were full of viruses?

Jacinta: Well, forget viruses for the moment, the exciting thing about the HeLa cells was that they stayed alive and multiplied, which was rare, and so they could be experimented on in a variety of ways.

Canto: But did they use the cells for vaccines? The 1954 Salk polio vaccine was tested using these cells. How can you do this with cancerous cells?

Jacinta: Well it was the suitability of these cells for mass-production that made them ideal for test-driving the Salk vaccine, and of course their prolific nature was tied to their cancerous nature – Henrietta’s cancer seemed to be horribly fast-spreading, it was just about everywhere inside her at her death. Her cancer was caused by the human papilloma virus (HPV) and I’ve read that this may have had something to do with their prolific nature. She also had syphillis, likely contracted from her philandering husband, and this suppresses the immune system, allowing the cancer cells to multiply more rapidly. But even though they were cancer cells they shared many of the properties of normal cells, including the production of proteins and susceptibility to bacterial and especially viral infections. Of course you would never inject HeLa cells into humans, but their malignancy is an advantage in that you get the results of say, viral infection of cells as they reproduce, much more quickly than with normal cells, because of their reproductive rate. It seems old George Gey hit the jackpot with them, though he never made any more money out of them than the Lackses did.

Canto: They initially used rhesus monkey cells to test their antibody levels in response to Salk’s killed polio virus, but they were too hard to get and too expensive, and the HeLa cells were an excellent alternative because they were easily infected by the virus… and they reproduced with unprecedented alacrity.

The malignancy of immortality (or vice versa). A HeLa cell splitting into two new cells. The green spots are chromosomes. Courtesy Paul D. Andrews)

Jacinta: Yes, that’s to say, they readily produced antibodies, and so could be experimented on to produce the level of antibodies to create immunity. But growing cell cultures in vitro and maintaining them in a viable state, that’s been a decades-long learning process. Tissue culture these days is big business, which has led to the murky ethical questions about tissue ownership that Skloot refers to at the end of her book.

Canto: Yes but I for one am quite clear about that issue. I’m more than happy for researchers to use any tissue that comes from, say, a biopsy done on me. Is that tissue mine, when it’s removed from my body?

Jacinta: Well, is it? Think of locks of hair kept from a loved one – something that happens a few times in Skloot’s book. Wouldn’t you be moved by a lock of hair that you knew came from someone you loved but who was no longer around? Wouldn’t you feel you had hold of a part of her? Not just a memory of her?

Canto: Interesting. I think I’d be in two minds about it. I’d think, yes, this is her hair, a small part of her, and that would bring all the emotion of identity with it. But then, what I know about science and cells tells me this is just hair, it’s not what makes her her. It’s nowhere near it. Our hair is discarded all the time.

Jacinta: If you had some of her brain cells? Or heart tissue haha?

Canto: Nothing but ultra-ultra minuscule parts of the whole. And essentially meaningless when disconnected from that whole. But this misses the point that the value of this tissue for research outweighs by far, to me at any rate, the sentimental value that you’re talking about.

Jacinta: But for some people, and some cultures, the intactness of the human entity, after death say, is of deep-rooted significance. Are you not prepared to respect that?

Canto: But we slough off our trillions of cells all the time. Even as a kid I was told we replace our cells every seven years. Of course it’s much more varied and complicated than that, but the general point of constant renewal is true.

Jacinta: Yes but they’re your cells, with your DNA in them, nobody else’s.

Canto: Well people are prepared to be operated on, which inevitably kills or removes cells, and in doing so they give themselves up to experts in healing their bodies and often saving their lives, so it would seem to me pretty mean-spirited not to allow those experts to make use of what’s removed, which is of no obvious use to them.

Jacinta: I think you have a good argument there, but what if these mad scientists use your cells for some nefarious purpose?

Canto: Well, call me a trusting soul, but why would they do that? And what nefarious purpose could they use them for?

Jacinta: Well it mightn’t even be nefarious. With the modern commercialisation of cell and gene technology, they might find your tissue perfect for developing something patentable, out of which they make shitloads of money while preventing independent research on the tissue, so using your cells in a way that you might strongly disapprove of. But you wouldn’t have the slightest say, as things stand today. Rebecca Skloot describes examples of this kind in the Afterword to her book. There’s been a raging debate about commercialisation and gene patents and patients’ rights for some time now in the USA, and no doubt elsewhere, with scientists and other stakeholders ranged along the spectrum. In fact, these are the last words of Skloot’s book, published in 2010:

2009: More than 150,000 scientists join the American Civil Liberties Union and breast cancer patients in suing Myriad Genetics over its breast-cancer gene patents. The suit claims that the practice of gene patenting violates patent law and has inhibited scientific research.

Canto: Right. As her investigations reveal, it’s not just about patients wanting a share of the loot from research on their cells, and so using the courts to bog everything down and hinder that research, it’s often about researchers themselves wanting to cash in, and patients joining with other researchers to try to free up the system for the common good. So how’s the Myriad Genetics case going, and how’s the situation regarding patient rights in this field, several years on?References

Jacinta: Well in the case of Myriad, it was all highly complex and litigious, with suits and countersuits, which the company mostly lost, in particular in a landmark (and unanimous) Supreme Court decision of 2013, in which they found that ‘merely isolating genes that are found in nature [in this case the BRCA-1 and BRCA-2 genes] does not make them patentable’. But of course this wasn’t so much about patients’ rights in the material that was once part of their bodies. It’s not all about money – though much of it is, and if you don’t want the money landing in lawyers’ pockets, the best thing is to have clear guidelines, disclosure, and fully developed and complex consent procedures. My impression from doing a fairly shallow dive on the issues is that we’re a long way from sorting this out, in an increasingly complex and lucrative field. Our own federal government’s NHMRC has a booklet out, available on PDF, called ‘Ethics and the exchange and commercialisation of products derived from human tissue: background and issues’, which is already six years old, but I don’t see anything in the legislative pipeline.

Canto: Looks like an issue to be followed up, if we have the stomach for it.

Jacinta: It pays to be informed, that’s one obvious take-away from all this.

Rebecca Skloot, The immortal life of Henrietta Lacks, 2010
Meredith Wadman, The vaccine race, 2017

Written by stewart henderson

July 3, 2017 at 12:22 pm

women in science, solutions, and why nobody reads my blog, among other things

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Okay I’ve written facetiously about getting rid of men, or seriously (but facetiously) reducing their proportion of the populace, but in future I want to look at real solutions to a problem that I think is already being addressed but far too patchily and slowly – the problem of male power and dominance. The general solution, of course, is the ascent of woman, to paraphrase Jacob Bronowski via Darwin, and how to promote and quicken it. (Incidentally I’ve just discovered that ‘The Ascent of Woman’ is a four part documentary on women’s history, recently produced for the BBC by Dr Amanda Foreman – look forward to watching it).

However, before continuing I want to issue a plea for help. My blog, which I’ve been writing for many years now, has never had much of a readership, due probably to my inability to network, or even communicate much with others (I’d rather not think it’s anything to do with my writing skills). However, last month even that minuscule readership virtually collapsed, as I recorded my lowest number of hits since my first month of blogging. I’ve soldiered on, but now at the end of September I find this month’s numbers even worse. I feel I need to make a decision about the blog’s future – How do I increase the numbers? Does the blog need a makeover? Can I blame the attention-span of others? I find if I write short pieces, they don’t really cover anything in depth, but I know also that the in-depth pieces, the ones I work on hardest, often get the least attention. Should I just give up and go back to journal writing? At least that way I won’t be faced with the world’s indifference…

Anyway, enough about me – it’s interesting that when you start focusing on an issue, you hear about it everywhere, everybody seems to be talking about it. Today, listening to a podcast of the ABC Science Show, I heard that teenagers are our biggest killers, worldwide, predominantly through motor vehicle accidents. And of course we’re talking largely of male teenagers. The researcher announcing this was female, and, typical female, she was complaining about us tackling this old problem (this has been the global situation for some sixty years) in the same old piecemeal way, rather than though global collaboration in researching and trying to figure out workable solutions to what is clearly a global problem. It was clear from this passionate speaker (and mother of teenage children) that with more females leading research in this and other fields, we’ll get more collaboration and quicker and more effective solutions. And when Robyn Williams, our honourable Science Show anchor, asked the researcher a double-barrelled question – is this teenage problem a male one, and should teenage boys be banned from driving? – her honourable response was ‘yes, and yes’.

The question is – would a law specifically targeting boys/young men as drivers ever be implemented? Of course, many males would describe it as discriminatory. And of course it does discriminate, because the statistics are clear. But why, a young male might ask, should I be treated as a statistic? I’m not like other young men.

It’s a valid point, and I can’t see an obvious way of screening out the potentially safe young men from the potentially dangerous ones. So all we could acceptably do is raise the driving age for all, preferably globally, which would effectively discriminate against the statistically safer drivers, the females. Still, I like the idea of a push, led in the main by women, for a discriminatory driving age policy backed by science. It would raise the profile of the issue, bring women together in an excellent cause, potentially save lives, and feature as another small episode in the ascent of women.

Of course it wouldn’t solve the terrible wee problem of young kids stealing cars and killing and maiming others and themselves for pumped-up kicks…

Written by stewart henderson

October 1, 2016 at 8:39 am

The Roman Catholic Church: how to slowly kill off a seriously patriarchal institution

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Catholic patiarch, tastefull and elegantly dressed in a classical red 33-buttoned cassock of watered silk with matching baretta and sash. For simplicity's sake he appears to have eschewed the traditional laced undergarments, and his gold cross with tastefully inlaid jewels is clearly a mark of humility and servitude. Only one kissable ring is on display

Catholic patiarch, tastefully and elegantly vested in a classical red 33-buttoned cassock of watered silk with matching baretta and sash. For simplicity’s sake he appears to have eschewed the traditional laced undergarments, and his gold cross with tastefully inlaid jewels is clearly a mark of humility and servitude. Only one kissable ring is on display

The Roman Catholic Church is one of the few institutions in the western world permitted to discriminate, in terms of employment, on the basis of gender. Recently it announced that it would allow women to become deacons. The term deacon comes from ancient Greek, meaning servant, which of course accurately expresses the RCC attitude to women. There’s no upward employment pathway for women who become deacons, and I’d strongly advise any woman against applying for such a position. Of course I’d also strongly advise them to reject Catholicism altogether, as the religion, or business organisation, whatever it is, clearly has an attitude towards women which should have no place in modern society.

So given the outrageous discrimination practised by the RCC, why do so many women sheepishly accede to its restrictions? Well, maybe they don’t. I know this is anecdotal, but in a recent trip around Europe I took a few tours of major European cities. These unsurprisingly involved visits to quite a handful of historic cathedrals, featuring tombs of popes and sculptures of saints and such, but what impressed me more was that each of our tour guides felt obliged, apparently, to say that though their city was nominally Catholic, few of its residents actually practised the religion today. Maybe there was collusion among the tour guides, maybe they were all keen not to frighten the many Asian tourists, but they were surely speaking the truth. Roman Catholicism is the largest non-practiced religion in the world (though of course in some parts it’s practised fervently).

So since the RCC isn’t yet dead from indifference, perhaps something should be done to kill it off legally, and mounting legal challenges to its discriminatory policies on employment and other matters would be a good way to speed up the dying process. Sadly, I can’t find any legal or rights-based organisations keen to take up the challenge. The influential American Civil Liberties Union has many strong statements about Catholic and other religious charities and health providers discriminating against the women they serve, on issues such as abortion, family planning and homosexuality, but nothing about employment within the religious orders of the RCC. Of course the RCC doesn’t discriminate against women in their welfare arm, because to serve is a woman’s vocation. And of course the ACLU only highlights issues, it doesn’t have the resources to go any further, nor would it succeed, as religious groups are routinely exempt from anti- discrimination laws.

In Australia, the Sex Discrimination Act, particularly sections 37 and 38, provides the legal backing to religious sex discrimination. The sections are written with ‘religious freedom’ in mind, and with an eye to Article 18 of the International Covenant on Civil and Religious Rights. These freedoms, though, aren’t absolute and are to be balanced against other human rights, such as equal opportunity based on gender.

There are of course good reasons why nobody is legally challenging the RCC on this issue. Women as priests, bishops, cardinals, popes – this is hardly low-hanging fruit, it’s the heart of the Catholic system. Better to focus on discrimination against homosexuals and LGBT individuals employed in, or just attending, RCC schools. This chips away at the edges of this dreadful patriarchy and slowly weakens it. Every concession the RCC makes to modernity is like another gulp of poison it’s forced to take. Its strength will ebb away…

Written by stewart henderson

August 22, 2016 at 7:11 am