5th Catholic International Stem Cell Symposium Proceedings. Seoul, Korea

The Catholic Church may seem an unlikely host for an international stem cell symposium, but this June the Catholic University of Korea and the Archdiocese of Seoul hosted a gathering of about 300 scientists and participants from some half-dozen countries in which I was invited to participate1. Although there was a wealth of basic science, I was surprised and impressed by how they are also bringing their science to the clinic. Some Korean stem cell science is already in trials. Indeed, South Korean scientists' commitment to translational research means they will probably be at the forefront in developing important therapies.

Within my own field of using non-embryonic stem cells (non-ESCs) for neurodegenerative diseases, I am developing relationships with South Koreans who are not only excellent scientists but also passionate and collaborative. They demonstrate that their country is still prominent in stem cell science, despite the well-publicized disgrace of one of the country's leading scientists, Woo-Suk Hwang.

Koreans still clearly plan to be in the forefront of stem cell research. The fallout of the Hwang scandal seems to be more caution, and also more research.

Koreans still clearly plan to be in the forefront of stem cell research. The fallout of the Hwang scandal seems to be more caution, and also more research. To me, the approach of using these stem cells is different from a conference on ESCs or one on cloning, which tend to focus on cell biology. This was more on developing treatments; the Korean government has committed itself to building and funding Good Manufacturing Practice (GMP) facilities. The Catholic University of Korea, a private school and one of the largest Catholic hospitals, is funding research, developing programs and facilities in non-ESC research, including the Catholic Institute of Cell Therapy and the Catholic High Performance Cell Therapy Center.

Presentations at the one-day meeting in Seoul focused on non-ESCs, including bone marrow, umbilical cord blood, mesenchymal and peripheral stem cells. They covered most aspects of basic and clinical research, including musculoskeletal, cardiovascular, neural, diabetes and immunotherapies.

One example of such work slated for clinical trials was presented by Sin-Soo Jeun and colleagues from the Catholic University of Korea. They have shown that mesenchymal stem cells (MSCs) from human umbilical cord blood can promote recovery of motor function in rodent models of stroke and spinal cord injury following direct injections into the damaged area2,3. Based on these translational studies, they received Korean Food and Drug Administration (FDA) approval to inject 13 chronic stroke patients with these cells directly into the brain.

More specifically, Sin-Soo Jeun and colleagues reported injecting human cord blood–derived MSCs in a study of chronic stroke patients, or those whose strokes happened months or years ago and for whom the period of spontaneous recovery has passed4. The surgical protocol was similar to that of Kondziolka and colleagues5,6, the first to inject progenitor neurons in stroke patients with some positive results. Sin-Soo Jeun and colleagues injected undifferentiated allogeneic MSCs separated from cord blood cells directly into the surrounding brain tissue of basal ganglia strokes. According to Jeun, the dose was 5 ml (1 × 107 to 1.5 × 107 cells/ml) divided into five injection sites around the frontal lobe of the stroke site. Patients included individuals who had chronic neurological deficits for at least 6 months before transplantation. The trial is continuing, and results will be reported in 12 months.

In another report of the initiation of a clinical study by the same group, four patients with significant spinal cord injury (SCI) had had transplants (by the time of the meeting), using allogeneic mesenchymal umbilical cord blood cells microinjected around the site of the injury. Although both of these ongoing trials are considered safety studies, the investigators and patients are hoping for some efficacy as well. In chronic disabling injuries such as stroke and SCI, even small changes in movement, speech, affect and cognition (as measured appropriately by reliable clinical scales during long-term follow-up) can improve quality of life. Of course, successful double-blind clinical trials will be needed before these stem cell treatments are available for approved clinical use.

What makes these studies important is that they are being done at a major university medical center, under Korean FDA guidelines, in collaboration with a biotech company (Medipost Biomedical Research Institute) providing the cells under GMP. The investigators were also involved in the preclinical animal experiments. This is not “medical tourism” of the sort where desperate patients pay thousands of dollars for questionable treatments and so enrich private clinics and companies. Subjects in this study will not pay for treatment, and results will be vetted by the research community.

For both ESCs and non- ESCs, translational research will be essential so as to use cell therapies to treat chronic degenerative diseases7. Some questions that need answers include the following: Will the transplanted cells survive? How many cells are necessary? Where is the best place to administer the cells? How will the cells interact with patient medications and the patient's immune system? The discovery of a multipotent cell is a far cry from an experimental therapy.

Attending this symposium, I felt surrounded by people who understood this. These non-ESCs will probably reach the clinic before therapies derived from ESCs will. Some of these treatments will probably not work at all or not work well; a few may even have unexpected side effects. This is not cause for pessimism: the first generation of any experimental therapy often serves only to better reveal the barriers that must be removed on the way to success. That is progress. The experience we get with these cells will help with the next set of cell therapies, whether their sources are embryonic or non-embryonic.

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Oh, S.J. Academic research in Korea. Nature Materials 6, 707–709 (2007) Article