Canada is at the cusp of a multibillion-dollar industry in regenerative medicine that will disrupt health care and medicine, says the head of the Stem Cell Network.
Cate Murray, executive director and chief operating officer of the national non-profit agency that supports research in stem cell technologies and regenerative medicine, says the country is a global leader in the sector.
“There’s going to be a very thriving industry in this country and it’s already started,” says Ms. Murray, one of a panel of experts brought together for the Globe and Mail’s Regenerative Medicine webcast on Nov. 30. “Regenerative medicine is the frontier for health care.”
The network alone supports more than 200 labs across the country working on everything from treatments for Parkinson’s disease to cellular repair of retinal degeneration.
“There’s a tremendous amount of activity coming from that research sector and, in fact, it’s spinning out into really vibrant biotech companies coast to coast,” she says.
A recent study by the Edmonton-based Institute of Health Economics forecasts considerable growth in regenerative medicine in the next 15 years, resulting in a global market estimated to be worth US$77-billion. Capturing just five per cent of that market could mean $5-billion (Canadian) in potential growth for Canada and 6,000 jobs, the report states.
“Those are conservative estimates. I think we will surpass that,” says Ms. Murray, pointing out that $20-billion was invested in the global sector last year and that amount is expected to be higher this year.
The power of regenerative medicine
In simple terms, stem cells are a blank slate, explains Gordon Keller, director of the McEwen Stem Cell Institute and another member of the webcast panel. They are cells from which all other cells generate.
Scientists have developed the means to differentiate, or direct, these so-called pluripotent cells to become specific cell types such as cardiac or neurons or liver cells. Regenerative medicine aims to treat damaged tissues and organs by introducing these engineered cells to repair or replace damaged cells.
“You could think in the case of a heart attack where we lose in the neighbourhood of a billion-plus cells; if we can take the cells from a petri dish, put them back into that damaged area and build the heart muscle… this will change the trajectory of that disease,” Dr. Keller says.
He notes clinical trials are either underway or imminent for many possible cell therapies including insulin-producing cells to treat diabetes, retinal cells to repair macular degeneration, and cardiac cells to restore cardiac function following a heart attack.
Dr. Keller is also the scientific co-founder of BlueRock Therapeutics, an engineered cell therapy company with an office in Toronto that’s currently enrolling patients in Canada and the U.S. for a clinical trial of its technology to treat neural damage in Parkinson’s patients. These new therapies need to undergo thorough testing to ensure they are safe for patients, he says.
“Lots of excitement. Not quite ready for primetime yet but we’re getting there,” he says. “I’m very optimistic that we will see therapies for some of the diseases we talked about where we’ve actually repaired the damaged tissue, not having to do an organ transplant. That is, I think, in the truest sense, what we consider regenerative medicine.”
Bringing hope to patients, but not a panacea
Regenerative medicine offers hope to Parkinson’s patients and sufferers of other neurodegenerative diseases, says Karen Lee, chief executive officer of Parkinson Canada. There are many different clinical trials underway into restoring dopamine-producing cells in the brain damaged with Parkinson’s disease, Dr. Lee says, not all of them cell-based therapies.
While exciting, stem cell treatments will not be a panacea, she says.
“Stem cells aren’t necessarily going to work for everybody. We have seen in other clinical trials… it’s worked really well in some people and others, it hasn’t,” Dr. Lee adds.
“There is definitely hope in terms of regenerative medicine. However, there needs to be a lot more work from the basic science all the way up to the clinical trials.”
There is also a question of affordability and access. With any treatment that becomes available, it’s important that it’s readily accessible to the community, Dr. Lee says.
Affordability and access are some of the ethical issues raised by the spectre of regenerative medicine, says Jonathan Kimmelman, a James McGill professor in the biomedical ethics unit at McGill University.
“Right now we’re seeing some kind of mind-blowing advances in the field of gene therapy in terms of the clinical applications, but these are incredibly expensive technologies and health care systems will only be able to afford them by taking resources out of other aspects of the health care system,” Dr. Kimmelman says. “So I think we’re going to be stuck with some major policy and ethical challenges and figuring out how to render these techniques accessible.”
He notes there are ethical issues with using embryonic stem cells, depending on the country, but it’s less common given that the science has progressed and technologies have been developed to induce pluripotent cells from non-embryonic sources. In Canada, for instance, embryonic cells can be used with the approval of the Stem Cell Oversight Committee.
Another challenge with this emerging technology is ensuring appropriate regulations are in place, Dr. Kimmelman says, noting that science can change quickly while regulations and laws change relatively slowly. He says patients also need to be protected from dubious claims of “stem cell” therapies.
“I think it’s a major challenge regulators face in trying to make sure that they are effective and yet also keeping up with developments in the science,” Dr. Kimmelman says.
Ms. Murray of Stem Cell Network adds governments and regulatory agencies will need to change how they think about our health care system to be prepared for changes that will come with cell-based therapies.
“This will be very disruptive over the next couple of decades,” she says.