Twenty Years Out Living In A State Of Punctuated Equilibrium

The Big Heart Disease Lie

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Chapter 19 proposed that over the next decade great strides will be made in the field of stem cell research. The future looked bright as long as the field could overcome the potential pitfalls of patient

1. One of Dr. West's many talents is that he is an engaging writer. In his 2003 book, The Immortal Cell: One Scientist's Quest to Solve the Mystery of Human Aging, he documents his personal quest to find—and alter or shut down—the biological machinery that relentlessly works to limit our lifespan beyond what is theoretically feasible.

safety and the pressure of special interest groups from all sides wishing to control and channel the research. However, we also hypothesized that in the absence of a biological version of Moore's Law—where the research could lead to a doubling of the improvements every eighteen months—commercially feasible technologies would be relatively rare in the first decade.

The second decade out promises to be more amazing as the companies working in the field of stem cell research build on the knowledge base acquired at such a painfully slow pace. These firms—Geron, Genentech, ATC, and others not yet founded—will begin to focus on production and bringing the cost of these therapies down to where patients from all social strata can use them. Finally, products resulting from the more difficult-to-handle embryonic stem cells will be entering the marketplace to compete against the more established offshoots from cord blood and bone marrow cells.

The state of the market will likely be one familiar to evolutionary biologists, as it will be one of punctuated equilibrium. This means that when a stem cell breakthrough occurs, it will do so in a sporadic, relatively quick manner. Uniform and steady growth of the field is unlikely, as any advance in the field—say a new, cheaper method to grow tissues for implantation—is likely to act as a disruptive technology.

Site-specific injections of stem cells will be one of the first widespread methods of administering these therapies. This has already been shown to work, both in cases of blood vessel repair and nerve cord regeneration (in animal trials). The way that the injected cells know what to grow into—and when to stop growing—will be a much more tightly controlled process. These methods promise to rejuvenate coronary arteries—thereby reducing the effects of heart disease. This will also be the way to repair damaged nerve tissue, eliminating the tortuous recovery period of those who suffer spinal cord or other injuries to the nervous system.

The use of tissue cultures will be another widely-used initial approach to applying stem cell technology. For example, where organ damage is too extensive for injections of cellular solutions to be effective, thin sheets or patches of tissue can be used. To continue with the example of heart disease—which is, after all, one of the greatest killers in our country—one can easily see how useful a sheet of tissue that has been grown into cells that line blood vessels could be. To replace or repair a torn or blocked artery, the tissue could be rolled up like a little scarlet cigarillo and used as a transplant that the body would never even notice, let alone try to attack.

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