The Argonaut Interview: Dr. Hyun Bae
By Gary Walker
Stem cell research remains a controversial topic throughout much of the nation, for religious as well as ethical reasons. Embryonic stem cells, which can differentiate into extraembryonic tissues and are derived from human embryos, are a particularly hot-button topic.
Scientists and researchers around the globe have been exploring the potential that adult regenerative stem cells could have on patients suffering from a variety of ailments, including spinal cord injuries, heart conditions and diabetes.
While stem cell research – especially clinic studies involving human embryos – remains highly politicized, Californians have shown their support for the controversial therapy. Voters approved a 2004 initiative that allocated $3 million toward human embryonic stem cell research.
Proposition 71 made California the largest state-funded scientific research initiative in the United States.
Three years ago, President Barack Obama signed an executive order that reversed President George W. Bush’s earlier policy of prohibiting the use of federal tax dollars for embryonic stem cell research.
Unlike embryonic cells, the use of adult stem cells in research and therapy is much less controversial. Dr. Hyun Bae, a spine surgeon at Saint John’s Health Center in Santa Monica, is the principal investigator in a clinical trial using adult stem cell technology. The hospital is one of only eight sites nationwide that have been chosen by the U.S. Food and Drug Administration for the studies.
According to literature on the clinical trial, these studies are intended to demonstrate the safety of allogeneic stem cells in spinal fusion procedures as well as to provide information about the potential benefits of stem cell therapy.
Bae uses what are known as “purified” or adult donor stem cells in his spinal transplants. Thus far, Bae has done approximately 25 spinal transplants.
A former director of education at the Cedars-Sinai Spine Center, Bae is one of the first surgeons to use growth factor tissue engineering for intervertebral discs and multi-level artificial disc replacements for the lumbar and cervical spine.
Researchers hope that spinal ailments that frequently leave some patients in pain for years can be alleviated with stem cell transplants and therapy.
The Argonaut spoke with Bae recently about his research, his thoughts on the potential benefits of stem cell therapy and the uses of adult vs. embryonic stem cell transplants.
Q: How long have you been a spinal surgeon?
Approximately 20 years.
Q: Embryonic cells can also replicate themselves and are being investigated in a clinical trial at the University of California, although it is for research purposes and not for transplants. Are there inherent risks with embryonic stem cells that there are not with adult cells, besides that fact that often the former cannot be replicated in larger quantities for investigative purposes?
There is also a risk of untoward growth with embryonic stem cells.
Purified donor cells are what are known as allogeneic or ‘off the shelf’ cells that are fit for treatments.
Q: Does the fact that Saint John’s is a Catholic health center factor into the decision not to use embryonic cells?
That’s one reason. The use of embryonic stem cells is very controversial. It is very politically, ethically and socially charged.
Also, in laboratory studies, they have not shown any equivalency with adult stem cells. So it’s much easier to use the adult cells.
Q: What is the process that you use for creating these stem cells?
They are replicated and cultured in a cell bank and grown to a level that is concentrated.
Q: How do you obtain these cells?
There are people that donate their cells.
Q: Does having the ability to regenerate make stem cell transplants such an intriguing new potential method of medical treatment?
Yes. Stem cells are imminoprivileged, which means that they do not cause tissue rejection like other transplants.
Q: What are some of the benefits that you foresee with stem cell therapy if the clinical trial is successful?
For people with lower back pain caused by a degenerative disk, to have a transplant that can regenerate tissue is almost like finding the fountain of youth.
Q: Do you use image guidance when you do the transplants? Two well-known spinal surgeons, a father and son team in Marina del Rey who also operate on high profile athletes, told me that this technology has greatly improved surgery.
We do use interoperative image guidance, which allows us to be less invasive. It also allows for the precise placement of cells.
Q: Where else on a patient’s anatomy do you think surgeons will be able to apply this new method of treatment?
As the technology grows, we’ll see regenerations of different tissues such as cardiac tissue, as well as regeneration in joints and tendons and spinal regeneration.
Q: How do you see this new surgical approach, using ‘purified’ stem cells to regenerate new cells, being incorporated into medical care and treatment over the next decade?
While it is still in its infancy, I think that this technology will become one of the primary modes of treatment (for spinal injuries). This is really a new frontier.
Q: How do you view the results of the clinical trial thus far and when do you anticipate that the findings will be published?
We are still approximately five years away from full release (of the study’s findings). But the results have been promising. ¤