Fetal tissue has been an important scientific research tool for nearly a century.
It has been instrumental in the development of life-saving vaccines and drugs.
Today, there is no good alternative for the tissue, which is more malleable than fully-formed human cells. Fetal tissue comes from both abortions and miscarriages, and would otherwise be incinerated.
It's use, though controversial, has received broad bipartisan support, because of the benefits to humanity. Fetal tissue from the 1970s was used to develop President Trump's recent coronavirus treatment.
But the Trump administration has clamped down on the use of fetal tissue in the US, essentially putting a hold on all new research that would use it.
"That's not really morally very consistent," one researcher said.
President Trump has benefitted from decades of medical research using human fetal tissue, and so have you.
When he got sick with the coronavirus in September, Trump's Regeneron antibody treatment had been developed with the use of HEK 293T cells, which have been a workhorse material on biomedical lab benches around the world, since they were first cultured from an embryonic kidney cell in the Netherlands in the early 1970s.
Even so, Trump and his administration have cracked down on new fetal tissue research being done today in the US — dampening hopes the same kinds of cells that helped create his treatment may continue being used in new research, to pave the way toward future treatments and cures for millions of people.
The ban could have a crippling effect on the hunt for treatments for neurodegenerative diseases, and new drug therapies for cancers and HIV. It's also affecting the way scientists study viruses that cause disease in humans, a critical impairment during the coronavirus pandemic.
The truth is, there is no great alternative (yet) for human fetal tissue in medical research. (Humans, and their development, are kind of complicated.) So, for now, we're missing out on an unknown number of medical advances, as the raw materials for this research get discarded after miscarriages and abortions.
"Scientists, such as myself, think that it's better for all of that tissue to go to research, than to just destroy it," Professor Lawrence Goldstein, a neuroscientist at UC San Diego, who has used fetal tissue to study Alzheimer's in the past, said.
What, exactly, is fetal tissue research?
"Most drugs and most vaccines have, at some point in their movement towards the clinic, passed through a stage in which they've been either developed or tested using cell lines that came from human fetal tissue," said Dr. Mike McCune, an HIV researcher who, in the 1980s, developed the first mice engineered to study human diseases using fetal tissue.
In McCune's lab, fetal tissue has been used to test out drug treatments that have turned HIV from a death sentence into a livable, chronic disease. Today, many branches of medical research, treating everything from cancer, to spinal cord injuries, Alzheimer's, and organ transplants have all, in some way, benefitted from fetal tissue research.
One of the most basic ways that fetal tissue has been used is in the creation of prolific cell lines (like the ones Regeneron's used in its labs) which can be dispatched indefinitely to test out how well treatments or vaccines might work, before they go inside people.
Such cell lines are also sometimes used not just to test, but to create treatments. Take the advent of the polio vaccine, which has prevented millions of cases of paralysis, and saved hundreds of thousands of lives. That was once grown inside fetal cells, as were many other vaccines.
Fetal tissue is also used as a gold standard comparison tool. For example, in organ development, it's used to make sure that stem cells being developed into artificial organs are mimicking real, human, cells in the proper way.
Studying human fetal tissue also helps researchers better understand the reasons why birth defects arise, and glean insights into how these congenital issues may be better prevented in the future.
During the coronavirus pandemic, fetal tissue could be used to develop precise human immune system models which could then be used to quickly try out drugs, determining within weeks which might work, and which are duds.
There are strict rules about how fetal tissue is used
Today, there is no reliably good alternative material to use for fetal tissue, the very makings of our humanness. Fetal cells are less specialized than fully-formed human cells, and as such, they are much more flexible tools than our own cells for using in the lab, and studying all kinds of diseases that only affect us.
Donating fetal tissue is a lot like organ donation. There are strict rules in place to ensure no exchange of money or favor occurs. Instead of being incinerated, then, that fetal tissue may be used in a lab.
"You have a family, a mother, or parents, who make the decision that they want something good to come out of this tragedy of losing, or terminating, a pregnancy," virologist Alexander Ploss, who does work on fetal stem cells at Princeton University, told Insider of fetal tissue donation. "We're basically now potentially restricting this option, and taking this option away."
Fetal tissue research has had strong bipartisan backing. Mitch McConnell voted for it in 1993.
Fetal tissue was already given the Congressional thumbs up by a bipartisan group of lawmakers in 1993.
The vote in the Senate that year was near-unanimous: 93 to 4, with anti-abortion senators Mitch McConnell and Chuck Grassley both voting "yes". They acknowledged there are clear benefits to humanity in using this tissue, just as the National Institutes of Health did, as recently as 2018.
The National Catholic Bioethics Center has for years, likewise, agreed that there are benefits to using fetal cell lines and tissues.
The NCBC said as recently as May 2020 on its website that "one is morally free to use the vaccine, despite its historical association with abortion, if there is a proportionately serious reason for doing so."
"This is especially important for parents," the NCBC added, "who have a moral obligation to protect the life and health of their children, and those around them."
But on June 5, 2019, the Department of Health and Human Services stopped funding all new human fetal tissue research, effectively shutting down the last private labs (in California and Montana) that were using federal dollars for fetal tissue work.
"Many of the researchers who may be most affected by this policy change study pathways and processes associated with disease in infants and children," professor Carolyn Coyne, who studies viruses that affect fetal and neonatal health, wrote in the Washington Post at the time. "As such, the only certain consequence of the new policy is that it will impede medical discoveries that could advance new treatments to save the lives of infants, the very lives those in favor of this policy claim they are trying to protect."
The NIH can technically still fund work on fetal tissue outside its own walls, but the agency has been hamstrung by a new fetal tissue advisory board, largely comprised of members with strong antiabortion group ties. At a recent meeting, the group approved just one of 14 fetal tissue grant proposals up for review, The Washington Post reported. It was a grant to study whether an alternative to fetal tissue works as well.
"The administration has developed a policy that the evangelical and hardcore pro-life community wants, which is a complete ban on the use of any federal funds for new fetal tissue," Goldstein, who sat on the recent NIH committee, told Insider. "You know, they're okay with the old stuff."
'The alternative is throwing it in the trash'
Antiabortion groups have largely shrugged off the fact that Trump's coronavirus treatment benefitted from medical research on fetal tissue, decades ago.
Goldstein sees this as pure hypocrisy.
"The claim they're making is that, 'well, it was done a long time ago, so it's okay now,'" he said. "Well, you know, that's not really morally very consistent. You're going to block us from developing new therapies with fetal tissue, but you're going to be okay using the ones that are already here?"
Goldstein says there are three main reasons to continue using fetal stem cells: One, there's no evidence that this research incentivizes anyone to have an abortion. Two: "it's really valuable research" which has saved and improved countless lives. And three: "The alternative is throwing it in the trash," he said. "How is that a dignified use of the material?"
"I don't know if that's going to persuade anybody, but those are the factors I'd cite," he added.
Losing America's competitive edge
The coronavirus isn't the only area where scientists now have a blind spot.
"There's a whole bunch of genetic diseases that we don't understand very well, neuro-developmental disorders that we don't understand very well, for which actually having access to, let's say, human neuronal tissue, or whatever it may be, is absolutely critical," Ploss said.
"I'm not particularly optimistic that it's possible right now to obtain any serious funding, federal funding, for this kind of research," he said. "It's pretty much impossible right now to get any kind of funding for research that involves human fetal tissue."
But, he says, the stakes are so high that he'll still try, in the coming months. He, and all the other scientists Insider spoke to for this story are already worried about the US losing some of its competitive edge in biotech.
"The reason we are a world leader is because we have been innovative, we have rewarded innovation, and for the most part, the government has stayed out of the way, except funding high-quality research, that's been competitively reviewed," Goldstein said.
"We are always at risk of losing our advantage to an aggressive competitor, and I don't want to see that happen. I'm a loyal American, and I want to see us be the best."
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