India is framing plans for a national stem cell initiative to increase clinical applications of research, build links between scientists and doctors and prioritise areas for research funding. The plans, being drafted by the Indian Council of Medical Research (I.C.M.R.) and the Department of Biotechnology, include creating a fund to boost stem cell research, reports to the reputed science portal scidev.net.

Stem cells are cells found in different parts of the body such as the bone marrow, eye and umbilical cord that have the remarkable ability to develop into different types of cells depending on the nature of inputs. Pioneering research in the area has helped scientists understand diseases better and develop new medical therapies.

The Indian government is also set to devise guidelines aimed at ending the unmonitored use of stem cells to treat medical conditions. Several private and public institutions are using stem cells in procedures such as heart surgery and treating blindness. But the clinics follow these procedures without being supervised by any regulatory body. And although some clinics have informed the ICMR about their planned use of stem cells, many private clinics have not.

A representative of the council said it was concerned that the safety and effectiveness of using stem cells were unproven, and that clinics could be using poor quality cells. The Council and the Department are now moving quickly to draw up guidelines on the clinical use of stem cells and to organise workshops to educate doctors about good clinical practice.

According to Dorairajan Balasubramaniam, former director of the Centre for Cellular and Molecular Biology in Hyderabad, India could take the lead in stem cell research as it is among the few countries with clearly defined ethical guidelines and has initiated so-called city clusters.

India is specially interested in clinical applications of stem cells in ophthalmology, cardiology and spinal cord repair, said Balasubramaniam, who is currently director of research at the L.V. Prasad Eye Institute in
Hyderabad.

The L.V. Prasad Eye Institute, for example, has treated blindness using stem cells derived from the eye. Similarly, the Christian Medical College at Vellore in Tamil Nadu plans to use stem cells from bone marrow to treat chronic liver failure, heart disease, traumatic brain injury and Crohn's disease - a form of inflammatory bowel disease whose incidence is rising worldwide.

Other centres for stem cell research include the National Centre for Cell Sciences in Pune and the National Brain Research Centre at Manesar near Delhi. While Manipal hospital is all set to dedicate an entire floor for housing a permanent stem cell research facility, Narayana Hrudayalaya intends to do an AIIMS act in Bangalore within three months — use bone marrow stem cells to cure coronary disease. St John’s Medical College is shortly going to open its bone marrow facility and “will look into stem cell research once this facility is established”.

AIIMS had earlier ministered to 40 heart patients who were treated using bone marrow stem cells.

Manipal Hospital has invested Rs 15 crore into Manipal Acunova according to Dr Satish Totay, who is heading its research team, research conducted in the last six months is already yielding results.

The hospital claims that it is ready to use stem cells for curing blindness. “We are working on culturing cornea and neuro related stem cells, and we are ready to conduct cornea transplants using stem cells,” he says. The research unit has already procured four embryonic stem cell lines and is working on creating more lines.

According to Dr Totay, the advantage that Indians have over their Caucasian and Chinese counterparts is that the population is not genetically diverse. “While only one out of 25,000 people match the donor’s stem cells in other populations, in India it is one per 8,000,” explains Dr Totay, quoting research. “This means that it is easier to find a match in India and we require fewer lines.”

Embryonic stem cell research has kicked up a controversy and those opposed to it allege that taking embryonic stem cells, which are considered basic life cells, is equivalent to taking a life.

However, the I.C.M.R. has released a white paper allowing embryonic stem cell research, provided the embryos are generated using in vitro fertilisation techniques. Some experts, like Dr S G Rao contend that the argument is premature. “It will take at least another ten years before it is ready for clinical application on humans,” Dr Rao says.