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Stem Cell Stories 1998–2008Ingrid Geesink a , Barbara Prainsack b & Sarah Franklin ca Cardiff University, UKb King's College London, UKc London School of Economics, UK

Version of record first published: 07 Mar 2008.

To cite this article: Ingrid Geesink, Barbara Prainsack & Sarah Franklin (2008): Stem Cell Stories1998–2008, Science as Culture, 17:1, 1-11

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GUEST EDITORIAL

Stem Cell Stories 1998–2008

INGRID GEESINK,� BARBARA PRAINSACK�� & SARAH FRANKLIN†

�Cardiff University, UK, � �King’s College London, UK, †London School of Economics, UK

To start with, people need a fairy tale. Maybe that’s unfair, but they need a story line

that’s relatively simple to understand . . . (Condic, 2007).

For stem cells, the future is now. Future-oriented expectations are an organizing principle

of stem cell innovation. As many commentators agree, stem cells are inextricably linked

with stories of hope and promise, as well as of risk and disappointment. In the stem cell

field, stories of breakthroughs are widely recognized—commercially, politically, and in

the media. Having a good story to tell is crucial to fundraising for research, be it public

or private, and for making the field ‘acceptable to the public’.

At the same time ‘over-hyping’ the new therapeutic promises of this rapidly expanding

sector of bio-innovation is assessed as a major risk (Braude et al., 2005). ‘Hope not hype?’

is the interrogative slogan of the Medical Research Council (MRC), the UK’s principal

public funding body for stem cell science. And to make sure that investors also get the

message right, an industrial network meeting on commercialization of stem cell therapies

was recently held under the banner ‘The hype has gone!’ Hope, hype and promise are

structuring scientific innovation; these stories are also organizing the responses of its

many public audiences.

Closely related to these themes is the narrative character of scientific discovery. As ana-

lyzed in an earlier special issue of Science as Culture, entitled ‘Procreation Stories’, nar-

rative structures animate the unfolding of events by aligning the future and the past with

value-laden expectations (Franklin & McNeil, 1993). Especially prominent is the belief in

scientific progress, with its accompanying moral economy of health enhancement,

manifest destiny and new frontiers to be conquered. Likewise, a recent special issue

Science as Culture

Vol. 17, No. 1, 1–11, March 2008

Correspondence Addresses: Ingrid Geesink, ESRC Centre for Economic and Social Aspects of Genomics

(CESAGen), 6 Museum Place, Cardiff University, Cardiff CF10 3BG, Wales, UK. Email: geesinki@cf.ac.uk;

Barbara Prainsack, Centre for Biomedicine & Society—CBAS, School of Social Science & Public Policy,

King’s College London, Strand Campus, London WC2R 2LS, UK. Email: barbara.prainsack@kcl.ac.uk; Sarah

Franklin, BIOS Centre, London School of Economics and Political Science (LSE), Houghton Street, London

WC2A 2AE, UK. Email: s.franklin@lse.ac.uk

0950-5431 Print/1470-1189 Online/08/010001–11 # 2008 Process PressDOI: 10.1080/09505430801915448

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analyzes ‘biofutures’ as a self-fulfilling prophecy: a specific biofuture is promoted as

rational in scenarios, policy and practice—while others are not (Birch, 2006, p. 173).

Discovery stories render a particular point in time—the ‘moment’ of scientific ‘break-

through’—as the basis to build hopes and expectations for the future. For the field of

stem cell research, as well as for the stem cell enterprise more generally, this particular

moment came in 1998.

1998 Thomson Paper: Creation of Immortals—Or an Immortal Creation?

It’s no longer in the realm of science fiction; I really believe that within my lifetime I

will see diseases treated by these therapies (James Thomson quoted in Marshall,

1998, p. 1014).

The above quote is from the ‘News of the Week’ section of the journal Science. In that

same issue, biologist James Thomson and his team at the University of Wisconsin pub-

lished long-awaited results: the first successful isolation of stem cells from human

embryos to grow in immortal cell lines. The research team had managed to isolate

so called ‘human blastocyst-derived, pluripotent cell lines’. These cell lines, the

authors claimed, ‘should be useful in human developmental biology, drug discovery,

and transplantation medicine’ (Thomson et al., 1998, p. 1145). The journal soon pro-

moted the event from ‘News of the Week’ to ‘Breakthrough of the Year’ (Vogel,

1999).

Looking back 10 years later, it is worth asking: what is the significance of this

‘breakthrough’? What has become of ‘human blastocyst-derived pluripotent cell lines’?

Injecting hope. Credit: Bernd Haberl, Email: bernd.haberl@illustrationen.at, http://www.illustrationen.at

2 I. Geesink et al.

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The standard answer has become a well-known mantra: stem cells possess a remarkable

potential to develop into many different cell types in the body. With the theoretical poten-

tial to divide without limit, these cells are seen to offer a means for renewing tissue

throughout an individual’s life. The potentially most powerful stem cells are found in

the early stage embryo and are believed to be pluripotent—i.e. able to develop into

many different cell types (Smith, 2006). In addition, human embryonic stem cells

(hESCs) are thought to be immortal (capable of dividing indefinitely without losing

their genetic structure) and malleable (able to be manipulated without losing cell

function).

These three attributes have stimulated the imagination of patients, politicians, and

media consumers alike. If we find out how to stimulate hESCs to differentiate into the

‘right’ kind of tissue, we will be able to alleviate (or even cure) injuries or diseases as

Selling hope - companies offering stem cell therapies online (2007) Clockwise from left corner:Tiantan Puhua Stem Cell Center. People’s Republic of China www.stemcellspuhua.com. CellMedicine. United States of America http://www.cellmedicine.com/. Medra Inc. United States ofAmerica, Georgia, Germany, Dominican Republic http://www.medra.com/. RegeneCell. United

States, Seychelles and other locationas http://www.regenecell.com/

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diverse as Alzheimer’s and Parkinson’s disease, heart and kidney failure, diabetes,

traumatic spinal cord injury, vision loss and hearing loss. However, more recent

reports from scientists in Japan and the US reprogramming adult skin cells ‘back’ into

the stem cell stage claim that those cells possess similar pluripotent functions as their

embryonic counterparts (Yu et al., 2007; Takahashi et al., 2007; Vogel & Holden,

2007). These discoveries have raised doubts about whether stem cells are a different

category of cells in the body, or whether they merely represent a particular stage (see

also Zipori, 2004).

Regardless of how one assesses the therapeutic promise of hESCs, there is one predic-

tion that Thomson et al.’s (1998) publication in Science doubtlessly fulfilled: it kicked off

a heated scientific and public debate. Some would claim it marked the birth of Regenera-

tive Medicine, often described as ‘a new era of medicine’ and a ‘paradigm shift’ in

research. Somewhat more unexpectedly, it gave rise to what US commentators later

called the ‘stem cell wars’ (Kass, 2005).

As one explanation for the almost instant ‘hype’ after the publication, some commen-

tators argued that the paper had caught by surprise not only the larger public but also most

of the scientific community (Holland et al., 2001, p. xv). Other narratives regard the event-

ual derivation of stem cells from the inner cell mass of early human embryos by Thomson

et al. as the logical next step in a long tradition of basic scientific research. Critics in

support of this argument tone down the novelty factor by referring to existing therapeutic

applications of stem cells, especially regarding those obtained from bone marrow, which

has been a standard treatment course for cancer since 1968. Furthermore, the successful

derivation of embryonic stem cells from mice had already been reported in 1981 by

recent Nobel laureate Sir Martin Evans and his team (Evans & Kaufman, 1981) and by

another group of researchers (Martin, 1981). In 1995, Thomson et al. celebrated the suc-

cessful isolation of an embryonic stem cell line in primates.

It has been claimed that the isolation of an embryonic stem cell line in humans had been

within reach—and therefore was less of a serendipitous surprise than some made it seem

afterwards. Indeed, another research project had success in isolating human embryonic

germ cell lines from foetal tissue in the same year as Thomson et al. reported theirs.

Shamblott et al. (1998) had used a different culturing methodology and source, but

their findings were considered by many as equally worthy of celebration. Consequently,

the novelty of Thomson’s work could be seen as

neither the existence of stem cells as such, nor of embryonic stem cells or

even human embryonic stem cells, but merely the successful ‘derivation’ of

human embryonic stem cells, which consequently was presented as technical and

practical knowledge more than as scientific and systematic knowledge (Nielsen,

2005, p. 32).

But Thomson et al.’s paper touched upon more than just technical and practical insight.

This becomes evident from a glance at the aforementioned Science Editorial, in a special

issue on the question of publishing controversial research. There, rhetorical questions were

posed: whether the publication of ethically controversial research was ‘harmful’, and

whether journals should ‘draw a moral line in the sand’ (Miller & Bloom, 1998,

p. 1045). A news article in the same issue discussed the implications of Thomson’s

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research in terms of a ‘versatile stem cell line’ raising ‘scientific hope’ and ‘legal

questions’ (Marshall, 1998).

In other words, in retrospect, the Thomson et al. paper might have been a ‘break-

through’ in terms of new ethical, social, and regulatory questions—at least to the same

extent that it charted new waters scientifically. Put differently, the Thomson et al. publi-

cation has come to represent a crucial turning point in scientific understandings of stem

cell biology, yet the more significant implications are better understood as social,

ethical and political. The paper marked a shift in the promissory economies aligned

with a new understanding of biological development (Thompson, 2005).

Regulatory Landscape

Society is not simply ‘reacting’ to the impact of new scientific developments. As the stem

cell saga illustrates, a scientific activity has been influenced by public debates and expec-

tations. There is a deep connection between stem cell biology and the prospect of

improved (or worsened) medical and economic prospects for the future, as well as

moral politics.

When Thomson and his colleagues had been involved in the work leading to the pub-

lication of their 1998 landmark paper, the legal situation surrounding their activities had

been uncertain. Above all, it had been unclear whether Thomson’s stem cell lines could be

used under US Federal law. Federal funds there could be used neither for ‘the creation of a

human embryo’ for research purposes, nor for ‘research in which a human embryo or

embryos are destroyed, discarded or knowingly subjected to risk of injury or death’.

Most of Thomson’s research was privately funded, via biotech company Geron, and via

a grant from the Wisconsin Alumni Research Foundation, the university’s patent agent.

Nevertheless Federal restrictions were anticipated because the cells used to create his

lines had come from embryos donated by couples undergoing IVF treatment in clinics

in Wisconsin and Israel (Marshall, 1998).

In the same month as Thomson et al.’s paper was published, US President Bill Clinton

ordered a review of the issues associated with human stem cell research by the National

Bioethics Advisory Commission. The NBAC subsequently reported on ethical issues

related to the sources of human embryonic stem cell research and included arguments

of federal funding and oversight of research (NBAC, 1999, 2000). As such, hESCs colo-

nized political arenas and venture capitalist agendas alike, thereby presenting a dominant

framing in which science and biopolitics, technology and biocapital were shown to be

intrinsically interwoven.

Notably, the Pontifical Academy for Life of the Vatican issued a declaration comment-

ing on Thomson et al.’s findings:

The results of these experiments had a great impact on the world of both science

and biotechnology . . . no less than the world of business and the mass media.

There were high hopes that the application of this knowledge would lead to new

and safer ways of treating serious diseases, something which had been sought for

years. But the impact was greatest in the political world (Pontifical Academy for

Life, 2000).

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A Self-Fulfilling Prophecy?

As the discoveries of modern science create tremendous hope, they also lay vast ethical minefields. As the genius of science extends the horizons of what we can do, we increasingly confrontcomplex questions about what we should do. We have arrived at that brave new world thatseemed so distant in 1932, when Aldous Huxley wrote about human beings created in testtubes in what he called a ‘hatchery’ (White House: President Discusses Stem Cell Research,2001).

Stem cell research offers unprecedented opportunities for developing new medical therapiesfor debilitating diseases and a new way to explore fundamental questions of biology (NRC/IoM, 2002).

Although the number of human embryonic stem cell lines has increased considerably in thepast two years, few of these have been well characterised, and large hurdles still need to be over-come to ensure safety and efficacy. These will require substantial further investment and research(Braude et al., 2005, p. 1159).

If scientists can reliably direct the differentiation of embryonic stem cells into specific celltypes, they may be able to use the resulting, differentiated cells to treat certain diseases atsome point in the future (‘Stem Cell Basics’, website National Institutes of Health resourcefor stem cell research, 2007).

Gradually, the curative and regenerative potential that lies in harnessing stem cells is beingrealized (Regenerative Medicine, 2007, Aims & Scope section).

Don’t be fooled by stem cell hype (Editorial title, New Scientist, 24 November 2007).

Immortal Promises?

Stem cell stories are usefully illuminated by concepts in the sociology of expectations,

such as the organizing power of hope (Brown, 2003; Brown & Michael, 2003; Brown

et al., 2000; Moreira & Palladino, 2005). Earlier biomedical innovations, such as IVF,

were described as ‘hope technologies’ (Franklin, 1997) or as a ‘political economy of

hope’ that drives forward biomedicine (Good et al., 1990). Likewise, hope provides

both the fuel and the trajectory for future scientific progress, while also allowing a flexible

roadmap for both. For example, reports in the mass media describing ‘a shift in stem cell

hopes’ away from therapies and near-term expectations function to reconstitute stem cells

as research tools rather than instant cures (Wade, 2006).

By such means, the therapeutic promises of stem cell research can be expanded to

encompass a broad range of diseases and conditions for which there is at present only

partial treatment or none at all. Even if their many promissory applications have not mate-

rialized, this gap becomes less relevant than the ability to maintain, and to manage, the

shape and direction of imagined futures—at the same time ensuring not to ‘overhype’

such scenarios. Such narratives carefully stage anticipatory futures that will unfold

along predicted lines of development. As Brian Salter observes: ‘Embedded in these

imaginations are hopes and expectations of what the future might bring and, if the faith

is sufficiently strong, a commitment to support the allocation of the resources required

to enable that imagined future to become reality’ (Salter, 2007, p. 4).

Narrative alignments of hope and expectation thus serve to create a self-fulfilling pro-

phecy orientated toward commercial markets and therapeutic applications. Charis

Thompson’s (2005) model of ‘promissory capital’ offers an important analysis of this

6 I. Geesink et al.

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process. Likewise Franklin (2001) has described the ways in which stem cells have been

‘cultured up’ to become forms of biocapital with in-built expectations. Hope narratives

enable the co-production of stem cell technologies, political culture and biocapital invest-

ment—which in turn makes these innovations so powerful:

Asking careful questions about the promissory work of new life forms brings us into

direct contact with the generative power of representations as animating technol-

ogies themselves. At risk in the effort to separate the reality from the hype are all

of the dense reciprocities and economies of co-production through which they

emerge and perform in tandem (Franklin & Lock, 2003, p. 15).

This Special Issue: ‘Stem Cell Stories’

Much public discussion of stem cells emphasizes their future potential. ‘Stem cell talk’ has

analogies with the ‘gene talk’ described by Evelyn Fox Keller (1995). So too have the

social sciences and cultural studies turned their attention to questions of hope, expec-

tations, promises and ‘progress’.

Complementing such analyzes, this special issue focuses on how these expectations for

a particular vision of stem cell futures are driven by science and capital. We explore their

‘futurity’—both as an imaginary domain of speculative promise, and as an instrumental

process of ‘realizing’ their potential. Commentators on these experimental cells often

attempt to distinguish between their realistic potential and merely speculative hope or

hype. Yet this distinction can be deceptive. Potential futures are being shaped by

various investments—be they in the form of expert promises, elusive hopes and prayers

or venture capital. So we explore how investments in stem cells entangle their futures

in the present and its history.

We analyze the following:

. how stem cells as objects attracting investment relate to stem cells as projects building a

new future;

. how scientific, political, and commercial discourses represent their potential, such as

immortalization;

. how scientific understandings constitute the objects they describe, especially for a non-

scientific audience; and

. how science classifies and characterizes cells in action.

As overall questions: what does the future of stem cell science promise to include? What is

left out? Who is interested in stem cells and why?

A subsequent special issue, focusing on controversy over stem cell research, will be

published in late 2008.

Overview of Papers

The building and meaning of the therapeutic promise is analyzed by Beatrix Rubin in her

article ‘Therapeutic Promise in the Discourse of Human Embryonic Stem Cell Research’.

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In the recent past, biomedical research has been repeatedly promoted on the grounds that it

will lead to novel cures. Drawing on the Foucauldian notion of a dispositif as well as the

concept of the ‘therapeutic promise’, Rubin discusses the important role of medical

proposals in the discourse on hESC research. She offers an alternative ‘story’ of the

emergence of this particular research domain. In particular the quest for therapies has

rendered the human embryo accessible first as an object of experimental manipulation,

then of public debate, and finally as the subject of regulation. This therapeutic promise

‘at work’ has fostered an alliance between bioethics and science ensuring the continuation

of hESC research.

Paul Martin, Nik Brown and Alison Kraft analyze expectation and ‘communities of

promise’ shaping emerging technologies exemplified by haematopoietic stem cells

(HSCs). Their article ‘From Bedside to Bench?’ discusses the changing relationships

between basic science and the clinic. Covering several decades of development, they

show how the relationship between basic science and clinical research communities has

been based on a two-way flow of knowledge, where clinical innovation has played a

key role in the translation process.

Lena Eriksson and Andrew Webster analyze efforts at ‘Standardizing the Unknown’. As

the authors argue, standardizing hESCs is an exercise in taming different kinds of

unknowns, while simultaneously changing understandings of what a stem cell is.

Scientists exchange research materials and data across institutions and national borders

to increase both competition and cooperation. Recognizing ‘known unknowns’, scientists

are equally aware of a different epistemic currency than the types of unknowns that could

lead to scientific fame and fortune. The notion of ‘pluripotency’ provides a discursive

resource when demarcating the capacities of embryonic stem cells from those of adult

stem cells, yet it can also present a practical problem. A more flexible definition allowing

for different stem cell ‘niches’ could render the cell lines less malleable but more potent.

The reconfiguration of pluripotency may serve to transport hESCs into a clinical, do-able

future.

Neil Stephens, Paul Atkinson and Peter Glasner show how the UK Stem Cell Bank links

future visions with past and present strategies. The Bank takes donations of ethically

approved stem cell lines, tests them, grows larger stocks, and re-distributes the material

internationally. As such the Bank has an important guardianship role in the international

movement of human embryonic stem cell lines. It also enacts a particular future vision of

stem cell science. Its strategies involve a complex temporal and spatial interplay: securing

accounts of the past (both technical and social), while validating the regulatory legitimacy

of the present. The authors analyze the centrality of trust, social networks, and wider

public legitimacy in the Bank’s work. It is important to recognize the ways in which

the Bank makes these social relationships tangible, and in some cases durable, through

their embodiment in documentary form. These practices are essential to the Bank’s par-

ticular vision of the future of stem cell science.

Inna Kotchetkova, Rob Evans and Susanne Langer contribute to the long-standing

debates about method and meaning of public participation in highly contested techno-

scientific fields. In their paper ‘Articulating Contextualized Knowledge: Focus Groups

and/as Public Participation?’ they reflect on calls for increased public participation in

science and technology policy for social scientists and policy-makers alike. The authors

analyze how a particular choice of method in assessing ‘public’ opinions can bear upon

public participation. They contrast findings obtained from various focus groups on

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perceptions of stem cell research, on the one hand, and more conventional survey-based

representations of public opinion, on the other. By contrast to the ‘pro’ and ‘anti’ positions

in survey research, focus groups highlight participants’ uncertainty and ambivalence. By

providing alternative representations of public concerns that resist polarization, social

science can inform a more broad-ranging ‘upstream’ debate about the social purposes

that science should serve.

Margaret Sleeboom-Faulkner likewise takes a fresh approach to the role and meaning of

public debate in her article ‘Debates on Human Embryonic Stem Cell Research in Japan:

Minority Voices and their Political Amplifiers’. Debate on the status of the embryo is said

to be hardly relevant to Japanese culture because this country has no cultural canons that

forbid hESC research. Nevertheless Japan has a ‘public’ debate, which is considered

crucial to science policy-makers, though monopolized by the voices of only a few

social groups. Sleeboom-Faulkner describes how the views of different stakeholders are

quoted and used by various political interest groups, including how these groups capitalize

on raised expectations of hESC research. The past experiences of the three social groups

with Japanese politics on health are linked to promises, risk perception and doubts about

the future of hESCR.

Acknowledgements

The idea for this special issue on stem cell stories, and a forthcoming one on controversies in

the stem cell landscape, arose during the EASST conference in August 2006 in Lausanne,

Switzerland. The guest editors would like to thank all participants in the panel on ‘Global

Governance of Stem Cell Therapies: Policies, Practices and Moral Systems’ for their

input and insights. Also the many referees for these special issues did a great job by

providing us with critical and detailed feedback, sometimes upon our rather last-minute

requests. We thank all authors for their patience and enthusiasm while working towards

tight deadlines. We are especially grateful to Les Levidow for his outstanding intellectual

and moral support in making these special issues happen. Last but not least, we thank the

Genomeresearch in Austria (GEN-AU) programme of the Austrian Federal Ministry for

Science and Research and the UK Economic and Social Research Council (ESRC grant

number PTA-037-27-0079) for their support.

Correspondence is welcome: please send comments to the email addresses on the title page.

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