Asia-Pacific Analysis: The growth of stem-cell therapy
Research into stem cells is taking place across South-East Asia, but proven disease treatments are currently out of reach, says Crispin Maslog.
Two scientists, Sir John Gurdon from the United Kingdom and Shinya Yamanaka from Japan, share the Nobel Prize in Physiology or Medicine 2012 awarded this month (10 December) in Norway for work that revolutionised the understanding of how stem cells develop — reviving ancient visions of a fountain of youth — and that readily found a huge following in South-East Asia.
These two scientists, from east and west and separated by a generation, demonstrated that adult cells can be changed to an infant form called stem cells, raising the possibility of creating replacement tissue for people affected by crippling and degenerative diseases.
- Stem-cell research is being done in many South-East Asian nations
- Although much of it is an early stage, stem-cell treatments have also been developed
- Issues over ethics and research quality are already emerging
"By reprogramming human cells, scientists have created new opportunities to study diseases and develop methods for diagnosis and therapy," the Nobel jury declared. 
Gurdon was surprised by the honour, since his award-winning research was done half a century ago. It was back in 1962 that he discovered that the DNA code in the nucleus of an adult frog cell stored all the information needed for it to develop into every other kind of cell. This meant that an adult cell could be reprogrammed.
More than four decades later, in 2006, Yamanaka showed how mature mice cells could be changed to their youthful state, averting the need to use stem cells from early-stage embryos that has stirred ethical controversy.
Potential to treat disease
Although promising, stem-cell research remains at a very early stage and few human trials have taken place. But scientists are already excited about its potential impact on regenerative medicine.
There is growing evidence that stem cells could be used to cure many age-related diseases and delay ageing. Stem cells, which have no tissue-specific structure, can replicate themselves into specialised forms such as heart muscle cells, blood cells, sperm cells and nerve cells that perform specific functions.
Medical researchers believe that it may soon be possible to use stem cells to treat diseases such as diabetes, heart disease, HIV/AIDS, hepatitis, arthritis and cancer that are problematic in the developing world.
But the most popular stem-cell research is to do with cosmetic applications to reverse the impacts of ageing. The US government broadcasting network Voice of America has reported the growing popularity of stem-cell therapy with this aim in Asia.
In South-East Asia, Singapore leads the way in stem-cell research. It has set up Biopolis, a biomedical research centre that does stem-cell science. 
It has also organised a stem-cell consortium with the aim of ensuring a coordinated and focused research and development programme on stem cells. The aim is to translate basic research into clinically viable therapies for diseases.
Other leading lights
Thailand is another leader in the region on such research. Unlike Singapore's government-run funding and management system, Thailand adopted a free enterprise model, with funding coming from various public and private sources.
In 2012 alone, three Thai universities reported achievements in stem-cell research.  Early this year, Chulalongkorn University announced that it was the first in the country to produce human embryonic stem cells.
Meanwhile, Police General Hospital developed adult stem cells to treat arthritis sufferers and is now conducting a clinical trial on 60 arthritis patients aged 45 to 60. The trial is expected to be completed next year.
Finally, researchers at Mahidol University's Siriraj Hospital said they had discovered a way to extract a pure sample of stem cells from human amniotic fluid. They believe that these cells could be used to treat conditions such as arthritis.
Thailand is also leading the way in stem-cell banking. Chulalongkorn University has set up Thailand's first embryonic stem-cell bank. And new private facilities — run by THAI StemLife, Cryoviva Thailand, CordLife and others — recently opened to store stem cells from the roughly 800,000 babies born each year in Thailand.
In Indonesia, stem-cell therapy has been used mainly for cardiovascular disorders. In 2011, 20 patients with such disorders underwent this treatment at Cipto Mangunkusumo National Hospital alone.
In the Philippines, stem-cell therapy has attracted the attention of celebrities and other famous people who want to maintain their youthful looks. One of its first people in the country to have this treatment was former Philippine president, Joseph Estrada, who admitted in a televised interview that he underwent anti-ageing stem-cell therapy.
A word of caution
But many members of the public do not understand that stem cell therapy is still a frontier intervention for disease and, for now, may be used only as a last resort to try to treat diseases such as cancer.
More research is needed to understand how stem cells behave after they are transplanted, such as how they interact with diseased or injured body tissues. While numerous stem-cell therapies have been performed, most of them are at an experimental stage.
Pankaj Kumar Mishra, a cardiothoracic surgeon at the Royal Wolverhampton Hospitals in the UK, writing in the European Journal of Cardio-Thoracic Surgery, said that evidence to support the use of stem-cell therapy to regenerate heart muscle had flaws. 
Mishra warned that some medical centres in South-East Asia have started charging patients for treatment with coronary artery bypass grafting and stem-cell therapy as a single procedure. This constitutes unethical practice, he said. As in other new fields of study and practice, there is a need to draw up standards and regulations.
This also begs the question: can poor people in South-East Asia afford expensive stem-cell treatments or will the medical benefits of stem cells remain only the privileged domain of those who can pay for it.
Crispin Maslog is a Manila-based consultant for the Asian Institute of Journalism and Communication. A former journalist, professor and environmental activist, he worked for the Press Foundation of Asia and the International Rice Research Institute.
This article has been produced by SciDev.Net's South-East Asia and Pacific desk.