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Interview with Doug Sipp, Manager at RIKEN CDB

August 17th 2011

In a recent interview with Danielle Nicholson from REMEDI, Doug Sipp Manager at the RIKEN Center for Developmental Biology (CDB) in Kobe, Japan had some interesting things to say about the new phenomenon of stem cell tourism.

What path did you follow in your studies and early career?
I traveled to Japan immediately after graduation and worked in the software, translation, and publishing industries, and over time increasingly began to focus on science, technology and medicine. This eventually led me to a position at the Nature office in Tokyo, where I worked prior to joining the CDB.

Did you know Japanese before your move?
I had studied a bit of Japanese in college, but lost most of it before I went, so it was a bit like having to start from scratch again. Prior to Nature, though, I worked for Japanese companies, so I had lots of opportunities for immersion and learning on the job.
Looking back when do you first recall being interested in science?
Well, even as a child I think I was essentially curious about learning, as most children are. But my first introduction to life sciences at the professional level was in contributing to the development of patient simulation software at a computer company a few years into my stay in Japan. This work entailed attending intensive lectures by consulting physicians, riding in ambulances, speaking with doctors and patients, and extensive reading of medical textbooks and publications. We tackled subjects such as critical care medicine, anesthesiology, and ECG simulation. The idea was to develop mathematical representations of changes in patient parameters, such as blood pressure or oxygen saturation, in response to pathologies, traumas and drug administration. What really got me hooked was studying basic physiology, such as the dynamics of synapses or how changes in ion concentration trigger contractility in heart muscle.
From there I moved to Nature where one of my main jobs was to help maintain quality control over translations and local content production. This position was a real crash course in an extremely broad range of fundamental sciences, from cold matter physics to paleoclimatology. It was during my time there that I realized that I was more interested in the science than in the business side of publishing.

How did you become interested in developmental biology and stem cell research?
It wasn’t until I started working at the CDB in 2002 that I read in these fields with more than passing interest. But my job entails writing about and representing the institute’s scientific achievements as well as, to some extent, these research fields in general, so I spent the first few years buried in textbooks and publications, as well as attending lots of conferences and seminars. It’s an exciting time in the field, with all the connections that are being made between the basic bench science and potential clinical applications.

Switching gears a bit, you recently published an article describing how stem cell tourism clinics are beginning to depict themselves as providing a form of alternative medicine. Can you talk a bit about that?
What seems to be happening is either a broadening of the industry, or an outright transformation. Most of marketing ploys that were originally being used to sell untested, implausible stem cell treatments directly to patients was based on the idea that this was the cutting edge of science. This, of course caused uproar with real scientists and doctors who said there is no evidence to back up this type of claim. But there is this whole culture of complementary, alternative medicine with the idea that the evidence is not important; if something makes a patient feel better in some way that is enough to claim efficacy. Also, there is this idea that natural things are better for you than the chemicals or injections that they give you in the hospital. To me, this is just another marketing ploy, ‘These stem cells are natural, almost magical building blocks that will automatically know what to do once they are put inside your body to heal what ails you.’ But what this really represents is a retreat to medieval standards of evidence and rigor.
If you spend a lot of time looking on websites, you will see that this is a diversification of the ways they are trying to sell these dubious products to very ill people or, in many cases, to the families of sick children. Some studies of the industry have indicated that 45- 50% of the patients in these stem cell clinics are children. Many of them are not suffering with life-threatening diseases either. There are clinics that claim to treat conditions like autism and even Down’s syndrome with stem cell injections, which is ludicrous and disturbing. Nonetheless, people are persuaded to bring their children to developing countries with no real record of producing biological innovation that lack a strong medical infrastructure, but may be trying to build a medical tourism industry. The risks are appalling when you think about it, not the least of which is the serious financial burden these charlatans exact on their patients. The lack of oversight means we have no idea what is being injected, either – we have already seen cases in which unscrupulous clinics gave people bovine cells or unsorted slurries of tissue from human fetal brain.
I have been studying stem cell tourism for 3-4 years now, and the more I look at it, and the characters who become involved in this form of charlatanry, the more I see it as a serious crime. These are well-organized criminal organizations that target sick people and their families. I think what makes this business model so attractive is the ease with which online companies can be set up. All you need is an Internet connection. There are little or no staff costs. Overhead is minimal if you set up in a developing economy and don’t have too many scruples about what you’re injecting. Patients pay their own travel costs and accommodations. What it amounts to is a profitable scam.
But one of the most concerning developments in the past year or two is that some doctors in the US and other developed countries, including Japan, have become emboldened by the lack of regulatory response, and are now treating patients with the same unsubstantiated cell injections as we have seen on offer in Mexico, Russia and much of Asia in the past. This is taking the “tourism” out of stem cell tourism, and weakens the foundations of science-based medicine by lending a veneer of credibility to what appear to be little more than high-priced placebos.

People need a widely accessible, publicized exposé on this.
Media organizations seem to be catching on to the fact that they have been made unwitting accomplices in this scamming of very sick people. Some major media organizations have done a good job doing undercover investigative journalism reporting and exposing the people behind some of these organizations. But I haven’t yet seen any successful prosecutions for putting people in jail for this sort of thing, and unfortunately one of the things that many of these companies excel at is marketing and spin.

This seems like large-scale medical malpractice.
This is the globalization of medical malpractice. A lot malpractice is accidental or the result of negligence but this intentional; this is medical fraud.

How can one detect a bogus stem cell clinic?
If they advertise stem cells online for a broad range of unrelated diseases and that is their sole form of business that should raise a red flag. Use this as your baseline if you are a patient. You should be deeply skeptical about any kind of miraculous claims. If you find a clinic that is making claims about a stem cell breakthrough, Google the names of the people associated with the clinic, and see what kind of evidence trail they have left online. Some clinics are operated by people with no credentials, or who have lost their medical licenses. Remember, this is a profitable business for people willing to behave unethically. Patients should also look to authoritative independent sources before believing claims made on a for-profit clinic website. Many disease advocacy groups have issued warnings about stem cell fraud, and the ISSCR has developed a website called A Closer Look at Stem Cells for patients who may be considering this kind of intervention.

Thank you very much. To wrap up, your typical day, what does it look like?
I travel a lot, but when I’m in the office I am usually writing news stories on new scientific findings or developing publications and reports, or else working on my own research into policy and ethics developments relating to stem cell research.

What do you like to do when you have time off?
I enjoy reading, and catching up on sleep when I can. I am also training for my first marathon.