I do not want to undermine the importance of the great work that was done in generating pluripotent stem cells from adult skin cells, but the only thing I think about when hearing this news is TIME and MONEY. I know I will be fielding questions from my friends and relatives over Thanksgiving weekend on whether or not Aastrom (my employer) is doing this type of work or if we have to change our business model. I will have to explain that this type of research is at such an early stage, that it will not be impacting what is going on in Biotech for 20 years, if not more. It is challenging enough to manufacture and distribute an autologous cell product based on the expansion of a patient’s bone marrow. I cannot imagine trying to develop and implement a process where every patient needs their cells to be genetically modified with multiple genes prior to expansion, and then there is the potential need to differentiate the cells or engineer them into vascularized tissues – it is enough to give a process engineer a migraine. Not only is something like this difficult to scale, but the in-process quality control testing would be so expensive and time consuming that the only companies making any money would be the supply companies, such as Invitrogen.

On another note: I wonder if our healthcare system will ever evolve to reimburse a therapeutic strategy that this work would enable. One would need to generate and bank a patient’s pluripotent cells well before they would be needed for most diseases. Does the average cardiac patient have 6 months to wait for their drug to be manufactured? What insurance company would pay for this type of expensive processing, and banking, just in case you get a disease? This may be a therapy only for the rich.

Overall, this is really exciting science and I am enthusiastic to see how this will expand our knowledge base and alter the political landscape. However, the reality is that there will be several cell-based products on the market before this technology is ready for prime time (and therefore fewer unmet medical needs) that there will be little need, or smart venture money available, to develop it.