Fetal stem cells and the sports heroes they revitalized

TIJUANA, Mexico -- John Brodie decided he had nothing to lose. So did Gordie Howe, who was losing his will to live.

After each suffered massive strokes, both sports heroes barely could walk, talk or take care of themselves.

"He was definitely close to giving up hope," said Howe's son, Murray.

So they tried something new. They left the United States to receive experimental treatments that included stem cell injections derived from the brain tissue of a single aborted human fetus.

Both men now can walk, exercise and communicate better, seemingly sparked back to life after reaching the precipice of death.

Their recoveries sparked a debate: The families say the stem cell treatments had a major impact, while skeptics say the therapies are unproven and that Brodie and Howe could have improved through natural healing, as stroke patients often do.

Just as notable is the controversy that did not occur. Fetal-related research in past decades drew vehement opposition in the U.S., but it went largely unnoticed in these cases because the company that manufactures the cells refers to them as "adult" stem cells.

The company, Stemedica Cell Technologies of San Diego, says calling them "adult" stem cells is scientifically correct because they are considered more mature stem cells with a specialized function, as opposed to embryonic stem cells, which are more akin to "blank slate" cells that are considered riskier and more likely to cause tumors.

Other parts of the world use more specific terminology. The National Stem Cell Foundation of Australia distinguishes fetal stem cells from adult stem cells in its handbook. Fetal stem cells are "stem cells derived from donated fetal tissue and share many of the characteristics of the adult stem cells," the handbook says.

"We don't use the word fetal too much," said Maynard Howe, Stemedica's CEO, who is no relation to Gordie Howe. "We just don't want to get people confused about what it is. They're really considered legally adult stem cells even if they're fetal-derived."

Yet Stemedica's choice of terms not only failed to avoid public confusion, it added to it. Once Gordie Howe's treatments became public, several media reports noted he had received "adult" stem cells, with no mention that Stemedica's original source of the cells was a fetus with a gestation age of 14 to 16 weeks.

In January, ESPN2 talk show host Keith Olbermann prefaced a television interview with Maynard Howe by telling him he wanted "to preclude people going off any stem cell controversy." Olbermann then told viewers what he thought to be true.

"Your firm uses the stem cells that are donated by adult volunteers," Olbermann declared.

Maynard Howe didn't correct him.

A writer for the conservative website American Thinker even argued that Gordie Howe's recovery shows that liberals were on the wrong side of the stem cell debate. They had pushed embryonic stem cells, the article said, instead of the "morally unobjectionable, adult variety" the writer thought was used by Gordie Howe.

Bill Weckesser wrote that the Howe case is evidence "adult stem cell therapy has had some amazing successes."

Stemedica confirmed to USA TODAY Sports that Gordie Howe, the legendary former hockey player, and Brodie, the former NFL MVP quarterback, received treatment involving two types of stem cells — mesenchymal cells, derived from the bone marrow of a young adult donor, and neural cells, derived from the brain tissue of a fetus.

The company says it has an accepted scientific reason to call both of them adult stem cells — fetal-derived cells function like mature stem cells, while embryonic stem cells do not. Likewise, the California Institute for Regenerative Medicine describes adult stem cells as "specialized cells found in tissues of adults, children and fetuses."

Yet the description also worked to Stemedica's benefit in the court of U.S. public opinion.

"Talking about fetal tissue raises concerns for some people, and being able to say you're using adult stem cells probably makes sense from a company's perspective when writing a press release or when asking for funding — just to minimize the controversy," said Aaron Levine, an associate professor at Georgia Tech who has researched stem cells and public policy. "I don't know if there is some deliberate thought there, but it may have helped the 'adult' terminology take hold just because it describes the science well and it also minimizes some of that concern."

Despite the controversy of being associated with abortions, fetal tissue has been valued by scientists for many years, in large part because it's thought to be much more potent than older tissue.

"The unproven theory in the field is that the younger you get the cells, the more the life they have in them, the more future division and expansion they have," said Brian Cummings, an associate professor at the University of California-Irvine who researches neural stem cells.

The fetal-derived stem cells received by Brodie, 79, and Howe, 87, were neural cells intended to heal their brains.

"They can engraft and generate new neurons in the brain," Maynard Howe said of the neural cells.

The mesenchymal cells they received are believed to fight inflammation and help develop new blood vessels.

From a political perspective, Stemedica's approach is understandable.

There are plenty of myths about the use of fetal-derived stem cells, starting with how they are acquired. While opponents have warned of a draconian world in which fetuses could be aborted so their stem cells could be harvested, strict laws prohibit such a practice.

It also is a fear rendered moot by science.

Stemedica, which says it has spent about $90 million in stem cell production and related costs over the last nine years, says the single tissue source it acquired can be replicated to produce more than 500,000 treatments.

"We're not donor-dependent," said Dave McGuigan, a vice president for Stemedica. "Once we have one original source, we can create a lot of product."

In the cases of Brodie, Howe and others who received the company's neural stem cells, all came from that same fetal brain tissue source, which was obtained from a licensed donor center in the U.S., McGuigan said.

Maynard Howe says his company is doing everything by the guidelines established by the U.S Food and Drug Administration, as well as the International Society for Stem Cell Research.

Similar research with fetal-derived cells has been underway around the world, including in the U.S. The fetal tissue used in stem cell research can come from spontaneous or induced abortions, though laws prohibit prearranged deals with women considering an abortion.

While scientists have thought fetal and embryonic research holds great promise, such research has been at the center of fierce religious and ethical arguments in the U.S. for years.

In 1988, President Reagan banned federal funding for fetal tissue transplantation research. Congress tried to overturn it in 1992, but President George H.W. Bush vetoed that effort, saying he wanted to "prevent tax money from being used for research that many Americans find morally repugnant and because of its potential for promoting and legitimizing abortion."

President Clinton lifted the ban in 1993.

Embryonic stem cell research has been the most controversial, with opponents typically arguing it violates the sanctity of life because embryos are destroyed in the process.

In 2001, President George W. Bush said embryonic stem cell research was "at the leading edge of a series of moral hazards." He restricted federal funding for such research until 2009, when his successor, President Obama, ended those limitations, saying, "the potential it offers is great."

Some states still have laws forbidding experimentation on fetuses, fetal tissue, fetal "remains" or the "product of human conception" from induced abortions.

In Wisconsin, Assemblyman Andre Jacque has pushed similar legislation, saying science should be held to a higher standard. He told USA TODAY Sports in March that he wasn't aware Howe received fetal-derived stem cells and couldn't find any media reports that said he did.

"We have very ethical standards in place for gaining the consent of the individual who is donating tissue," Jacque said. "Obviously an aborted child cannot consent in that case."

On the other side of the argument are those who point to the cases of Howe, Brodie and others whose lives dramatically improved after receiving treatments. Given that single abortion was going to happen anyway, they argue, why not have some good come from it?

"It's great that this tissue can be used for something that can help mankind," said Murray Howe, who is a doctor. "That's kind of my position on that. It's up to our whole society to decide what ends up in the tissue bank. To me, this is only positive — using the cells to help people."

Brodie has lived a life defined by the grace and skill of his movement and speech. He was a college football Hall of Fame quarterback at Stanford, then had a 17-year career with the San Francisco 49ers, who retired his No. 12 jersey. After football, he worked as a broadcaster for NBC and played golf on the Senior PGA Tour.

Brodie suffered a stroke in 2000 that left him largely unable to speak or walk. He was described as depressed and mostly wheelchair-bound when, at the suggestion of a friend, he decided to try stem cell treatments.

"His doctors didn't want him to do it," said his wife, Sue Brodie. "It was his own motivation to do it, and the family supported that, because, frankly, what have you got to lose?"

One problem: Brodie has had to travel abroad to get the kind of treatment he has wanted. In the USA, this kind of experimental two-cell treatment is not available — mesenchymal and neural stem cells.

The company said this year that it would apply to have the two-cell treatment tested in U.S. clinical trials for similar stroke victims. But Stemedica also says it is far more cost-effective to have its products tested instead in foreign clinics to determine if they are safe and effective for use on a global scale.

Most U.S. patients who have received the company's stem cells have gotten them in clinical trials in Mexico and Kazakhstan — two licensed clinics that buy the stem cells from Stemedica.

Brodie's first treatment came in 2006 in Moscow, where some physicians are licensed to administer stem cells like this, unlike in the USA, McGuigan said. Brodie then had treatments in clinical trials in Kazakhstan, which has been testing the two-cell treatment for several years.

After that, Brodie went to Novastem, a sleek stem cell therapy center in the old part of Tijuana, just steps away from dental clinics and a taco restaurant.

He now has improved speech, increased mobility and independence from caretakers.

"Stem cells, wow!" John Brodie told USA TODAY Sports after a recent workout at a gym in Solana Beach, Calif.

He has been working out regularly with a trainer, Brian Mahon.

"His energy levels are up pretty high," Mahon told USA TODAY Sports. "When he's walking up and down the stairs … in the beginning, he got pretty tired. Now he gets up and down pretty quick. … The biggest improvement I've noticed is his mobility and walking around."

Gordie Howe's family thought he was near death after he suffered a stroke in October.

"But we wanted to give him the opportunity, if he still wanted to be with us," said his son Murray. "And if he wanted to check out, then we were going to let him check out."

In a last-ditch effort, they traveled to the same Tijuana clinic in December after Stemedica helped arrange for his experimental treatment through McGuigan, who previously worked for Howe's former team, the Detroit Red Wings.

Howe received the treatment free of charge, though it typically would cost about $30,000, said Rafael Carrillo, Novastem's president.

Within hours of his treatment, he was walking again, Murray Howe said. And now, "He can pretty much do all the things he likes to do: be helpful around the house, sweep, grocery shopping, go out for a hike, toss the ball around," Murray Howe told USA TODAY Sports in late February. "He's completely mobile."

Murray Howe said Saturday "you can't even tell he had a stroke" but that his dad has had ups and downs and still struggles with short-term memory.

Skeptics point out that natural stroke recovery also could be responsible for the hockey great's improved health. They also point out the risk of desperate patients being tempted to cross international borders to get unproven medicine in countries with less oversight for safety.

Both families said they understand that but also believe in the treatment's safety and efficacy. They also reject stereotypes that medical care in Mexico is always subpar, pointing to the modern Novastem clinic they visited. Gordie Howe also plans to return here for another treatment in June.

Sue Brodie says U.S. medical culture goes "too far the other way," meaning it's not very tolerant of new or alternative possible treatments. She also would like to see football players with chronic brain damage have access to it.

"Stem cells aren't a cure for anything yet," McGuigan said. "But if we can return quality of life to people like John or Gordie and we can learn and discover more because of those experiences, that's a victory."

Follow sports reporter Brent Schrotenboer @Schrotenboer. E-mail: bschrotenb@usatoday.com