Cell Society, La Jolla, CA - February 18 and 19, 2011
Opening Keynote and Welcome
Kiyoshi Kurokawa, MD / 2,150 words
Our body has been a wonder and miracle to all of us.

Just think, one fertilized egg,

through cell multiplications in an amazingly orderly and coordinated manner, becomesa baby and comes out of the mother in 10 months. It continues to grow for 15-20
years when it becomes almost an adult with some 50 trillion cells, with distinct forms
and functions of very complex organs and complete body systems. AND OUR BRAINFUNCTION, to think and to create - it made our civilization what it is today.
Hundreds of millions of cells die every day, replaced by a similar number of new cells- thus the size of the entire system will remain stable and our body size will remain
more or less constant after around the age of 20.
We knew about these things for years, but could not understand HOW they happened.
As our indigenous knowledge about health, disease and body systems increased andaccummulated, we began to understand HOW.
Nonetheless, we recognize major scientific discoveries were made in the last 100years or so. They were built upon many years of prior critical observations,knowledge, and experiments of many - aided by a variety of scientific discoveries
and technological and engineering advances:
1. Edward Jenner ’ s small-pox vaccination of 200 years ago is a major
breakthrough in the human history of medicine.
2. We learned of sanitation, hygiene, nutrition, and they become a major force toimprove health.
3. We could see major breakthroughs of the past 100 years or so in the list of Nobel
laureates which began in 1901; the first year of the 20th century.
4. They included discoveries of the existence of ABO blood types, the nature ofvarious infectious diseases by bacteria, virus, and other forms like malaria,
vitamins and hormones, cell function and regulation, molecules to DNA and manyother breakthroughs.
Indeed, now detailed anatomy, function, regulatory mechanism of body system havemost been clarified to the level of organs and body systems, of cells and molecules,of genomes, and even at the level of chemical and atomic compositions.
While many cells die and regenerate, which is the dynamic process of our body, manyorgans may have their own resident STEM CELLS – as the origin of its own celltypes, generating new cell types; such stem cells may sometimes attach to deadspaces from circulation with some specific signaling interaction.
Stem cells have been found in many organs, and could be used under certain
conditions, to become pluripotent - the ability to become many different cell type.
1. Stem cells for a patient could be obtained by the enrichment of organs such as
adipose tissue for potentially several distinct diseases, e.g., cardiac infarction, liverdisease, or reconstruction of a removed organ, e.g., breast reconstruction aftersurgery.
This is the focus of this conference and we will hear great deal of progress in its
science as well as their clinical applications. Thus, I will briefly touch upon the otherstem cell types described below.
2. Embryonic stem or ES cells; created via in vitro fertilization and thus contains theeggs of a donor along with its related ethical issues--- this ES cell was particularly
genuine since it could become a baby and thus a human being.
3. Umbilical cord blood cells
4. Induced pluripotent stem cells; or iPS by Dr. Yamanaka and others.
This iPS or re-programming ordinary cell of our body, e.g., a small piece of our skin,
opened a new way, bypassing the use of embryonic stem cells and thus the ethicalissues of securing human eggs.
However, because of various issues, including markings of DNA of the original welldifferentiated cells, or epigenetics, there may still be more rigorous steps needed forits clinical use. Nonetheless, iPS provide various clinical utility for cell function,screening for drug action, specific disease cell types from patients with specificdiseases and genetic disorders.
We are not certain of the impact and mid- to long-term consequences, thus we haveto be very careful in balancing the potential benefits and risks to patients until more
be known through various studies and data. Such prudent and transparent
processes are the key to securing public trust and support.

CHANGING WORLDInternet and connectedness have changed the way we communicate and engage insocial activities and life style.

Many of you had PC’s and laptop computers in the80s and 90s. The internet has become more and more accessible and connected
every year since the introduction of the world wide web in 1991.
Initial barriers for access to internet, have been overcome very fast - year afteryear so that now, almost everyone uses and carries at all times one, two and eventhree computers in their pockets. Technologies like the iPhone, iPad and BlackBerryare used constantly, wireless in a completely mobile manner.
We have become more and more inter-connected. Increasingly, the general public
has access to a lot more information and those who suffer from various diseases aredesperate to have the ‘dream therapy’ like those related to stem cells.
The research results are not owned only by the science community, but shared witha large public across national borders. Nonetheless, scientists must be careful topursue research in the labs and with patients.
Potential risks, safety, efficacy, quality of research as well as clinical studies andother elements for the new discovery of stem cells to patients are tedious andcarefully conducted through a critical analytic process. Transparency and rigorous,
critical assessments are of vital importance.
This forum of the Cell Society is aimed at exactly that; to provide such progress andto share with you, the scientists, clinicians, patients and their families as well as thegeneral public, the frontier and the state-of-the art of stem cell research.
Further the forum should promote better understanding and stronger support fromthe public and various stakeholders and, as situation permits, an opportunity forinvestment -- I will come back to this a bit later.
When such therapy becomes clinically available, then who will pay?

Health andreimbursement policies differ by various countries. Even with a well-establishedpublic health policy, a question always remains - who pay for what disease and inwhat condition.
Even in this era with a wide range of ability to travel, many patients will go abroad toreceive such treatments. This may create a situation where only the rich can afford
such treatment.

Is this ethical? What should be the guideline? Is it just?

A few days ago, we learned that Watson, IBM’s supercomputer scored a major
victory over two human champions in a quiz-show called ‘Jeopardy’.
What does this mean? It may mean that the ability of computing system went NOW,
to real artificial intelligence. Watson takes questions in spoken in English,
recognizes spoken language, searches thru a massive database, matching back andforth through vast databases and picking up the most likely answer in just a few
seconds.
The implications are huge.

When you think of some question, how do you find theanswers? Many of us now use Google, but you still have to think of your answers.
NOW, this Watson will do it for you.
You may say it’s expensive. Of course, but remember your lap-computers of 90s?
Its size, cost, functions and speed?
In these days, there were many search engines and some have gone, some havesurvived. Google was founded in 1998, just 12 years ago, and went public in 2006.
Its service was, in principle, provided at no cost to users (recently on newspapers andbooks, they proposed a new business model based on the tough competition with

Apple).
Watson’s database could become available sometime in the not-so-long future hopefully. How about cloud computing? Microprocessor becomes faster, smaller,and cheaper. The speed of progress in IT and its associated technologies andbusiness models has been very, very fast and similarly unpredictable.

Just think ofFaceBook. Its history is only a few years old, yet the speed of its spread is very,very fast indeed.
You may argue biomedical science is more complex and difficult since theirapplications are for humans. That is true, but many unexpected things could happenin very unpredictable way in this global world with more competitors.
Just think of the human genome project.

It began as an international collaborative

effort headed by Dr. Francis Collins, now Director of the NIH. This consortium wassupported, in principle, by public money. Then, Craig Ventor jumped in with the new‘shot-gun approach’, but he began his attempt as a private venture company.
fund? Of course, it came from private investors.

TheBut, because of this competition, the human genome project was almost completed in2000 with President Clinton, Francis Collins, Craig Ventor and Tony Blair on TV
together.
Originally, the Human Genome Project was expected to reach this stage of decoding
around the year 2005. However, it can be said that Ventor saved a great amount oftax payers’ money by shortening the time period for decoding.
The same could apply to stem cell research. And now there are more and morecompetitors with rising new economies.
Everyone will want to have the right cure for various diseases.

Stem cells are a big

hope for many very difficult diseases such as spinal cord injury, various
neuronegenerative diseases, stroke, and many other conditions you hear about todayand tomorrow.
Stem cells could eventually eliminate organ transplants by repairing the heart, liver,and kidney directly as well as skin grafts, tissue engineering and many more.
Even stroke - by replacing lost brain cells, ie, neurons and glia. Great hope.
We all wish to live a good and long life. What kind of life? Healthy, stay young; look,
feel and live long young life.

All of course.

How about if you could never look over 50 years-old, even though you may actually
be 80, 90 or even 100? Skin texture and hair? That is really, really super, and it
is a big possibility. Thus, internal organs, organ system and external body system
may artificially regenerate at certain intervals. Many may eventually live longer than
100 or even 130 while staying healthier and looking no more than 50 or 60 year-old.
This is great stuff, but this may not be a medical issue, but cosmetic one.
Suppose if you receive stem cells after brain stroke, recovering from paresis orparalysis. This is great.
As you live longer you may receive such procedures more than few times eventually losing a considerable portion of your original brains?
Is this still you? You may lose a lot of old memories replaced with perhaps newmemories?
NEW YOU may be someone else?
Such things are not beyond imagination.
How about a combination with robotics? Many robots or humanoids already do many
human functions. You can make something just like humans or even you. There
are a few devices that support a fragile musculoskeletal system of the aged andthose who suffer from stokes.
You may eventually have your own ‘second life’ or ‘avatar’.
This may not be as far-fetched as you may think. Watson is a major decision makerfor you - to choose the right answers whenever you have a question.

You alreadydo this quite often everyday - by Googling your questions using keywords and finding
your own answer.
one for you.

Now, you can speak to Watson who will immediately find the rightWith ICT, nanotech and nano-materials and biotechnology, Ray Kursweil, a futuristand entrepreneur, predicts in his book ‘Singularity is Near’ that in coming 20-30
years, all knowledge currently learned through college could be embedded on a very
tiny chip which you could simply implant into your brain.
It is amazing the speed at which science, technology and engineering progresses.
Now, with more and more such experts involving in this process, thus tougher
competition, many unpredictable things will happen.
Think of Steve Jobs, who created a tabletop computer, animation movie at Pixar,
music business by iTune and iPod, mobile phone by iPhone, and now a publishing houseand newspaper by the iPad.
How about Google, Facebook, twitter?
They are the forces behind recent major and unpreditables in Tunisia and Egypt aswell as several other places in the Middle East. How about Wikileaks? Clearly, theworld has become seemingly quite fragile.
Even this frontier of stem cell research with great and various implications, its
impacts on human life and societal changes may be unpredictable and quiteinteresting.
Unpedictables could always happen in sciences.
I am very much looking forward to listening to the presentation today and tomorrow,on what you are exploring in this new frontier of biomedical sciences.
Your effort and dedication are very much appreciated and Cell Society is committedto connect this area of research to the patients and their families inviting
participation of multistakeholders of our global society at large

THANK YOU.