Dubious stem cell trials for autism and the darker side of quackademic medicine

And now for something completely different…

Given how much I’ve been writing about COVID-19 science, pseudoscience, public health policy, and crankery, I feel as though I’ve been neglecting other issues relevant to science-based medicine. So this week, I’ll take a little break from the pandemic (don’t worry—I’m sure it’ll probably be back next week to look at another bit of COVID-19 grift), and revisit another form of grift, a particularly disturbing one. I’m referring to stem cell quackery. It’s a topic that I addressed initially on my not-so-secret other blog a couple of weeks ago, but that now has a major update, along with a paper, meaning that I can summarize what happened initially and, hopefully, update in a way to make a more complete story for this blog. It all started when I saw this Tweet:

Does Duke autism team partly have Panama stem cell clinic to thank for $10s of millions? https://t.co/W7d9tTlrDU

— Paul Knoepfler (@pknoepfler) October 13, 2020

We here at SBM have often bemoaned the infiltration of what I like to refer to as “quackademic medicine” in medical academia. It’s true that I did not coin the term “quackademic medicine” (Dr. R. W. Donnell did) but I did adopt it and popularize it to the point where many mistakenly think that I coined the phrase. In brief, quackademic medicine is a term to describe the increasing study and adoption of unscientific and pseudoscientific medicine in medical academia, mainly medical schools and academic medical centers. It’s gotten so bad that even my medical alma mater, the University of Michigan, the school where I proudly earned my MD, now features acupuncture, naturopathy, and even anthroposophic medicine. The Department of Family Medicine there even invited a prominent homeopath to give grand rounds on his field! It even indoctrinates residents into the quackery of “integrative medicine”. I pick on U. of M. because the embrace of quackery by some of its personnel pains me deeply, but I could easily rattle off at least a dozen other examples without even pausing to take a breath, and then there’s the NIH’s National Center for Complementary and Integrative Health (NCCIH) (formerly known as the National Center for Complementary and Alternative Medicine, or NCCAM), which is currently run by an acupuncture believer.

The dark(er) side of quackademic medicine: Teaming up with a quack clinic

As bad as the embrace of naturopathy, traditional Chinese medicine, and even reiki and homeopathy by academic medical institutions that would normally be expected to be bastions of science-based medicine is, I’ve discovered that there can be an even darker side to quackademic medicine. I’m referring to when researchers and universities team up with companies selling outright quackery, such as when St. Elizabeth Healthcare in Cincinnati took money from dōTERRA, a company selling essential oils, to start a center for “integrative oncology”. Unfortunately, what Dr. Knoepfler described a couple of weeks ago at Duke looks even worse than that:

There is a puzzle when it comes to the controversial idea of using cord blood for autism, because two of the strongest proponents are the autism cord blood program at Duke and for-profit, unproven stem cell clinics. On first glance it seemed like this was a bit of an odd couple to me.

The links between the Duke autism program and one particular Panamanian stem cell clinic called generically enough “The Stem Cell Institute” appear to go beyond just their enthusiasm about cord blood for autism.

Those apparent connections involve a mega-donor who has given a vast sum perhaps as high as $10s of millions to Duke’s autism cord blood group. Furthermore, The Stem Cell Institute says the donor and people in his circle have also been their customers. The clinic also makes another particularly startling claim I go into later in the past [sic].

As I’ve described more times than I can remember, bogus stem cell therapies are a particularly favorite form of autism quackery. Indeed, long time readers might remember the time twelve years ago that I wrote about Kent Heckenlively and how he took his severely autistic daughter to Costa Rica for “stem cell therapies” involving injecting “stem cells” directly into her cerebrospinal fluid and even borrowed $15,000 from her grandparents to do it. Indeed, I’ve even written about Duke University’s ethically dodgy “pay-to-play” clinical trials of cord blood stem cells for autism, noting that the Stem Cell Institute was the single largest recipient of money from patients who crowdfunded their treatments. (Northwestern University was another culprit doing, as Dr. Knoepfler described, the same sort of dubious things.)

Dr. Knoepfler also notes that investigators in Duke’s autism program, led by Dr. Joanne Kurtzberg, still share major enthusiasm for stem cell therapy using umbilical cord blood for autism, despite a negative phase II randomized, double-blind, placebo-controlled clinical trial of umbilical cord blood for autism that showed no improvement in socialization skills or reduced autism symptoms. Other clinical trials also show no benefit. (Why anyone is doing these ethically problematic trials anymore is beyond me.) Despite that resoundingly negative study, these Duke researchers continue to want to bravely paddle up the river of pseudoscience, apparently rationalizing that they need to use more stem cells, rather than just cord blood:

Remarkably the Duke team has subsequently begun not one but two more new, related trials.

The first seems focused specifically on lab-amplified cord blood stem cells for kids with autism and the second is for young adults with autism.

How can they still be so enthusiastic?

I don’t know.

There always seems to be some rationalization to keep them going.

Things like this pop up, “If only we had designed our trial differently and excluded some patients, we would have seen benefit”, and so on. Maybe now they think that instead of cord blood it’ll be better to use lab-grown cord stem cells?

It feels to me like they just can’t let go of their idea that cord cells must help autism despite the data generally saying otherwise so far both from their own and other trials.

The Stem Cell Institute, located in Panama, is clearly a quack stem cell clinic, although that didn’t stop Duke University researchers from partnering with it. Indeed, the first trial opened to accrual on October 1; the second is expected to open this month. Its website advertises stem cells to treat autism, cerebral palsy, heart failure, multiple sclerosis, osteoarthritis, rheumatoid arthritis, spinal cord injury, and autoimmune diseases, complete with very little actual science but a whole lot of testimonials. Its founder, Neil Riordan, has shown up with Mel Gibson on the Joe Rogan Experience (as has a Stem Cell Institute patient, welterweight champion Kamuru Usman) to tout his snake oil.

As an aside, in other marketing, Ozzie Osbourne also went to the Stem Cell Institute for treatment for Parkinson’s disease:

VIDEO: Kelly Osbourne discusses Ozzy's great progress after his recent stem cell therapy in Panama. https://t.co/2oDDisWXew #Ozzy #stemcells pic.twitter.com/viiWQPwPfc

— Stem Cell Institute (@Stemcellspanama) March 30, 2020

Now here’s where the connection I was talking about comes in:

As I’ve tried to learn more about all of this over the years, I found that the Panama stem cell clinic often kept popping up in a parallel way to the Duke Autism Program on the web with different searches. Some patients mention both.

More concretely, Duke has reportedly received more than USD $10 million (media reports range from $15 million to $26 million or even $40 million) for its autism research from a philanthropic organization called the Marcus Foundation, which also has connections to The Stem Cell Institute clinic in Panama, at least according to the clinic. The Marcus Foundation is led by Home Depot founder and billionaire, Bernie Marcus.

Bernie Marcus, besides being a billionaire, is a believer in stem cell treatments and has been a patient at the Stem Cell Institute. There’s even a story about it in the News section of the Stem Cell Institute’s website:

Bernie Marcus, cofounder of Home Depot and the company’s first CEO, suffered from bronchiectasis, a chronic lung condition that caused him to have difficulty, especially when public speaking. As a prominent businessman and active philanthropist, Bernie is a sought-after speaker. When his condition worsened and interfered with his speaking ability, he knew something had to be done. “I would get hoarse and cough ten to fifteen times every hour,” he said. “It was difficult to handle and progressively getting worse.” He went to the nation’s top respiratory hospital—National Jewish Health—where the doctors told him he would have to take antibiotics for two years to address the bacterial infection in his lungs. This treatment would do a number on his digestion, however, so he sought an alternative.

His physician recommended that he try stem cell treatment in Panama. Another good friend of Bernie’s had already been down to Panama to treat a stomach disorder that completely cleared up, so he felt comfortable with the recommendation.

Bernie was treated with stem cells and shortly thereafter stopped coughing and was able to return to his work. “I was able to go back to public speaking without embarrassing myself,” he said.

The story even claims that Marcus brought his wife, who has severe osteoarthritis of both knees and needs bilateral knee replacements, to Panama for stem cell treatments and claims that she is without pain now.

So we’ve established that the Marcus Foundation, which was founded by a billionaire who believes in unproven stem cell treatments that are basically quackery, has donated tens of millions of dollars to Duke to research cord blood and now stem cell treatments for autism. As Dr. Knoepfler notes, now that cord blood therapies have resoundingly failed in Duke’s phase II clinical trial, Duke researchers are moving on to treatments based on growing stem cells in a lab to infuse into patients, treatments much more like what the Stem Cell Institute claims that it is doing. (I always say “claims” with respect to what stem cell clinics like the Stem Cell Institute say they are doing, because in many cases it is not at all clear to me that they are actually correctly isolating and expanding the needed stem cell populations.) That’s bad enough. Although it’s certainly not illegal to seek donations from a foundation that clearly promotes dubious stem cell therapies, it should raise many red flags ethically to any researcher looking at science-based therapies based on stem cells. After all, the connection between Marcus and Riordan appears real, unless Riordan is lying about it, which seems unlikely, and the Stem Cell Institute is selling stem cell snake oil.

There is also this photo on the Stem Cell Institute’s Facebook page:

Here’s where it really gets dicey. As Dr. Knoepfler describes, it appears that Dr. Riordan is one of the scientific reviewers of grant applications to the Marcus Foundation and that he reviewed Duke University’s grant application. In a response to an article critical of Duke University’s stem cell trials for autism, Dr. Riordan himself did a sort of “Q&A” about the article and questions raised. I’m going to quote a bit more than what Dr. Knoepfler quoted:

13. Did you collaborate with any researchers from Duke when designing this study? Have you collaborated with researchers at Duke in any way?

I know Dr. Kurtzberg at Duke. Bernie Marcus, who funded the Duke trials, has been a patient in Panama (public information) and saw children with autism benefitting from treatment with umbilical MSCs first hand. I was asked to review the Duke proposal for the Marcus Foundation and was at the Foundation Board meeting that led to the funding.

So, basically, it sounds as though Dr. Riordan is basically bragging about having steered some of that sweet, sweet Marcus Foundation cash to Dr. Kurtzberg and Duke University. It goes beyond that, though:

14. Do you have plans for follow-up studies, and if so, what are the goals of those studies? If you have a specific study underway now, how many children do you plan to recruit?

There is currently no follow-up study in Panama underway. We do have plans for future studies in the U.S. but there is no timeline as of yet.

“We” have plans for future studies in the US? What does this mean? Whom does Dr. Riordan mean by “we”? It could be that he means the Riordan Medical Institute, located in Texas. Or does he mean Duke University? Or both? Inquiring minds want to know!

It also turns out, unsurprisingly, that Bernie Marcus is into more quackery than just stem cell quackery and has long been using his fortune to support and promote quackademic medicine. Here’s Marcus himself in an interview:

Yes. I have a particular doctor who is an integrative medicine doctor. He has used herbs. He has used massage. He has used chiropractic, and he has taken care of my family for well over 20 years. And I have watched the things that he does, and I have watched the fact that he could give us herbs instead of medicines—medicines where we always had a serious reaction, medicines that in fact could be dangerous in some situations. And instead of that, he gave us simple remedies that worked for us.

And I can tell you that some of them were exotic. Some of them were like umbilical cord stem cells, heavy doses of vitamin C, which he uses for cancer patients, that we know anecdotally alleviates some of the side effects of chemotherapy—losing the hair, the energy, the appetite, et cetera, et cetera. And it has been used by holistic medicine/integrative doctors for the last 15–20 years. And medicine turns its nose up at it, even though it is a vitamin and it goes in and out of the body, it is very, very hard to sell to anybody.

Fortunately, we now have some rigorous clinical trials going on at leading institutions, hopefully to prove this effect, and have the data available for others to use. That is what integrative medicine is. It is trying different, non-traditional ways of dealing with ailments that people have—you might call it different strokes for different folks.

And:

So I have experienced the value of integrative medicine myself, and I am a great believer in it. We helped open this clinic at Jefferson, and hopefully we are going to prove this. I think the other thing that will happen is that medical students are going to be exposed to it, which I think is very important—that they do not have blinders on their eyes that most medical doctors have when it comes to these kinds of nutrients. For most doctors, if it is not taught in medical school, it is not kosher. So I think it is going to have a very, very important effect on medicine in the future.

Unsurprisingly, rare is the actual rigorous clinical trial that actually shows benefit from these “alternative” and “integrative” treatments. Also, how is “stem cell therapy” in any way “integrative” or “alternative,” other than in the sense that it is unproven, except for a handful of indications, and that there are a huge number of quack clinics out there profiting from it?

Lack of evidence aside, there’s a center for “integrative medicine” named after him at Jefferson University, after the Marcus Foundation donated a $20 million grant to the university to form the first full department of “integrative medicine” in a major academic medical center, after having previously donated $25 million to integrative medicine projects including the creation of the Marcus Institute of Integrative Health, which offers “functional medicine“, a make-it-up-as-you-go-along “specialty” that relies on massive overtesting and overtreatment, high dose intravenous vitamin C, “restorative” micronutrients, and more. Meanwhile, at Duke, in 2018 a Marcus Foundation donation led to the founding of the Marcus Center for Cellular Cures (“cures”?), which is dedicated to—you guessed it!—stem cell-related treatments and “cures” for autism and other neurodevelopmental disorders.

This brings us to the latest on this arrangement, courtesy of Prof. Knoepfler and a new paper in Cytotherapy by Jeremy Snyder and Leigh Turner, who previously published about crowdfunding for unproven stem cell treatments and how it induces kind-hearted strangers to pay for quackery. In previous work Turner described how crowdfunding is abused by quack cancer clinics.

The dark side of quackademic medicine: Tainting science by consorting with quacks

Last week, Paul Knoepfler continued the story he had begun about the highly ethically questionable relationship between The Stem Cell Institute and Duke University, in particular Dr. Joanne Kurtzberg. Being a stem cell researcher himself Dr. Knoepfler mentions in his post how difficult it is for him to write an article like this, asking, quite reasonably, who “wants to take the risk to be critical of the practices of a team led by a fellow academic stem cell researcher?” and noting that, after his previous discussion of the same sort of setup at Northwestern University, leader Dr. Richard Burt pushed back with a piece in Science. I fully understand his reluctance. After all, given their prominence in the world of stem cell research, researchers like Drs. Burt and Kurtzberg that Knoeopfler criticized could well be the members of NIH study sections who will be evaluating his grant applications. Moreover, before drifting into studying dubious stem cell treatments for autism, these researchers had built their reputations with solid research. So Knoepfler answers his question about why he is writing posts like these:

Given all of that, why do a post like last week’s?

The well-being of pediatric patients and their families is the primary reason I decided to pull the trigger on this particular post.

I’m also very concerned more broadly about the practice of some universities requiring large fees for patients to receive unproven cellular therapy offerings, often in ways such as via off-study or compassionate use where the data from the patients often does not end up published. These arrangements may have less chance for benefit and more risks than are portrayed.

Some universities are at the same time hyping or exaggerating on-going clinical trials as though the cell therapy drug in question is already known to work.

He’s right, too. Duke, Northwestern, and some other universities are falling into hype that sounds very much like the hype of the for-profit stem cell clinics with which they’ve gotten into bed, while risking corrupting legitimate academic research:

This Duke-stem cell clinic situation is a prime example of muddy waters between a place overall doing robust clinical science and for-profit clinics. In terms of the actual biomedical science in this case, it seems to me like this is likely the realm of stem cell “magic” where one’s hopes and ideas prevail over actual data.

I’ve frequently said the very same thing, namely that, if you believe the advertising of for-profit stem cell clinics, stem cells are magic! They seem to think that they can just isolate any old stem cells, be they from amniotic fluid, mesenchyme, or wherever, inject them into the bloodstream, and expect that they will magically home in on wherever they need to go to fix whatever problem they’re being used to fix. This might make some sense in degenerative diseases involving chronic inflammation causing damage to a structure or organ, such as for various forms of arthritis, although I’d still say there was a huge assumption being made there. The same applies to damage from an acute injury, such as spinal cord injury or a stroke, although, again, it is a huge assumption to postulate that the cells will just magically “know” where to go and “know” how to fix the damage.

I said at the beginning of my post that this alliance between Duke University researchers and the Stem Cell Clinic represents the “dark side” of quackademic medicine. Basically, through its hard-to-find ties to the Stem Cell Institute Duke University has sullied its good name by getting into bed with stem cell quacks like Neil Riordan. It’s all fun and games (and easy to laugh at and off) when academic medical centers embrace, for example, the faith healing that is reiki. It’s not so funny anymore when they start taking money from believers in quackery to run scientifically dubious clinical trials of that quackery and even set up centers dedicated to dubious treatments. Real children could end up being hurt. Without robust preclinical evidence in cell culture and animal models of the disease being treated to show that the stem cells do what you claim they will do, it is not just a leap to test them in humans. By the Declaration of Helsinki, it is unethical. It’s arguably even more unethical to require patients (or their parents or other relatives) to pay huge sums of money to participate in these clinical trials.

This brings us to the paper by Snyder and Turner, “Crowdfunding, stem cell interventions and autism spectrum disorder: comparing campaigns related to an international “stem cell clinic” and US academic medical center“. In this paper, Snyder and Turner compare and contrast “crowdfunding campaigns, identifying an international stem cell clinic marketing a purported umbilical cord blood-derived stem cell treatment for autism spectrum disorder, with campaigns soliciting donations intended to help children with autism spectrum disorder either participate in clinical studies or obtain expanded access to stem cell products provided at an academic medical center in the US”. They begin by noting in the introduction that not all clinical trials of stem cell therapies come from for-profit direct-to-consumer clinics selling unapproved stem cell interventions:

However, not all crowdfunding campaigns related to purported cell therapies are confined to the direct-to-consumer marketplace for unapproved stem cell interventions. Some campaigns solicit donations that will help individuals access investigational stem cell products provided at academic institutions, either in the context of clinical trials or outside clinical studies on what in the US is known as an expanded access (EA) basis. For example, a study of crowdfunding campaigns for unproven stem cell interventions for neurological conditions identified campaigns for participation in clinical trials conducted at academic health centers or to utilize EA pathways at those facilities. In this study, although the top three destinations for purported stem cell treatments were clinics operating on a direct-to-consumer basis, the fourth most commonly named destination facility was Northwestern University. This location was named in crowdfunding campaigns seeking experimental stem cell interventions for multiple sclerosis. The site has reportedly ceased enrolling new participants in clinical studies. The fifth most frequently named destination facility was Duke University. These crowdfunding campaigns all sought experimental stem cell interventions for autism spectrum disorder (ASD).

Online crowdfunding activity identifying academic medical facilities as intended destinations for accessing experimental interventions has largely escaped scrutiny by scholars and journalists. This lacuna is striking because many investigational products are first tested in clinical trials conducted by researchers based at academic health centers. In particular, there has been little effort to compare and contrast crowdfunding campaigns for individuals seeking access to clinical studies or the EA regulatory pathway at academic health centers with crowdfunding campaigns for persons hoping to undergo unproven stem cell procedures at clinics operating on a direct-to-consumer commercial basis. Thus, the content of campaigns for participation in clinical trials and to access unproven treatments on an EA basis is largely unknown.

So what did Snyder and Turner do? They decided to compare the pitches made for clinical trials of stem cell treatments for autism by The Stem Cell Institute (SCI) in Panama and the Duke Center for Autism and Brain Development, noting that, although a phase 1 clinical trial of intravenous infusion of autologous umbilical cord blood cells was safe and resulted in significant improvements in behavior among children with ASD, a “more recent phase 2, randomized, double-blinded and placebo-controlled study by these same researchers found no improvement in ASD symptoms and socialization skills”.

The authors then did this:

The authors searched the GoFundMe crowdfunding platform for campaigns seeking funds to access stem cell interventions at these two sites. GoFundMe was selected for study, as it is by far the largest platform for medical crowdfunding campaigns worldwide. Searches took place using GoFundMe’s internal search engine and a search tool that scraped the GoFundMe site for crowdfunding campaigns seeking donations for ASD and specifying that the subject of the campaigns would travel to either Duke or SCI for stem cell intervention. Search terms used were “Duke” and “autis*” (to capture both “autism” and “autistic”) for campaigns with Duke University as a destination facility and “autis*” and “stem cell institute” or “autis*” and “stem cell” and “panama” for campaigns with SCI as a destination. This search took place on May 25, 2020, and returned 69 campaigns referencing Duke and 92 referencing SCI.

Snyder and Turner identified and analyzed ten campaigns to obtain access to stem cell interventions at Duke, with six to participate in a clinical trial, three to access stem cells on an expanded access basis, with one unclear as to which of these funds were being raised for. There were 76 campaigns for interventions at SCI. They then categorized statements about the perceived efficacy of stem cell interventions into “definitive statements that the intervention would work in all or some specific subset of cases (including specific percentages of positive outcomes or testimonials) and no definitive statements of efficacy”. To summarize the results, campaigns connected to both sites contained inaccurate claims, but campaigns identifying SCI as the intended destination for treatment made stronger claims about efficacy and included more testimonials than campaigns associated with Duke University. However, they also noted that press releases, clinical studies, and news stories about Duke’s program played an important role in “lending the perception of credibility to the putative stem cell treatments marketed by the international clinic”. In other words, news coverage of Duke’s trials and Duke press releases not only enticed parents of autistic children seeking stem cell treatments to want to enroll in Duke’s clinical trial, but that sheen rubbed off on SCI, where campaigns also cited Duke as evidence that SCI’s intervention was efficacious.

In addition, Snyder and Turner analyzed an additional eleven crowdfunding campaigns for children with ASD seeking to take the child to someplace other than Duke or SCI, which included for-profit stem cell clinics in the US, Russia, India, and Mexico. They observed that these campaigns “discussed inadequate numbers of umbilical blood stem cells for the procedure, cost, lack of availability in the US and lack of Food and Drug Administration approval as barriers to accessing this intervention at Duke” and “mentioned news coverage of the Duke trial to support the legitimacy of the intervention being sought”. They concluded that, although there were “meaningful differences” between the claims showing up in crowdfunding campaigns for treatment at SCI versus Duke, even so:

Acknowledging these important distinctions, there nonetheless are striking ways in which the clinical trials conducted at Duke help support and sustain a market for unproven and unapproved stem cell interventions provided at Panama’s SCI. For example, campaigns seeking donations for stem cell procedures conducted at SCI frequently refer or even link to information about clinical trials conducted at Duke. Campaigns reference these studies to bolster their claims that stem cells can now be used as safe and effective therapies to treat children with ASD. Some campaigns note that members of the philanthropic family supporting Duke University’s stem cell research in the area of ASD visited SCI and had stem cell procedures there. In other cases, campaigners referred to first seeking stem cell interventions at Duke University and then deciding to travel to SCI after being unable to access stem cell procedures at Duke. One campaigner claimed that they selected SCI as their preferred destination after being referred there by staff at Duke. Such claims might be inaccurate, but they suggest that the clinical research program at Duke propels significant interest in SCI’s products and bolsters confidence in their effectiveness.

Snyder and Turner conclude by urging universities to be more aware of how they’re being used:

The authors urge clinicians, institutional leaders and media relations or communications staff members at academic health centers and similar medical facilities to anticipate that their research can be used and, in some cases, abused in this manner.

And:

Researchers at academic institutions and comparable health care facilities cannot prevent representatives of businesses engaged in direct-to-consumer marketing of unlicensed and unproven stem cell interventions from making misleading or otherwise problematic promotional claims. However, they can play an important role in shaping how their own research is depicted in press releases and on institutional websites. Wherever and whenever feasible, stem cell researchers need to emphasize the preliminary nature of early-stage clinical studies and avoid making claims about efficacy until convincing evidence is available to support such assertions. Connections to direct-to-consumer sellers of unproven and unapproved stem cell products—no matter how fleeting—should also be avoided due to the documented propensity of these facilities to exploit these connections and of patients, their caregivers and their social networks to interpret these connections as endorsements.

From my perspective, the question boils down to: Are stem cell researchers at universities like Duke who consort with dubious for-profit stem cell clinics useful idiots for those quack clinics, or are they aware of what they’re doing? From my perspective, the two explanations are not mutually exclusive. There could be elements of both. Having observed quackademic medicine for nearly 16 years, I’ve come to realize that there really is an ivory tower, and many academics really are that naïve, although that doesn’t rule out an element of mutually beneficial grift. It’s basically impossible to say without a lot more in-depth knowledge of the arrangement and situation, although Knoepfler notes:

It is surprisingly easy to fall into the trap of viewing your favorite particular kind of stem cells as some kind of medical magic. I actively try to avoid this with one of my favorite types of stem cells, IPS cells. Over the years I’ve posted many times about limitations and even setbacks to clinical IPS cell research along with the milestones and stepwise successes.

Stem cells in a general sense are remarkable cells with unique qualities, but that doesn’t mean that any particular kind of stem cells can treat or cure a wide array of diseases.

These are wise words. Not only is it unlikely that stem cells, of whatever type, will be the panacea that quack stem cell clinics portray them as (and that even reputable stem cell researchers sometimes imply that they are), but scientists and physicians are human, too. They’re just as prone to all the cognitive biases and shortcomings hardwired by evolution into our primate brains. Scientists and physicians have a similar all-too-human tendency to become so enamored of their pet hypothesis or pet treatment that they have a hard time being objective about it and can sometimes, when sufficiently in love with their idea, rationalize getting help to study it from sources that they would normally dismiss as too tainted.

Is that what’s going on at Duke? Who knows? What I do know is that, from my perspective, SCI has all the hallmarks of a quack stem cell clinic. No reputable academic medical center or researcher at such a medical center should have anything to do with a clinic like SCI. While it may be amusing to see academic medical centers embrace, for example, the faith healing that is reiki, it’s not so funny any more when they start taking money from believers in quackery to run scientifically dubious clinical trials of that quackery and even set up centers dedicated to dubious treatments. Real children could end up being hurt.