Sweet victory


He may shirk the limelight, but his mastery of reproductive science often throws Alan Trounson into the public eye. And while he's been wounded before, his time is at hand.


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AS ALAN TROUNSON drove across the Golden Gate Bridge on the morning of 9 March 2009, the rising Sun peeked through fog, as it often does in San Francisco. He was headed for his office near the bay – the US$3 billion California Institute for Regenerative Medicine (CIRM), the world’s best-funded centre for embryonic stem cell research, which he leads.

His staff of around 40 was gathering at 8:00 am, to watch the much-anticipated announcement that U.S. President Barack Obama would lift restrictions placed by the previous administration of George W. Bush on federal funding for stem cell research. Trounson, like the rest of his staff, was excited. To him, it was not an average Monday morning but the dawn of a new scientific era.

“It was a great, buoyant feeling,” says Trounson of the mood that morning. As they watched it live from the White House, “There were lots of hurrahs and clapping and a bit of dancing.”

After lunch, he bought champagne for his staff to continue celebrating a day that for them seemed as momentous as the Moon landing.

“The morale in the scientific community lifted dramatically. It was a very significant moment. It changes the way people and institutions look at our research, because the administration has embraced and encouraged it rather than discouraged it. At a time when things are pretty grim otherwise in the economy, this is a good story – not just for scientists, but for everybody. Almost everyone knows someone who could benefit from embryonic stem cell research.”

For Trounson, an Australian who had left his family and an established career in Melbourne to come to San Francisco on a gamble that stem cell research would take off in the USA, the announcement was a vindication.

Since his arrival in early 2008, Trounson has been working tirelessly to realise the potential of the tiny dots that are embryonic stem cells, alongside some of the world’s top scientists, celebrities and politicians, including California governor Arnold Schwarzenegger and former U.S. President Bill Clinton (a photo of the two of them sits on his desk in his brand new home north of the Golden Gate Bridge).

He’s already handed out US$700 million in research grants, helped establish 70 teams of researchers to work with pharmaceutical companies, and has seen some promising results in spinal cord research, retinal repair and juvenile diabetes. He believes embryonic stem cells will deliver massive new advances in medicine that will be in clinical trials within two to four years (see end of story).

Alan Trounson is no stranger to the drama that surrounds controversial scientific research. He cut his teeth on the world's early IVF advances and now heads up a leading stem cell research centre, the California Institute for Regenerative Medicine.
CALIFORNIA INSTITUTE FOR REGENERATIVE MEDICINE

HE SPENT NEW YEAR’S EVE in Washington DC with his family, who joined him to live in California late last year, and spent New Year’s Day advising the Obama transition team on stem cells. He declined the invitation to go to the White House on the day of the announcement because, he said, his travel schedule was already so hefty.

Those who know him, though, felt it was his classic self-effacement; he felt it more appropriate that other people took the spotlight. After a year of dramatic changes in his life, when the day of the announcement arrived, he admits it was a bit of an anti-climax.

“It’s been magical to be part of all this. I don’t get the same ‘rocks off’ feeling like the moments I used to get when I was in the lab, it’s just different. But I’m very proud and pleased about what we’ve done so far.”

The man who invited Trounson to apply for the job in California, Bob Klein, did attend. The trees were starting to blossom in Washington DC after a long winter on the day Obama signed the executive order ending the 7.5-year ban on federal funding. It was also a vindication for Klein, a multi-millionaire lawyer and low-income housing developer, who had dedicated much of his time, fortune and political prowess to advancing embryonic stem cell research against the enemies of the science.

He has a son with juvenile diabetes and a mother with Alzheimer’s disease – both illnesses which stand to benefit from the research. Klein organised the Californian stem cell ballot initiative – Proposition 71 – which created the new state agency that Trounson now heads. In the 2004 ballot, Californians voted to allow US$3 billion (raised by selling bonds) to be used exclusively for stem cell research.

Klein first met Trounson in Australia in 2006 when the Australian was director of the Monash Immunology and Stem Cell Laboratories, a renowned centre of excellence established within Monash University.

“When I saw funding constraints for stem cell research in Australia were signifi cant, it occurred to me that there might be a tremendous opportunity for Alan to lead us in California,” says Klein. “He has such an extraordinary network of researchers around the world. Alan is the global ambassador for international stem cell research.”

For his part, Trounson was happy Klein was at the White House for the announcement as “he likes all that political stuff”. The two – the scientist and the businessman – work together in much the way Trounson worked with Monash University’s Carl Wood in the early days of IVF research, of which Wood was a pioneer. Trounson was always happy to be the backstage manager of the medical maverick, at a time when both were making astounding advances in human reproductive technology.

WHEN TROUNSON, originally from Sydney’s Blue Mountains, graduated from Hurlstone Agricultural College, he had intended to be a vet. At 16, he went to the University of New South Wales on a wool technology scholarship, and was studying reproduction in ewes at the university’s research farm in Jerilderie.

Wood, who these days suffers from Alzheimer’s disease, has said of his first meeting with Trounson on that Jerilderie farm: “I was very impressed. He was terribly energetic, very pleasant, and easy to talk to – easy to bullshit to. I could say anything silly and then he’d correct me and get me right.”

Judy Wood, Carl’s wife, recalls Trounson “was as impressed with Carl as Carl was impressed with him. They worked together extremely well and complemented each other.” In 1977, Trounson joined Monash IVF, an infertility clinic, and helped achieve eight of the world’s fi rst 10 in-vitro fertilisation births.

John Leeton, a scientist who led early work in IVF, recalls Trounson was talking about the potential of stem cells in the early 1980s, long before most. Trounson went on to become Australia’s foremost advocate for stem cell science, helping set up the National Stem Cell Centre. “Alan is an enthusiast for scientific research that helps people. He wasn’t a scientist stuck in an ivory tower, he was down there among the patients,” he says.

Friends and family say Trounson is a sensitive man, with an empathy for illness and injustice. His mother was an artist – from whom he inherited a lifelong love of art (her paintings grace the walls of his Californian home). His father fought in Borneo in World War II, lost good friends on the Kokoda Trail in Papua New Guinea and, it seems, never really recovered from the trauma of war.

When Trouson’s gay brother Ian, 10 years his junior, came out to his parents and told them he was HIV positive, he thought his politically conservative father would disown his youngest son. Although his parents had never understood much of the science he had devoted his life to, this was one time when Trounson’s understanding of genetics brought him back into the family fold.

He says he explained to his father the likely genetic component of homosexuality. “[He] felt he hadn’t been a good father because he hadn’t taken my brother fishing and sailing … We all thought dad was homophobic, but he ended up becoming Ian’s biggest supporter.”

RAISED AN ANGLICAN, but with no religious affiliations these days, Trounson is as interested in matters of the soul as those of science.

In 1980 – the same year Candice Reed, Australia’s first IVF baby was born – Australian bioethicist Peter Singer set up the Centre for Human Bioethics at Monash University, the same campus where Trounson was doing his IVF research. The two had totally different positions on animal research – Singer wrote the seminal book Animal Liberation in 1975 – but they did have long and engaging ethical discussions: sometimes they’d speak for hours about the soul, recalls Singer.

Colleagues unfailingly paint a picture of Trounson as a compassionate man: he helped set up low-cost IVF clinics in Africa, to aid people with HIV to have children free from the virus. That same sensitivity is also evident in his work with embryonic stem cells, according to Don Reed, a patient advocate, who attended the White House that March morning with his 34-year-old son Roman, who was paralysed at 19 while playing football.

At a press conference on the steps of the White House that day, Reed junior said: “President John F. Kennedy was first to put man on [the] Moon. Under President Obama, the paralysed will be the first to walk on Earth.”

Trounson felt this day belonged to people like Reed, who stand to gain from stem cell research. Don Reed, who has watched Trounson grow in his role at CIRM, calls him a “gutsy individual” who has championed the need to lift previous constraints on embryonic stem cell research, which limited federal funding to research using only the existing 22 stem cell lines, not newly derived embryonic stem cell lines.

“Edison took 4,000 tries to get the right filament for a light bulb – and we were supposed to save all the world’s incurable diseases with just 22 stem cell lines. Alan saw this was a problem,” recalls Reed.

In his first year on the job, one of the major frustrations Trounson saw in the scientific community was the low morale because of the federal restrictions on research.

“Scientists had to keep everything separate – microscopes, rooms, research – if they were collaborating with the NIH [National Institutes of Health]; otherwise their federal grant money was at risk. But Obama’s decision meant many big problems were gone. Suddenly scientists in our field were able to relax. There’s already been an increased interest in the field from young scientists – suddenly everyone wants to work in embryonic stem cells.”

Back in Australia, on the day of the Obama announcement, Trounson’s friend and scientific colleague from Monash University, physiologist Graham Jenkin, awoke to the sound of Trounson’s voice on ABC Radio. Seconds later, Trounson called his fellow fly-fishing friend on his mobile phone in Melbourne.

“I HEARTILY CONGRATULATED HIM on his part in this but, as usual, he was typically modest about his role,” says Jenkin. Trounson is regarded by friends not just as a humanist, but also a humourist, with a mind as keen as his sense of humour. “Hang on tight – we are definitely on the luge again,” he’d say to Jenkin, alluding to the hair-raising, ice sled-like ride of misunderstanding and controversy that often surrounds his work.

As one of the world’s foremost researchers in IVF in the 1970s, and then later with embryonic stem cells, he is no stranger to controversy.

“Everything he’s done has been controversial,” says his personal assistant for 12 years, Jill McFadyn. None more so than the role he played in trying to persuade Australian parliamentarians and the public of the benefits of stem cell research, in particular the event that lead to his departure from Australian academia, known as the ‘rat incident’.

In the parliamentary debates about embryonic stem cell research in Canberra, he showed a video in which a paralysed rat walked again; Trounson mistakenly claimed an embryonic stem cell – rather than an embryonic germ cell (derived from an aborted foetus) – was responsible.

Although scientists say the two terms are largely interchangeable, the Canberra press gallery and the anti-abortion movement seized on the slip-up and accused Trounson of spin and even deliberate distortion.

In the charged atmosphere of Capital Hill – an unreal bubble universe where rational debate can often perish on the shoals of specious political and media spin – he was labeled a liar and forced to apologise to parliament. Colleagues and fellow scientists were furious.

Martin Pera, who left Australia after the episode to work in California, said Trounson had taken the time and trouble to explain his science, which was more than most. “There weren’t many to take up the cause to grapple with the politicians like Alan did … Australia has a small scientifi c community, and as a consequence, he was very vulnerable.”

IT WAS A SIMPLE SLIP, says Richard Boyd, the man who has replaced Trounson at Monash University.

“He inadvertently used the wrong word: stem cell versus germ cell. There’s four days difference [between one becoming the other]. There’s a lot of professorial poppies in Australia and they’re all bouncing around in their own world, but every so often one of them lifts their head above the pack. Like in rugby, when they lift a guy up above the others. And Trouson does that. He is one of those guys who rises above but who also can play the game. He doesn’t just see the new horizons of science, he embraces them.”

In Mill Valley, the picturesque old timber town north of San Francisco where the Trounson family now lives, his second wife Karin Hammarberg was getting their seven-year-old son off to second grade at about the time Obama was making his decree. For her the excitement had begun with the election win by the Democrats, then spending New Year’s Eve in Washington DC while her husband talked to the transition team.

Trounson’s first marriage ended while he still worked in IVF. He met his second wife in a medieval castle in Sweden, where they both attended an IVF conference. She was a nurse in the team that delivered Sweden’s first IVF baby in Gothenburg in 1982.

She moved to Australia in 1988 to head up a clinical IVF program, and has gone on to complete her masters in women’s health as well as become mother to Trounson’s two younger children. They lived together for 19 years before marrying so that she could migrate to the USA.

She sees this San Francisco opportunity as the pinnacle of Trounson’s career. “It’s a perfect capping of his endeavours. He’s been on a campaign to educate the community to have digestible information on stem cells. He’ll do that, as he’s very competitive – anyone who plays Scrabble with him will tell you that! You don’t get to where he is if you don’t have a strong drive.”

Hammarberg would like to see her 63-year-old husband take life a little easier at some point. She’d like him to return to Australia and work as a mentor for Aborigines, encouraging more of them into science – Trounson himself is part Aboriginal. But for now she knows his heart is in his San Francisco stem cell work, and expects it to be for another few years at least.

HIS FAMILY, including four children and three siblings, are accustomed to his strong work ethic. Eldest daughter Kylie, 31, spent most of her childhood weekends in the laboratory with her dad. She also remembers not being allowed to answer the phone. “There were right-wing Catholics and right-to-lifers calling our home making death threats,” she recalls.

Australian ethicist Margaret Somerville – who now works at McGill University in Montréal – recalls the days when emotions ran hot in the IVF debate and Trounson “in his cowboy boots and opennecked shirts” copped a lot of that flack.

“Those were the days when you picked up the newspaper or you turned on the radio to listen to the ABC, and science fiction was becoming science fact – and Alan was right at the forefront of many of those advances in reproductive technology. And here is again doing it with stem cells.”

Trounson agrees there are many parallels between community perceptions of embryonic stem cells and IVF.

“The whole research world is moving so quickly, there is no need for nuclear transfer or cloning work, which makes our work less controversial. In terms of the social impacts of our science, it is now like IVF. There are people who disagree with IVF and embryonic stem cell research, there’s the occasional archbishop or person against genomics, but they are relatively minor in numbers.”

There is work still to be done though, he says. Sherry Lansing, a former Hollywood film executive and now a member of the committee that oversees much of his work at CIRM, says Trounson is a man of integrity, disarming charm, warmth and humour. “We want his leadership to take us to the next level.”

Trounson spent the night of March 9 with his family at their home among the Californian redwoods, where they gather for meals around a wizened old Australian redwood table.

As he drove home across the Golden Gate Bridge that night, he peered at the blue stretch of the Pacific. Trounson, who in his teenage years used to escape his Sydney boarding school on weekends to surf at Manly Beach, often thinks those days dodging dumpers have been good training for his scientific life: first with IVF, now with embryonic stem cells.

That day, thanks to Obama’s announcement, he knew he was riding on the crest of a new wave in science. “In the parlance of the surf, the ride is on. We’re on the wave and we’re riding it.”

What are stem cells?

They are cells that have yet to commit to being a particular type. Researchers believe stem cells may change the face of human medicine because they can be used to repair many tissues, or even grow new organs. There are two basic types: embryonic stem cells are the ones most prized, because they can become any type of human tissue. And, because they grow limitlessly, they can generate the quantities of tissue that could help alleviate the worldwide shortage of transplant tissue.

Embryonic stem cells are derived from surplus test-tube embryos; embryos are grown for five days until they form a microscopic 100-cell ball (see image below). Then a clump of cells in the interior, known as the inner cell mass, is removed and cultivated until embryonic stem cells appear. These continue to grow but fail to specialise. This process requires the destruction of embryos left over after fertility treatments such as IVF. Such surplus embryos would, in any event, be discarded; but the use of embryonic stem cells in research generates intense controversy because some argue that each embryo is a potential person. Until March 2009, the U.S. forbade the use of federal funds by any researcher who also works in a building where stem cell research was being conducted – which is why California had to raise money and construct new buildings to house separate facilities for stem cell research.

Adult stem cells are reservoirs of stem cells found in the organs of all humans. These are capable of replenishing cells of the same type as their host organ: bone marrow stem cells can make bone marrow cells, and brain stem cells can make brain cells.

The CIRM was founded in 2005 with US$3 billion to fund stem cell research at Californian universities and research centres. It has so far allocated US$761 million in grants for the discovery and development of cures, therapies, diagnostics and research technologies to relieve human suffering from chronic disease and injury.

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