Even as they celebrate clearing a legal hurdle, worries of stem cell research grant money evaporating constantly weigh on scientists like Dr. Ted Dawson, whose projects at Johns Hopkins Hospital have helped inform treatment of neurological diseases like Parkinson's and Alzheimer's.
A three-year court battle by two researchers to stop stem cell research using human embryos ended Monday when the Supreme Court declined to review the case. Scientists like Dawson say that frees up grant opportunities and are relieved — for now.
"It takes some of the uncertainty out," Dawson said. "It takes us back to a situation where we're hopefully only limited by our creativity, our talent in doing the science and the resources available."
The problem is that more limitations appear likely. Research advocates fear a handful of threats to funding for all types of stem cell research and scientific study in general: the so-called "fiscal cliff," more legal challenges, an eventual new administration in Washington and the possibility of a more competitive peer review process.
Altogether, the hazards have tempered researchers' enthusiasm over the high court's non-decision.
"It's good for research in general," said Dan Gincel, director of the Maryland Stem Cell Research Fund. "It doesn't stop any future presidents from having another executive order to go the other way. If the Supreme Court would have discussed that, it would have put an end to it one way or another."
Embryonic stem cell research has long faced hurdles from those who see it as morally wrong, akin to abortion. Generating a line of the cells requires destroying the embryo. President George W. Bush limited federally funded embryonic stem cell research to only projects using lines developed before August 2001.
President Barack Obama reversed the decision in April 2009, opening up new embryonic stem cell lines to federal funding. But a federal court in Washington, D.C., suspended the change in August 2010 when two scientists sued on behalf of "plaintiff embryos." The opponents lost on appeal. The Supreme Court's refusal to hear the case means the appeals court's ruling in support of the policy stands.
Proponents of the research argue that the cells can be key in the treatment of many diseases because they have the potential to develop into many different cell types in the body. The scientists who challenged the Obama policy, and others like them, argue that research should be limited to using stem cells derived from adult tissue, though some scientists question whether the adult cells have the same potential.
Uncertainty over how courts might have handled appeals of the lawsuit meant few options for stem cell research projects for the past decade. Scientists are reluctant to take on any project for which funding is or might become scarce, Gincel said.
In Maryland, state money goes to research using both embryonic and adult stem cells. The Maryland Stem Cell Research Fund has awarded $80 million in grants since 2006, something that has helped to insulate the state from some of the concerns, said Dr. Curt Civin, director of the Center for Stem Cell Biology and Regenerative Medicine and associate dean for research at the University of Maryland School of Medicine.
While the state funding is enough to launch projects, there have been few options when researchers want to expand them, Civin said. Opening federal funding to more of the projects is a welcome, if not unsurprising, development, he said.
But researchers still fear automatic budget cuts that could set back the progress. The National Institutes of Health is slated to receive an 8.2 percent smaller budget under the "sequestration" cuts that weren't resolved in negotiations in the final hours of 2012. If they go through, the chilling effect on research innovation could be even worse than any uncertainty from the embryonic stem cell research challenge.
"If the NIH budget was reduced by a substantial amount, then it's going to become even more competitive than it already is," Dawson said. "That, I would think, would have the potential to weigh heavily on an investigator who let's say is struggling with his funding. Is it worth the struggle when it's becoming even harder now?"
Hopkins has repeatedly been the top recipient of NIH grants, with nearly $607 million in fiscal year 2012 and $645 million in fiscal year 2011. The University of Maryland's medical school ranked No. 33 among grant recipients in fiscal 2012, with nearly $156 million.
The lack of a Supreme Court decision or federal law also means the Obama policy remains open to challenge. While it is "the most certain policy" in years for stem cell researchers, there could still be uncertainty to discourage new projects, said Mark Frankel, director of a program on scientific responsibility, human rights and law at the American Association for the Advancement of Science. The group is lobbying for Congress to act.
"People would feel free to proceed … into the field to do the kind of research that wasn't possible 'X' number of years ago," Frankel said.
Competition for dwindling dollars also could intensify under an NIH pilot program testing blind grant application evaluations, in which peer reviewers would not know applicants' names or institutions. Diversity advocates say that competition is necessary — an NIH-commissioned study published in 2011 found that black applicants were 10 percentage points less likely than white applicants to win grants. Some also are concerned that smaller institutions have more difficulty earning grants than larger ones.
But researchers at Hopkins and University of Maryland say they would not want to see their research track records discounted in the application process.
"What's made the NIH such a powerful force for research worldwide is that it traditionally has been focused on funding the very best science," Dawson said. "My concern is that some of these new things being talked about are trying to spread the limited resources amongst everyone, but by doing that you're perhaps creating a scenario where you may not be funding the best science