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Dr. Johnny Huard, one of the nation's leading gene-therapy researchers, never intended his groundbreaking medical research to cause any trouble.

His goal in pushing the boundaries of modern science was to improve quality of life, be it through a new treatment for muscular dystrophy or a quicker recovery time from a torn knee ligament. But the more he uncovers and the more he learns, the more he finds himself standing in front of the anti-doping watchdogs, explaining the potential performance-enhancing capabilities of his research.

Although most of the focus on the future of cheating and doping in sports centers on gene doping, in which an athlete might someday be able to be injected with a gene that will produce muscle-building hormones, one of Huard's latest theories involving adult stem cells has the anti-doping establishment newly concerned.

And here's why: The new technology, at the absolute forefront of tissue re-engineering research, could allow athletes to use their own stem cells to grow bigger, stronger muscles. And because the stem cells would be an entirely natural substance, from an athlete's own body, they theoretically would be undetectable.


Photo courtesy Dr. Johnny Huard
Dr. Johnny Huard believes if stem cells are injected into healthy tissue, they would respond by making that tissue "even stronger."
"In essence, we're talking about taking part of yourself and injecting it back into you somewhere else. It's 100 percent naturally you," says Huard, director of the Growth and Development Laboratory at the Children's Hospital at the University of Pittsburgh. "And if that's the case, do we call that cheating?"
In ongoing research, doctors have discovered that if you take a biopsy of a biceps muscle, for example, and inject the stem cells from that biopsy into an injured tissue, the stem cells will repair that tissue faster and with more proficiency than conventional treatment. The theories already have been put to use to help repair cardiac tissue, broken bones and torn muscles in rodents. Early testing with humans has shown that adult stem cell injections can help elderly patients regain bladder control.

What does tissue regeneration have to do with performance enhancement? Although specific studies have not been conducted yet, Huard believes that if the stem cells were injected into tissue that didn't need repair, they would respond by making the healthy tissue "even stronger."

"We're not talking about taking a bad athlete and making him super," Huard said. "We're talking about taking a super athlete and giving him that fraction-of-a-second edge to get that gold medal."

Beyond gene doping and stem cells, the quest for gold likely will lead athletes to more functional elective surgeries in the future, procedures with benefits similar to the way LASIK improves vision. British bioethicist Dr. Andy Miah, author of the book "Genetically Modified Athletes: Biomedical Ethics, Gene Doping and Sport," believes we're not far from the day when athletes will have microscopic devices implanted in their brains to boost performance.

It sounds like science fiction, but the technology is being studied to help people suffering from Parkinson's disease. A convergence of nanotechnology, biotechnology, information technology and cognitive science could lead to the implementation of a chip that would help an athlete keep in shape, keep his arm or head steady, or elicit other physiological responses during competition, Miah said.

"Some would argue that this opens the door towards creating freak shows," Miah said. "Yet if we look carefully at an athlete's capability in relation to what is normal, we are already there."

It is stem cell research such as Huard's that could cause the most headaches for the watchdogs. For one, is it actually cheating if you're using something from your own body and just moving it somewhere else? And if it is, how would the watchdogs and the testers be able to detect that?

"I don't think this is any different than anything we've seen in the past," said Travis Tygart, the senior managing director of the U.S. Anti-Doping Agency. "Whether it's designer steroids or new pharmaceutical drugs like EPO or human growth hormone, it's the same sort of idea, that athletes who are going to cheat are going to go to all extremes to do so without getting caught. And that's why it's so important to have a mechanism in place to get at all those new forms of cheating."

By mechanism, Tygart means USADA itself, the independent anti-doping agency for Olympic sport in this country, which has been in operation only since October 2000. Although the public perception might be that groups such as USADA are always one or two steps behind the cheaters, the reality is the cheaters had one heck of a head start.

Stem Cells
Stem cells are the foundation for every organ, tissue and cell in the body. The three main categories of stem cells are embryonic stem cells (derived from blastocysts), adult stem cells (found in adult tissues) and cord blood stem cells (found in a baby's umbilical cord after birth.)
Controversy has surrounded embryonic stem cell research because the cells can be obtained only through the destruction of days-old embryos from fertility clinics. Many oppose this research because they consider this embryo the moral equivalent of a human being.
Dr. Johnny Huard's research involves adult stem cells that are already in a human's body, similar to the way stem cells in bone marrow are used to treat leukemia. Dr. Thomas Vangsness's clinical study on meniscus injuries also involves adult stem cells. And Dr. Harris is the director of Cord Blood Registry, a company that stores an infant's cord blood should it be needed to treat injury or disease in the future.
- Wayne Drehs But now, Tygart believes that gap is nearly nonexistent. In working alongside local, state and federal law enforcement -- as well as doctors, trainers, scientists and researchers such as Huard -- Tygart is confident his group is at a point where it can stay ahead of the cheaters.
For Huard, the balance between helping a boy with muscular dystrophy and creating the formula a high-jumper needs to win gold is a difficult one.

"As soon as you help one side, you have to worry about the other," Huard said. "I just look at it as a sign of success. If I'm getting calls from USADA, it means I'm doing something pretty good in terms of muscle healing."

Said Tygart: "You don't want these researchers to stop developing these technologies. It would be ridiculous to suggest that. You want to have these productive discussions to examine what we can do so these drugs and developments don't become abused by an athlete seeking an advantage."

The science might be here already.

Dr. Thomas Vangsness, a professor of orthopedic surgery at the University of Southern California and a team physician for USC athletics, is working on the first clinical study for stem cell biology in orthopedic surgery, in which stem cells are being used to repair meniscus tears in the knee. Although the double-blind project is only a year old and has yet to draw any conclusions, Vangsness knows what his experienced eyes can see.

"I personally see things growing," he said. "But I'm still blinded, so I can't really tell you for sure."

As with any medical advancement, there are concerns about cost as well as potential side effects.

Research in gene therapy was dealt a blow last month when Jolee Mohr, a 36-year-old mother from Springfield, Ill., died after receiving the second dose of a genetically engineered arthritis therapy in experimental stages. Although the exact cause of Mohr's death is not known, it was the second death in the history of gene-therapy trials. In 1999, 18-year-old Jesse Gelsinger, part of a University of Pennsylvania study, died of a massive immune reaction to gene-therapy treatment.

Dr. Freddy Fu, who works with Huard as an orthopedic surgeon at the University of Pittsburgh, shares similar concerns about the effect stem cell injections could have on the body.

"There is some concern that a stem cell is like a cancer cell," Fu said. "Like going from Darth Vader to Obi-Wan, they might not be too far apart. But knowing what we do about athletes, someone will try it."

Not everyone is convinced the technology will work. Dr. David Harris, an immunology professor at the University of Arizona and the director of the Cord Blood Registry (one of the largest cord blood banks in the country), doesn't agree that stem cells will strengthen an already-healthy muscle.

"If there's no stress or damage to the tissue, they don't do anything," Harris said. "This is not a way to get bigger muscles or hit more home runs. It's a way for athletes to recover quicker from a potential career-ending injury."

Whatever the future might bring, the idea of reproducing the next Michael Jordan through stem cells, gene therapy, cloning or any other scientific discovery is far-fetched. "You could clone Michael Jordan and have the world's greatest accountant," said Dr. Tom Murray, president of the Hastings Center, a bioethics research firm. "So much more goes into it than genes."

But that doesn't mean there shouldn't be concern. According to Murray, who also serves as chairman of the ethics panel for the World Anti-Doping Agency, sports is at a crossroads.

"Either it will become a free-for-all, where it's less and less about who's the best athlete and more about who has the best chemist and biomedical guy, or athletes and fans will become disenthralled with all this scientific manipulation and will want to see what human beings are capable of on their own," Murray said.

"Or we'll probably continue to muddle somewhere in between."