RESUMO
Stem cells can be coaxed to self-organize into dynamic models of human development and early embryo formation. Despite their scientific promise, might widespread use of these technologies alter people's beliefs about what it means to be a human individual? Attention to some important philosophical distinctions may help navigate our thinking.
Assuntos
Desenvolvimento Embrionário , Humanos , Desenvolvimento Humano , Modelos Biológicos , AnimaisRESUMO
Given the explosion of research on induced pluripotent stem (iPS) cells, it is timely to consider the various ethical, legal, and social issues engaged by this fast-moving field. Here, we review issues associated with the procurement, basic research, and clinical translation of iPS cells.
Assuntos
Pesquisa Biomédica , Células-Tronco Pluripotentes Induzidas/citologia , Transplante de Células-Tronco , Humanos , Política Pública , Doadores de TecidosRESUMO
Research that uses stem cell-based chimeras promises to advance our understanding of human developmental biology, as well as new medical interventions, such as generating transplantable human organs in livestock. However, along with these exciting research possibilities come moral concerns about the moral humanization of animals, especially when it comes to the potential effects of human cells in the brains of experimental animals. Recent work involving neurologically chimeric mice may suggest that such worries are reasonable. However, this overlooks the crucial social and neurological conditions for enabling the development of conscious self-awareness, the absence of which leaves us only with animal welfare to monitor and consider.
Assuntos
Quimera/metabolismo , Modelos Animais , Modelos Neurológicos , Pesquisa com Células-Tronco/ética , Bem-Estar do Animal , Animais , Humanos , CamundongosRESUMO
RESEARCH QUESTION: Has acceptance of heritable genome editing (HGE) and whole genome sequencing for preimplantation genetic testing (PGT-WGS) of human embryos changed after the onset of COVID-19 among infertility patients? DESIGN: A written survey conducted between April and June 2018 and July and December 2021 among patients at a university-affiliated infertility practice. The questionnaire ascertained the acceptance of HGE for specific therapeutic or genetic 'enhancement' indications and of PGT-WGS to prevent adult disease. RESULTS: In 2021 and 2018, 172 patients and 469 patients (response rates: 90% and 91%, respectively) completed the questionnaire. In 2021, significantly more participants reported a positive attitude towards HGE, for therapeutic and enhancement indications. In 2021 compared with 2018, respondents were more likely to use HGE to have healthy children with their own gametes (85% versus 77%), to reduce disease risk for adult-onset polygenic disorders (78% versus 67%), to increase life expectancy (55% versus 40%), intelligence (34% versus 26%) and creativity (33% versus 24%). Fifteen per cent of the 2021 group reported a more positive attitude towards HGE because of COVID-19 and less than 1% a more negative attitude. In contrast, support for PGT-WGS was similar in 2021 and 2018. CONCLUSIONS: A significantly increased acceptance of HGE was observed, but not of PGT-WGS, after the onset of COVID-19. Although the pandemic may have contributed to this change, the exact reasons remain unknown and warrant further investigation. Whether increased acceptability of HGE may indicate an increase in acceptability of emerging biomedical technologies in general needs further investigation.
Assuntos
COVID-19 , Infertilidade , Diagnóstico Pré-Implantação , Gravidez , Adulto , Feminino , Criança , Humanos , Pandemias , Edição de Genes , Testes Genéticos , Infertilidade/genética , Infertilidade/terapia , AneuploidiaRESUMO
In recent years considerable progress has been made in the development of faithful procedures for the differentiation of human pluripotent stem cells (hPSCs). An important step in this direction has also been the derivation of organoids. This technology generally relies on traditional three-dimensional culture techniques that exploit cell-autonomous self-organization responses of hPSCs with minimal control over the external inputs supplied to the system. The convergence of stem cell biology and bioengineering offers the possibility to provide these stimuli in a controlled fashion, resulting in the development of naturally inspired approaches to overcome major limitations of this nascent technology. Based on the current developments, we emphasize the achievements and ongoing challenges of bringing together hPSC organoid differentiation, bioengineering and ethics. This Review underlines the need for providing engineering solutions to gain control of self-organization and functionality of hPSC-derived organoids. We expect that this knowledge will guide the community to generate higher-grade hPSC-derived organoids for further applications in developmental biology, drug screening, disease modelling and personalized medicine.
Assuntos
Bioengenharia , Organoides/crescimento & desenvolvimento , Células-Tronco Pluripotentes/metabolismo , Humanos , Organoides/citologia , Células-Tronco Pluripotentes/citologiaRESUMO
Research involving human organoids and gastruloids involves ethical issues associated with their derivation as well as their current and future uses. These include unique issues related to the extent of maturation that can be achieved in vitro or through chimeric research, as well as fundamental ethical considerations such as those concerning the provenance of human biomaterials and the use of gene-editing technologies. Many of these issues are not specifically addressed by existing ethics oversight mechanisms, but these mechanisms might be easily extended to help ensure that human organoid and related research moves forward in an ethically appropriate manner.
Assuntos
Pesquisas com Embriões/ética , Gástrula/fisiologia , Organoides/fisiologia , Humanos , PolíticasRESUMO
The National Institutes of Health (NIH) is poised to lift its funding moratorium on research involving chimeric human/nonhuman embryos, pending further consideration by an NIH steering committee. The kinds of ethical concerns that seem to underlie this research and chimera research more generally can be adequately addressed.
Assuntos
Quimera , Pesquisas com Embriões/ética , Princípios Morais , Pesquisa com Células-Tronco/ética , Animais , Humanos , National Institutes of Health (U.S.) , Estados UnidosAssuntos
Encéfalo/fisiologia , Estado de Consciência/fisiologia , Experimentação Humana/ética , Modelos Biológicos , Neurociências/ética , Organoides/fisiologia , Animais , Encéfalo/citologia , Quimera , Morte , Embrião de Mamíferos/citologia , Xenoenxertos , Humanos , Técnicas In Vitro , Consentimento Livre e Esclarecido/ética , Camundongos , Organoides/citologia , Organoides/crescimento & desenvolvimento , Propriedade/ética , Ratos , SuínosAssuntos
Implantação do Embrião , Pesquisas com Embriões/ética , Pesquisas com Embriões/legislação & jurisprudência , Desenvolvimento Embrionário , Modelos Biológicos , Pesquisa com Células-Tronco/ética , Pesquisa com Células-Tronco/legislação & jurisprudência , Animais , Embrião de Mamíferos/citologia , Embrião de Mamíferos/embriologia , Feminino , Fertilização in vitro , Humanos , Camundongos , Placenta/citologia , Placentação , Gravidez , Medicina Reprodutiva/ética , Medicina Reprodutiva/legislação & jurisprudência , Medicina Reprodutiva/tendências , Biologia Sintética/ética , Biologia Sintética/legislação & jurisprudência , Biologia Sintética/tendências , Saco Vitelino/citologia , Saco Vitelino/crescimento & desenvolvimentoRESUMO
In recent years, there has been much interest in the prospect of generating and using human stem cells that exhibit a state of naïve pluripotency. Such a pluripotent state might be functionally confirmed by assessing the chimeric contribution of these cells to non-human blastocysts. Furthermore, the generation of naïve human pluripotent stem cells in vitro could lead to the creation of chimeric animal models that can facilitate the study of human development and disease. However, these lines of research raise thorny ethical concerns about the moral status of such chimeric animals. Here, I call attention to these ethical barbs and suggest a way in which to proceed cautiously.
Assuntos
Quimera/metabolismo , Células-Tronco Pluripotentes/citologia , Pesquisa com Células-Tronco/ética , Animais , Humanos , CamundongosAssuntos
Quimera/crescimento & desenvolvimento , Pesquisas com Embriões/ética , Pesquisas com Embriões/legislação & jurisprudência , Pesquisa com Células-Tronco/ética , Pesquisa com Células-Tronco/legislação & jurisprudência , Bem-Estar do Animal/ética , Bem-Estar do Animal/legislação & jurisprudência , Animais , Quimera/embriologia , Medo , Humanos , National Institutes of Health (U.S.)/legislação & jurisprudência , Estados UnidosAssuntos
Pesquisas com Embriões/ética , Pesquisas com Embriões/legislação & jurisprudência , Desenvolvimento Embrionário , Feminino , Humanos , Cooperação Internacional , Masculino , Princípios Morais , Linha Primitiva/embriologia , Técnicas de Reprodução Assistida/ética , Técnicas de Reprodução Assistida/legislação & jurisprudência , Pesquisa com Células-Tronco/ética , Pesquisa com Células-Tronco/legislação & jurisprudência , Fatores de TempoAssuntos
Guias como Assunto , Internacionalidade , Pesquisa com Células-Tronco/ética , Pesquisa com Células-Tronco/legislação & jurisprudência , Animais , Quimera , Ensaios Clínicos como Assunto/métodos , Ensaios Clínicos como Assunto/normas , Humanos , Células-Tronco Pluripotentes Induzidas , Doação de Oócitos/ética , Doação de Oócitos/normas , Sociedades CientíficasAssuntos
Clonagem de Organismos/legislação & jurisprudência , Pesquisas com Embriões/legislação & jurisprudência , Regulamentação Governamental , Pesquisa com Células-Tronco/legislação & jurisprudência , Adulto , Idoso , Animais , Clonagem de Organismos/ética , Pesquisas com Embriões/economia , Pesquisas com Embriões/ética , Células-Tronco Embrionárias/citologia , Células-Tronco Embrionárias/metabolismo , Feminino , Genoma Humano , Humanos , Internacionalidade , Masculino , National Institutes of Health (U.S.)/legislação & jurisprudência , Pesquisa com Células-Tronco/economia , Pesquisa com Células-Tronco/ética , Estados UnidosRESUMO
In response to calls for public engagement on human genome editing (HGE), which intensified after the 2018 He Jiankui scandal that resulted in the implantation of genetically modified embryos, we detail an anticipatory approach to the governance of HGE. By soliciting multidisciplinary experts' input on the drivers and uncertainties of HGE development, we developed a set of plausible future scenarios to ascertain publics values-specifically, their hopes and concerns regarding the novel technology and its applications. In turn, we gathered a subset of multidisciplinary experts to propose governance recommendations for HGE that incorporate identified publics' values. These recommendations include: (1) continued participatory public engagement; (2) international harmonization and transparency of multiple governance levers such as professional and scientific societies, funders, and regulators; and (3) development of a formal whistleblower framework.
RESUMO
Li et al.1 report on the generation of cynomolgus monkey models of blastocyst-stage embryos (called "blastoids") using naive cynomolgus embryonic stem cells. These blastoids recapitulate gastrulation in vitro and induce early pregnancy responses when transferred into cynomolgus monkey surrogates, prompting consideration of the policy implications for human blastoid research.
Assuntos
Blastocisto , Embrião de Mamíferos , Gravidez , Animais , Feminino , Humanos , Macaca fascicularis , Células-Tronco EmbrionáriasRESUMO
Precision medicine has evolved from the application of pharmacogenetic biomarkers to the prospective development of targeted therapies in patients with specific molecular/genetic subtypes of disease to truly "N-of-1" medicines targeted to very small numbers of patients - in some cases, a single identified patient. This latter iteration of precision medicine presents unprecedented opportunities for patients with severe, life-threatening, or life-limiting diseases. At the same time, these modalities present complex scientific, clinical, and regulatory challenges. To realize the promise of individualized medicines, a multistakeholder approach to streamlining medical diagnoses, advancing the technologies that enable development of these therapeutic modalities, and re-envisioning collaborative environments for access and evidence generation is of critical importance. Herein, we highlight some of these challenges and opportunities.
Assuntos
Farmacogenética , Medicina de Precisão , Humanos , Estudos ProspectivosRESUMO
BACKGROUND: MR-guided focused ultrasound is a promising intervention for treatment-resistant mental illness, and merits contextualized ethical exploration in relation to more extensive ethical literature regarding other psychosurgical and neuromodulation treatment options for this patient population. To our knowledge, this topic has not yet been explored in the published literature. OBJECTIVE: The purpose of this paper is to review and discuss in detail the neuroethical implications of MR-guided focused ultrasound for neuropsychiatric illness as an emerging treatment modality. METHODS: Due to the lack of published literature on the topic, the approach involved a detailed survey and review of technical and medical literature relevant to focused ultrasound and established ethical issues related to alternative treatment options for patients with treatment-resistant, severe and persistent mental illness. The manuscript is structured according to thematic and topical findings. RESULTS: This technology has potential benefits for patients suffering with severe mental illness, compared with established alternatives. The balance of technical, neuroscientific and clinical considerations should inform ethical deliberations. The nascent literature base, nuances in legal classification and permissibility depending upon jurisdiction, influences of past ethical issues associated with alternative treatments, tone and framing in media articles, and complexity of clinical trials all influence ethical assessment and evaluations of multiple stakeholders. Recommendations for future research are provided based on these factors. CONCLUSION: Salient ethical inquiry should be further explored by researchers, clinicians, and ethicists in a nuanced manner methodologically, one which is informed by past and present ethical issues related to alternative treatment options, broader psychiatric treatment frameworks, pragmatic implementation challenges, intercultural considerations, and patients' ethical concerns.