Patient-specific embryonic stem cells derived from human SCNT blastocysts

Stem cell based therapies to treat muscular dystrophy

Muscular dystrophies comprise a heterogeneous group of neuromuscular disorders, characterized by progressive muscle wasting, for which no satisfactory treatment exists. Multiple stem cell populations, both of adult or embryonic origin, display myogenic potential and have been assayed for their ability to correct the dystrophic phenotype. To date, many of these described methods have failed, underlying the need to identify the mechanisms controlling myogenic potential, homing of donor populations to the musculature, and avoidance of the immune response. Recent results focus on the fresh isolation of satellite cells and the use of multiple growth factors to promote mesangioblast migration, both of which promote muscle regeneration. Throughout this chapter, various stem cell based therapies will be introduced and evaluated based on their potential to treat muscular dystrophy in an effective and efficient manner.

Concise review: scientific and ethical roadblocks to human embryonic stem cell therapy

Despite the identified therapeutic potential of embryonic stem cells for treating human disease and injury, a number of roadblocks, scientific and ethical, stand in the way of progress toward this goal. We identify six areas of particular interest: tumorigenicity, animal product contamination, genetic compatibility, funding, cell type for transplantation, "embryo-friendly" derivation methods and discuss avenues for moving beyond the difficulties.

What can we learn from the Hwang and Sudbø affairs?

The recent publication, in prestigious scientific journals, of two major studies that were subsequently shown to contain fabricated data may compel reviewers and editors to adopt a more rigorous policy in accepting articles for publication. The current manner of peer reviewing research articles provides no assurance that the proffered work is not the result of fraud. The present guidelines for contributors in large team investigations may need to be updated to avoid giving credit to co-authors who may have made little, if any, contribution to the work.

Ethical issues in deriving stem cells from embryos and eggs

Human embryonic stem cell (ESC) research has attracted wide media coverage. It has been headline news for the past several months, revealing the complex case of Professor Hwang Woo-Suk and the scientific fraud where he purported to have created the first human patient-specific stem cell lines generated by cell nucleus replacement (CNR). To ethically obtain the raw materials (eggs, sperm and embryos) for human ESC research is an enormous challenge, yet essential if this research is to proceed in its quest to try to deliver some of the expectations placed upon it: developing treatments and possible cures for a range of serious diseases. This article examines some of the ethical issues surrounding human ESC research using the four principles frequently applied to healthcare and medical research; autonomy, beneficence, non-maleficence and justice. The author strives to ask questions throughout which will encourage debate and discussion.

Role of Histone Acetylation in Reprogramming of Somatic Nuclei Following Nuclear Transfer1

Before fertilization, chromatins of both mouse oocytes and spermatozoa contain very few acetylated histones. Soon after fertilization, chromatins of both gametes become highly acetylated. The same deacetylation-reacetylation changes occur with histones of somatic nuclei transferred into enucleated oocytes. The significance of these events in somatic chromatin reprogramming to the totipotent state is not known. To investigate their importance in reprogramming, we injected cumulus cell nuclei into enucleated mouse oocytes and estimated the histone deacetylation dynamics with immunocytochemistry. Other reconstructed oocytes were cultured before and/or after activation in the presence of the highly potent histone deacetylase inhibitor trychostatin A (TSA) for up to 9 h postactivation. The potential of TSA-treated and untreated oocytes to develop to the blastocyst stage and to full term was compared. Global deacetylation of histones in the cumulus nuclei occurred between 1 and 3 h after injection. TSA inhibition of histone deacetylation did not affect the blastocyst rate (37% with and 34% without TSA treatment), whereas extension of the TSA treatment beyond the activation point significantly increased the blastocyst rate (up to 81% versus 40% without TSA treatment) and quality (on average, 59 versus 45 cells in day 4 blastocysts with and without TSA treatment, respectively). TSA treatment also slightly increased full-term development (from 0.8% to 2.8%). Thus, deacetylation of somatic histones is not important for reprogramming, and hyperacetylation might actually improve reprogramming.

Craniofacial bone tissue engineering

Repair and reconstruction of the craniofacial skeleton represents a significant biomedical burden, with thousands of procedures per-formed annually secondary to injuries and congenital malformations. Given the multitude of current approaches, the need for more effective strategies to repair these bone deficits is apparent. This article explores two major modalities for craniofacial bone tissue engineering: distraction osteogenesis and cellular based therapies. Current understanding of the guiding principles for each of these modalities is elaborated on along with the knowledge gained from clinical and investigative studies. By laying this foundation, future directions for craniofacial distraction and cell-based bone engineering have emerged with great promise for the advancement of clinical practice.

Toti-/Pluripotential Stem Cells and Epigenetic Modifications

Nuclear reprogramming induces global changes of epigenetic profile and confers pluripotency on specialized somatic nuclei. Embryonic stem (ES) cells retain nuclear reprogramming activity as shown by cell fusion with adult somatic cells. The reprogrammed somatic nuclei resemble ES cell nuclei in pluripotential competence. Changes of histone tail modifications in somatic cell-derived genome by cell fusion demonstrate that the molecular process of nuclear reprogramming is separable at least in two steps: erasure of somatic epigenetic modification (genome-wide reprogramming) and establishment of pluripotential epigenetic modification (gene-specific reprogramming). In the latter step, the newly identified transcriptional factor Nanog functions in maintaining pluripotency in cooperation with other key gene Oct4. Somatic-derived Nanog is reactivated in the reprogrammed nuclei in hybrid cells and also in cloned blastocysts. It is unclear which key molecules are responsible for the nuclear reprogramming. It is, however, evident that adult somatic cell nuclei are capable of being reprogrammed in vitro by cell fusion with ES cells. A technological innovation for eliminating ES-derived chromosomes from the hybrid nuclei could make the production of personalized pluripotential stem cells without the need for therapeutic cloning possible.

Regeneration of teeth using stem cell-based tissue engineering

Tooth autotransplantation, allotransplantation and dental implants have existed for many years, but have never been totally satisfactory. Thus, the development of new methods of tooth replacement has become desirable, and with the increasing knowledge of stem cell biology becomes a realistic possibility. Stem cell-based tissue engineering involving the recapitulation of the embryonic environment demonstrates that dental, non-dental, embryonic and adult stem cells can contribute to teeth formation in the appropriate setting. Evidence that stem cell populations may be present in human teeth provides the opportunity to consider biological tooth replacement 'new for old'.

From teratocarcinomas to embryonic stem cells and beyond: a history of embryonic stem cell research

We are currently facing an unprecedented level of public interest in research on embryonic stem cells, an area of biomedical research that until recently was small, highly specialized and of limited interest to anyone but experts in the field. Real and imagined possibilities for the treatment of degenerative and other diseases are of special interest to our rapidly ageing population; real and imagined associations of stem cells to cloning, embryos and reproduction stir deeply held beliefs and prejudices. The conjunction of these factors could explain the recent sudden interest in embryonic stem cells but we ought to remember that this research has a long and convoluted history, and that the findings described today in the scientific and popular press are firmly grounded in research that has been going on for several decades. Here I briefly recapitulate this fascinating history.

Bioethical aspects of regenerative and reproductive medicine

The birth announced in 1997 of Dolly, the lamb cloned from the somatic mammary cells of an adult ewe, and the discovery of human embryonic stem cells in 1998 have been the most exciting developments in the biological sciences in the past decade. Reproductive somatic cell nuclear transfer (SCNT) in additional species has been inefficient in that relatively few births, harmful side effects and high fetal and neonatal death rates have resulted from many attempts. Ongoing debates about the ethics of reproductive SCNT have revealed that some researchers regard human reproductive SCNT as morally unacceptable in all circumstances, others see merit in reproductive SCNT in certain circumstances and others await more information before making judgment about the ethical status of the procedure. Regenerative medicine and emerging biotechnologies started to revolutionize the practice of medicine. Advances in stem cell biology, including embryonic and postnatal somatic stem cells, have made the prospect of tissue regeneration a potential reality. Mammal cloning experiments have provided new impetus to the prospect of regenerative medicine through stem cell research. The procedure of SCNT could be used to create the raw material to replace defective or senescent tissue as a natural extension of the biology of stem cells. Researchers working in reproductive medicine should consider the potential hope given to many patients against the requisite and ethically contentious creation of human blastocysts for therapeutic intent.

(Re)constructing embryos in stem cell research: Exploring the meaning of embryos for people involved in fertility treatments

The use of human embryos is a key controversy in public debates on stem cell research (SCR), yet little attention has been given to the context or sources from which embryos are obtained: people involved in fertility programmes. How they feel about the use of embryos in SCR, and what may lead them to agree or refuse to donate embryos, remains unexplored. In this paper, I investigate the views of people involved in fertility programmes who may be approached to donate their embryos for SCR, drawing on focus group discussions with two support groups in Scotland. I illustrate how people come to make particular decisions and what factors shape this, and show that participants' views are context-bound, borne out of lived experiences both within the clinic and wider society. In particular, the evidence highlights the importance of understanding their views of what constitutes a 'spare' embryo and what areas of medical research are considered potentially legitimate for using embryos. Peoples' understandings of embryos as potential lives, and the context in which embryos are created, have direct implications for their views about donating embryos for SCR. Attention is paid to how SCR further disrupts the teleology of embryos and undermines the narrative of life that suffuses the hopes of people undergoing fertility treatment. The paper also brings to the fore the sense of moral obligation experienced by participants who feel they have little means or power for influencing the topic and content of SCR. In this context, I suggest there is a need to explore further the views of people involved in fertility treatments in order to identify mechanisms for limiting the potential for coercion when SCR is embedded in and dependent on fertility practices. Debates about using embryos for SCR must, therefore, include the voices of those who thus remain marginalised.

Environmental monitoring in stem cell banks

The processing of stem cell lines for application in human therapy requires a physical environment in which air quality (i.e., the number of airborne particles) is controlled to minimize risk of contamination. The processing facility should be constructed and operated to minimise the introduction, generation and retention of particles and microorganisms. A formal program of environmental monitoring should be maintained in each stem cell bank to specify and assess key factors and their influence on the microbiological quality of the process and product. This program should assure the manipulation of cells involved in the derivation of stem cell lines and their culture under established limits for airborne particles and for microbial contamination of the air and surfaces. Environmental monitoring should also address the regulatory requirements in the countries in which the cells will be used. The monitoring programme will depend on local conditions in each processing centre or cell bank. Each centre will need to evaluate its specific needs and establish appropriate monitoring procedures which should not become intrusive to the extent that they might compromise the quality of the cell banks or products.

Gradual DNA demethylation of the Oct4 promoter in cloned mouse embryos

During differentiation, somatic cell nuclei acquire unique patterns of epigenetic modifications, such as DNA methylation, which affect the transcriptional activity of specific genes. Upon transfer into oocytes, however, the somatic nucleus undergoes reprogramming of these epigenetic modifications to achieve pluripotency. Oct4 is one of the critical pluripotency regulators, and is expressed in the germ line, including the pluripotent early embryonic cells. Previous studies showed that the upstream regulatory sequences of the Oct4 gene are distinctly methylated in somatic cells, and the DNA methylation of the regulatory sequences suppresses the transcriptional activity. Thus, successful reprogramming of the somatic cell nucleus to gain pluripotency must be accompanied by the demethylation of the Oct4 regulatory sequences. Here, we investigated the methylation pattern of the Oct4 promoter during early development of cloned mouse embryos. We found that the Oct4 promoter was only gradually demethylated during the early cleavage stages and that the ineffective demethylation of the promoter was associated with developmental retardation. We also found that the upstream sequences of the other pluripotency regulators, namely Nanog, Sox2, and Foxd3, were considerably under-methylated in cumulus cells. These results suggest that the Oct4 gene, as compared to the other pluripotency regulators, needs to undergo extensive demethylation during nuclear reprogramming, and that the failure of such demethylation is associated with inefficient development of cloned somatic cell embryos.

Directed differentiation of human embryonic stem cells into functional dendritic cells through the myeloid pathway

We have established a system for directed differentiation of human embryonic stem (hES) cells into myeloid dendritic cells (DCs). As a first step, we induced hemopoietic differentiation by coculture of hES cells with OP9 stromal cells, and then, expanded myeloid cells with GM-CSF using a feeder-free culture system. Myeloid cells had a CD4+CD11b+CD11c+CD16+CD123(low)HLA-DR- phenotype, expressed myeloperoxidase, and included a population of M-CSFR+ monocyte-lineage committed cells. Further culture of myeloid cells in serum-free medium with GM-CSF and IL-4 generated cells that had typical dendritic morphology; expressed high levels of MHC class I and II molecules, CD1a, CD11c, CD80, CD86, DC-SIGN, and CD40; and were capable of Ag processing, triggering naive T cells in MLR, and presenting Ags to specific T cell clones through the MHC class I pathway. Incubation of DCs with A23187 calcium ionophore for 48 h induced an expression of mature DC markers CD83 and fascin. The combination of GM-CSF with IL-4 provided the best conditions for DC differentiation. DCs obtained with GM-CSF and TNF-alpha coexpressed a high level of CD14, and had low stimulatory capacity in MLR. These data clearly demonstrate that hES cells can be used as a novel and unique source of hemopoietic and DC precursors as well as DCs at different stages of maturation to address essential questions of DC development and biology. In addition, because ES cells can be expanded without limit, they can be seen as a potential scalable source of cells for DC vaccines or DC-mediated induction of immune tolerance.

(Re)defining stem cells

Stem-cell nomenclature is in a muddle! So-called stem cells may be self-renewing or emergent, oligopotent (uni- and multipotent) or pluri- and totipotent, cells with perpetual embryonic features or cells that have changed irreversibly. Ambiguity probably seeped into stem cells from common usage, flukes in biology's history beginning with Weismann's divide between germ and soma and Haeckel's biogenic law and ending with contemporary issues over the therapeutic efficacy of adult versus embryonic cells. Confusion centers on tissue dynamics, whether stem cells are properly members of emerging or steady-state populations. Clarity might yet be achieved by codifying differences between cells in emergent populations, including embryonic stem and embryonic germ (ES and EG) cells in tissue culture as opposed to self-renewing (SR) cells in steady-state populations.

Correction of sickle cell disease by homologous recombination in embryonic stem cells

Previous studies have demonstrated that sickle cell disease (SCD) can be corrected in mouse models by transduction of hematopoietic stem cells with lentiviral vectors containing antisickling globin genes followed by transplantation of these cells into syngeneic recipients. Although self-inactivating (SIN) lentiviral vectors with or without insulator elements should provide a safe and effective treatment in humans, some concerns about insertional mutagenesis persist. An ideal correction would involve replacement of the sickle globin gene (beta(S)) with a normal copy of the gene (beta(A)). We recently derived embryonic stem (ES) cells from a novel knock-in mouse model of SCD and tested a protocol for correcting the sickle mutation by homologous recombination. In this paper, we demonstrate the replacement of the human beta(S)-globin gene with a human beta(A)-globin gene and the derivation of mice from these cells. The animals produce high levels of normal human hemoglobin (HbA) and the pathology associated with SCD is corrected. Hematologic values are restored to normal levels and organ pathology is ameliorated. These experiments provide a foundation for similar studies in human ES cells derived from sickle cell patients. Although efficient methods for production of human ES cells by somatic nuclear transfer must be developed, the data in this paper demonstrate that sickle cell disease can be corrected without the risk of insertional mutagenesis.

[Embryonic stem cells. Future perspectives]

Embryonic stem cells (ES cells) are able to differentiate into any cell type, and therefore represent an excellent source for cellular replacement therapies in the case of widespread diseases, for example heart failure, diabetes, Parkinson's disease and spinal cord injury. A major prerequisite for their efficient and safe clinical application is the availability of pure populations for direct cell transplantation or tissue engineering as well as the immunological compatibility of the transplanted cells. The expression of human surface markers under the control of cell type specific promoters represents a promising approach for the selection of cardiomyocytes and other cell types for therapeutic applications. The first human clinical trial using ES cells will start in the United States this year.

Human embryonic stem cells: origin, properties and applications

Human embryonic stem cells originate from the human preimplantation embryo. The derivation of the first human embryonic stem cells was reported in 1998. Since then we have learnt a great deal about how to isolate and culture these cells. Additionally, their stem cell phenotype and differentiation competence have been determined. Although it is expected that many basic biological properties, such as self-renewal and cell specification, are evolutionary conserved, at least from the mouse, we lack significant knowledge about the molecular events that regulate the unique stem cell features of human embryonic stem cells. The pluripotent nature of human embryonic stem cells has attracted great interest in using them as a source of cells and tissues in cell therapy. Recent progress in human somatic cell nuclear transfer suggests that there may be a solution to the immunotolerance problems associated with the use of human embryonic stem cells in cell-replacement therapy. Thus, human embryonic stem cells supply the research community with unique research tools to study basic biological processes in human cells, model human genetic diseases and develop new cell-replacement therapies.

Genetic medicines: treatment strategies for hereditary disorders

The treatment of the more than 1,800 known monogenic hereditary disorders will depend on the development of 'genetic medicines' - therapies that use the transfer of DNA and/or RNA to modify gene expression to correct or compensate for an abnormal phenotype. Strategies include the use of somatic stem cells, gene transfer, RNA modification and, in the future, embryonic stem cells. Despite the efficacy of these technologies in treating experimental models of hereditary disorders, applying them successfully in the clinic is a great challenge, which will only be overcome by expending considerable intellectual and economic resources, and by solving societal concerns about modifications of the human genetic repertoire.

Embryonic stem cells and cardiomyocyte differentiation: phenotypic and molecular analyses

Embryonic stem (ES) cell lines, derived from the inner cell mass (ICM) of blastocyst-stage embryos, are pluripotent and have a virtually unlimited capacity for self-renewal and differentiation into all cell types of an embryoproper. Both human and mouse ES cell lines are the subject of intensive investigation for potential applications in developmental biology and medicine. ES cells from both sources differentiate in vitro into cells of ecto-, endoand meso-dermal lineages, and robust cardiomyogenic differentiation is readily observed in spontaneously differentiating ES cells when cultured under appropriate conditions. Molecular, cellular and physiologic analyses demonstrate that ES cell-derived cardiomyocytes are functionally viable and that these cell derivatives exhibit characteristics typical of heart cells in early stages of cardiac development. Because terminal heart failure is characterized by a significant loss of cardiomyocytes, the use of human ES cell-derived progeny represents one possible source for cell transplantation therapies. With these issues in mind, this review will focus on the differentiation of pluripotent embryonic stem cells into cardiomyocytes as a developmental model, and the possible use of ES cell-derived cardiomyocytes as source of donor cells.

Molecular genetics: DNA analysis of a putative dog clone

In August 2005, Lee et al. reported the first cloning of a domestic dog from adult somatic cells. This putative dog clone was the result of somatic-cell nuclear transfer from a fibroblast cell of a three-year-old male Afghan hound into a donor oocyte provided by a dog of mixed breed. In light of recent concerns regarding the creation of cloned human cell lines from the same institution, we have undertaken an independent test to determine the validity of the claims made by Lee et al..

Recombinant Human Albumin Supports Development of Somatic Cell Nuclear Transfer Embryos in Mice: Toward the Establishment of a Chemically Defined Cloning Protocol

Culturing embryos in different media is a useful approach to characterize their nature in regard to "memory" of the donor nucleus and its "reprogramming" after somatic cell nuclear transfer (SCNT). However, efforts to elucidate the mechanisms of reprogramming are seriously undermined when embryo culture conditions are not completely defined. Using recombinant human albumin (rHA) is a step toward establishing defined culture conditions for mouse cloning. Recombinant HA supports blastocyst formation of cumulus cell-derived clones at a rate comparable with two types of bovine serum albumin (BSA); following transfer of blastocysts to the genital tract, rates of development to midgestation (10.5 dpc) were indistinguishable. rHA also supports the derivation of germline competent embryonic stem (ES) cells from SCNT blastocysts at a substantial rate compared with BSA counterparts and with zygotic blastocysts. Unlike the developmental parameters, the gene expression patterns of clones cultured in rHA or BSA were not superimposed; identical patterns were observed for zygotic blastocysts in the two albumins. In summary, the present study demonstrates that (1) rHA can replace BSA, proving a defined protein source for SCNT in mice; (2) although using rHA is similar to BSA, it is not equal (rHA leaves a mark on gene expression of clones but not zygotes). Future studies that investigate reprogramming after SCNT will need to consider not only the implications of culture media for cloning but also the supplement choice.

Embryonic Stem Cells: Similarities and Differences Between Human and Murine Embryonic Stem Cells

The derivation of murine embryonic stem (mES) cell lines was reported for the first time in 1981 (Nature, 1981; 292:154-156; Proc Natl Acad Sci U S A, 1981; 78:7634-7638), and they have since proved to be a very useful tool with which to study mammalian development, which is characterized by pluripotency and differentiation. About 20 years later, the successful generation of human embryonic stem (hES) cell lines was described (Science, 1998; 282:1145-1147). Although mES and hES are derived from mammals, they cannot be looked at as being one and the same. While basic information for hES can be derived from mES, such information does not correspond on a one-to-one basis. This review gives an overview of the characteristics of embryonic stem cells with the main focus on the similarities and differences between human and mES cells.

Embryonic stem cell-derived neuronally committed precursor cells with reduced teratoma formation after transplantation into the lesioned adult mouse brain

The therapeutic potential of embryonic stem (ES) cells in neurodegenerative disorders has been widely recognized, and methods are being developed to optimize culture conditions for enriching the cells of interest and to improve graft stability and safety after transplantation. Whereas teratoma formation rarely occurs in xenogeneic transplantation paradigms of ES cell-derived neural progeny, more than 70% of mice that received murine ES cell-derived neural precursor cells develop teratomas, thus posing a major safety problem for allogeneic and syngeneic transplantation paradigms. Here we introduce a new differentiation protocol based on the generation of substrate-adherent ES cell-derived neural aggregates (SENAs) that consist predominantly of neuronally committed precursor cells. Purified SENAs that were differentiated into immature but postmitotic neurons did not form tumors up to four months after syngeneic transplantation into the acutely degenerated striatum and showed robust survival.

Moving human embryonic stem cells from legislature to lab: remaining legal and ethical questions

Greely discusses unanswered ethical and legal issues, such as those surrounding the creation of embryos, derivation of cell lines, uses of cell lines, and questions of intellectual property.

Changing genetic world of IVF, stem cells and PGD. B. Polarities and gene expression in differentiating embryo cells and stem cells

Novel genetic techniques in the later twentieth century led to new analytical methods for assessing the growth of embryos and stem cells and improve preimplantation diagnosis. Increasing attention to the nature of polarities in mouse and human embryos revealed the existence of an animal-vegetal axis in human oocytes and embryos. Combinations of meridional and transverse cleavage divisions, the latter due to spindle rotation, determined the unequal division of ooplasm to embryonic blastomeres. Blastomeres with differing functions were accordingly formed in 4-cell embryos, including founders of inner cell mass and trophectoderm. New forms of gene analysis led to the polymerase chain reaction, while fluorescence in-situ hybridization revealed astonishingly high degrees of heteroploidy in human embryos. Developmental genetics gained immense analytical power as cDNA libraries, microarrays, transcriptomes RNAi and other methods clarified the roles of hundreds of genes in pre- and early post-implantation embryos and stem cells.

Mice in the world of stem cell biology

The ability of embryos to diversify and of some adult tissues to regenerate throughout life is directly attributable to stem cells. These cells have the capacity to self-renew-that is, to divide and to create additional stem cells-and to differentiate along a specific lineage. The differentiation of pluripotent embryonic stem cells along specific cell lineages has been used to understand the molecular mechanisms involved in tissue development. The often endless capacity of embryonic stem cells to generate differentiated cell types positions the field of stem cells at the nexus between developmental biologists, who are fascinated by the properties of these cells, and clinicians, who are excited about the prospects of bringing stem cells from bench to bedside to treat degenerative disorders and injuries for which there are currently no cures. Here we highlight the importance of mice in stem cell biology and in bringing the world one step closer to seeing these cells brought to fruition in modern medicine.

An approach to the ethical donation of human embryos for harvest of stem cells

This paper considers embryo grading within a given infertility treatment and suggests an ethical approach to embryo donation for embryonic stem cell harvest. It is concluded that ethical considerations regarding human embryos do not necessarily preclude the use of certain embryos for biomedical research or transplantation. The argument is based on the following rationale: all embryos are not physiologically equal, some low-grade embryos will never be chosen for implantation, cells from low-grade embryos may be donated for transplantation or research, and embryonic stem cells can be harvested from low-grade embryos. This argument bears special importance at this time as embryos created by IVF are still the only source of embryonic stem cells, given the current controversy surrounding published studies of human somatic cell nuclear transfer.