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Stem Cells |
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Why do some people have such a problem with
improving the human condition? |
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Human Embryonic Stem
Cells
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discovered in 1998
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found in five-day-old
human embryos
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multiply prolifically
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unlike adult cells,
have the potential to turn into any of the
human body's ±220
cell and tissue types
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scientists
are beginning to cultivate them in
laboratory dishes to grow replacement
tissues for patients
Stem Cell Milestones
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1960s: Research begins on stem cells taken from
adult tissue
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1968: Adult stem cells used to treat immunodeficient patient
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1998: US scientists
grow stem cells from human embryos and germ cells, establishing cell
lines still in use today
2001: Embryonic stem cell turned into a blood cell
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2004: South Korean
scientists clone 30 human embryos and develop them over several days
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2005: Korean team
develops stem cells tailored to match individual patients
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Stem Cell
Signals
In October 2004,
Robert Benezra, a researcher at the
Memorial Sloan-Kettering Cancer Centre in New York,
was studying mice that tended to die of a genetic heart defect as
embryos. They were missing two proteins that are important for developing a
healthy heart. To extend their lives, Benezra injected the mouse embryos
with stem cells that had the missing proteins.
"And it was to our surprise and amazement that when we injected even
just a few embryonic stem cells, the animals not
only survived a little bit longer but they were actually born and
running around quite happily", says BenezraThe
stem cells hadn't simply taken over and replaced the defective mouse heart
cells. Instead, the stem cells were actually sending chemical signals to the
defective cells around them that made the bad cells grow normally.
Benezra now thinks doctors might be able to use the signalling chemicals of
stem cells -- rather than stem cells themselves -- to treat degenerative
diseases.
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Is Heaven Populated Chiefly by the Souls
of Embryos?
Harvesting stem cells without tears
Ronald Bailey
Reson.com
Dec 22, 2004
What are we to think about the fact that Nature (and for believers,
Nature's God) profligately creates and destroys human embryos? John
Opitz, a professor of pediatrics, human genetics, and obstetrics and
gynecology at the University of Utah, testified before the President's
Council on Bioethics that between 60 and 80 percent of all naturally
conceived embryos are simply flushed out in women's normal menstrual flows
unnoticed. This is not miscarriage we're talking about. The women and their
husbands or partners never even know that conception has taken place; the
embryos disappear from their wombs in their menstrual flows. In fact,
according to Opitz, embryologists estimate that the rate of natural loss for
embryos that have developed for seven days or more is 60 percent. The total
rate of natural loss of human embryos increases to at least 80 percent if
one counts from the moment of conception. About half of the embryos lost are
abnormal, but half are not, and had they implanted they would probably have
developed into healthy babies.
So millions of viable human embryos each year produced via normal conception
fail to implant and never develop further. Does this mean America is
suffering a veritable holocaust of innocent human life annihilated? Consider
the claim made by right-to-life apologists like Robert George, a Princeton
University professor of jurisprudence and a member of the President's
Council on Bioethics, that every embryo is "already a human being." Does
that mean that if we could detect such unimplanted embryos as they leave the
womb, we would have a duty to rescue them and try to implant them anyway?
"If the embryo loss that accompanies natural procreation were the moral
equivalent of infant death, then pregnancy would have to be regarded as a
public health crisis of epidemic proportions: Alleviating natural embryo
loss would be a more urgent moral cause than abortion, in vitro
fertilization, and stem-cell research combined," declared Michael Sandel, a
Harvard University government professor, also a member of the President's
Council on Bioethics.
As far as I know, bioconservatives like Robert George do not advocate the
rescue of naturally conceived unimplanted embryos. But why not? In
right-to-life terms, normal unimplanted embryos are the moral equivalents of
a 30-year-old mother of three children.
Of course, culturally we do not mourn the deaths of these millions of
embryos as we would the death of a child—and reasonably so, because we do in
fact know that these embryos are not people. Try this thought experiment. A
fire breaks out in a fertility clinic and you have a choice: You can save a
three-year-old child or a Petri dish containing 10 seven-day old embryos.
Which do you choose to rescue?
Stepping onto dangerous theological ground, it seems that if human embryos
consisting of one hundred cells or less are the moral equivalents of a
normal adult, then religious believers must accept that such embryos share
all of the attributes of a human being, including the possession of an
immortal soul. So even if we generously exclude all of the naturally
conceived abnormal embryos—presuming, for the sake of theological argument,
that imperfections in their gene expression have somehow blocked the
installation of a soul—that would still mean that perhaps 40 percent of all
the residents of Heaven were never born, never developed brains, and never
had thoughts, emotions, experiences, hopes, dreams, or desires.
Yet millions of intelligent people of good will maintain that seven-day-old
embryos have the exact same moral standing as do readers of this column.
Acting on this sincere belief, they are trying to block biomedical research
on human embryonic stem cells that is desired by millions of their fellow
citizens.
But there may be a way out of this politico-theological impasse. The
President's Council on Bioethics held an extraordinarily interesting session
earlier this month in which two different avenues for obtaining human
embryonic stem cells were proposed, in ways that would skirt right-to-life
moral objections.
First, Howard Zucker and Donald Landry, two medical professors at Columbia
University, proposed "a new definition of death for the human organism, an
organism in development, and that is the irreversible arrest of cell
division." They pointed out that a good percentage of in-vitro fertilized (IVF)
embryos consist of a mixture of cells, some containing the wrong number of
chromosomes (aneuploidy), some with the normal number. Embryos with such
cell mixtures often cease development by cell division and thus cannot
develop into fetuses, much less babies. Zucker and Landry argue that such
embryos can be considered dead, and the normal embryonic cells they contain
can be harvested just as organs can be ethically harvested from brain-dead
adults. (Animal experiments have already shown that cells harvested from
defective embryos will produce normal tissues.) Thus, we get stem cells from
an entity that could not, under any circumstances, have become a human
being.
William Hurlbut, a consulting professor in the Program of Human Biology at
Stanford University and another member of the President's Council on
Bioethics, proposed another way to produce cloned human embryonic stem cells
that right-to-lifers should not find morally objectionable. Hurlbut cited
work by researcher Janet Rossant at Mount Sinai Hospital in Toronto in which
she inactivated the cdx2 gene in mice. Once the cdx2 gene is inactivated,
the mouse embryo cannot form a trophoblast—the tissues that grow into the
placenta. However, embryonic stem cells do develop, although they cannot
form an embryo. Hurlbut proposed an attempt to find similar genes that could
be inactivated in the nuclei of adult human cells before they are installed
in enucleated human eggs to produce cloned embryonic stem cells that are a
genetic match for the person who donates the adult nucleus. (Transplanted
cells and tissues produced by such therapeutic cloning would not be rejected
by the donor's immune system.) Once the stem cells have been derived, the
inactivated genes could be reactivated so that the stem cells could be used
to produce normal transplantable cells and tissues.
"This process does not involve the creation of an embryo that is then
altered to transform it into a non-embryonic entity," explained Hurlbut.
"Rather the proposed genetic alteration is accomplished ab initio, the
entity is brought into existence with a genetic structure insufficient to
generate a human embryo."
Will this research reduce the number of embryos populating heaven? Who
knows? But these options offer a possible way around the moral blockades
that impede promising biomedical research on human embryonic stem cells.
Should we halt current human embryonic stem-cell research while these
possible new avenues of research are being explored? Absolutely not. That
would be surrendering to the moral bullying of a minority that wants to halt
promising medical research that could cure millions on theological grounds
that many of their fellow citizens do not share.
Ronald Bailey is Reason's science correspondent. His new book, Liberation
Biology: A Moral and Scientific Defense of the Biotech Revolution will be
published in early 2005. His coverage of the COP10 conference is also being
carried at Tech Central Station
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Swiss endorse stem cell research
Voters in Switzerland have strongly backed a new law
permitting research on the stem cells of human embryos.
BBC News
2004/11/28
Two-thirds of voters said "yes" to the government's proposals, opposed by
religious and left-wing groups.
Nationwide referendums are common in Switzerland, but this vote makes it the
first country in the world to put the controversial issue to a popular vote.
Scientists believe stem cells may hold the key to treatments for illnesses
including Parkinson's and diabetes.
Switzerland, which is a world leader in medical and pharmaceutical research,
has so far not permitted research on human embryos.
For and against
Opinion polls had indicated the Swiss were deeply divided and more than 20%
said they were finding it hard to decide how to vote on an issue which many
regard as ethical as well as scientific.
In the end, the result - a 66.4% approval - was a surprise, says the BBC's
Imogen Foulkes in Berne.
The Swiss government, the universities and the pharmaceutical industry all
urged support for embryonic stem cell research.
They said Switzerland, with its long tradition of medical research, should
not be left out of such potentially ground-breaking work.
But the Catholic Church, Switzerland's influential Green Party and medical
ethics groups oppose the new law.
Many say the claim that stem cell research could bring cures for illnesses
is offering false hope to sufferers, and they suggest cloning will be
Switzerland's next step, our correspondent says.
The proposals are strict. Research would be permitted only on cells from
embryos less than seven days old which were left over from fertilisation
treatment and due for destruction anyway.
Countries such as Britain and Sweden already have much more relaxed laws.
For many people, research into human embryos is about more than science and
economics, our correspondent says.
It raises profound questions about the best way to value human life, she
says.
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Stem cells to cure incontinence
Scientists are successfully treating stress incontinence with
a transplant of the patient's own stem cells.
BBC News
2004/11/30
Cells are removed from muscle tissue in the patient's arm, cultured in a
lab, and injected into the wall of the urethra and the sphincter muscle.
This prevents urinary incontinence - sometimes within 24 hours - by building
up muscle volume and tone.
The Medical University of Innsbruck presented their work to the Radiological
Society of North America.
"We believe we have developed a long-lasting and
effective treatment" - Dr Ferdinand
Frauscher
The transplant can be completed in just 15 to 20 minutes as an outpatient
procedure.
Lead researcher Dr Ferdinand Frauscher said: "Urinary incontinence is a
major problem for women, and for an increasing number of men.
"We believe we have developed a long-lasting and effective treatment that is
especially promising because it is generated from the patient's own body."
Stress incontinence affects nearly 15 million people - primarily women -
around the world.
It occurs when the urethra, which carries urine from the bladder, narrows or
becomes otherwise abnormal, or when the sphincter muscles that help open and
close the urethra become weak or diminished.
This leads to urine leakage when an individual exercises, coughs, sneezes,
laughs or lifts heavy objects.
Twenty women, aged 36 to 84, who were experiencing minor to severe stress
incontinence took part in the research.
Millions of new cells
Cells were taken from each patient's arm, and grown using a patented
technique which yielded 50 million new muscle cells (myoblasts) and 50
million connective tissue cells (fibroblasts) after six weeks.
When implanted into the patient under general or local anaesthesia, the new
stem cells began to replicate the existing cells nearby.
One year after the procedure, 18 of the study's 20 patients remain
continent.
Dr Frauscher said: "These are very intelligent cells. Not only do they stay
where they are injected, but also they quickly form new muscle tissue and
when the muscle mass reaches the appropriate size, the cell growth ceases
automatically."
The Innsbruck team used sophisticated 3D ultrasound to make sure the stem
cells were in contact with the correct urethra and sphincter tissue when
transplanted. This was crucial to ensure the new cells began to produce the
right type of tissue.
Stem cells are the body's master cells, capable of growing into any tissue
of the body.
Scientists believe that adult stem cells are located in small numbers
throughout the tissues of the human body, where they quietly reside until
activated by disease or injury and begin dividing.
Dr Judith Wardle, director of the Continence Foundation, welcomed the
Austrian research, but stressed that it was a small study without long-term
follow-up.
"We would want to see this treatment compared with the data on the use of
other injected substances, not just collagen," she said.
"It would also be appropriate to compare with results from the recently
launched drug, duloxetine."
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At least we will always
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The False Controversy of Stem Cells
If you think it through, the case for embryonic
research is an easy one
By MICHAEL KINSLEY
TIME Magazine, Monday, May. 31, 2004
Congratulations to representative Dana Rohrabacher, 56, and his wife Rhonda,
34, who gave birth to triplets last month. As we tend to suspect when a
couple has triplets, the new parents used the services of a fertility
clinic. Modern in-vitro techniques generally involve creating multiple
embryos in the laboratory, transferring two or three and hoping that at
least one will make it through to birth. Often it doesn't work. Sometimes it
works unexpectedly well. Successful or not, the process creates many more
embryos than babies. There is a built-in presumption — really, an intention
— that even most of the transferred embryos will die. As for embryos that
aren't transferred, they get destroyed or frozen indefinitely — unless, that
is, they are used for stem-cell research.
So it's interesting that Rohrabacher has changed his position on the medical
use of embryonic stem cells. The California Republican was a supporter of
President Bush's three-year-old policy severely restricting
government-funded stem-cell research. But he signed a recent letter to Bush
from 206 members of Congress urging the President to reconsider that policy.
Bush says he won't reconsider.
"Embryonic stem-cell studies are controversial because they involve the
destruction of human embryos," the New York Times explained in a May 6
article reporting on the shifting politics of stem-cell research. (For
example, Nancy Reagan, whose husband has Alzheimer's, has gone public with
her opposition to the Bush restrictions.) But that can't be right. Fertility
clinics destroy far more human embryos than stem-cell research ever would,
yet they are not controversial. Death or deep freeze is the fate of any
embryo spared by the Bush policy from the indignity of contributing to
medical progress.
Stamping some issue as controversial can be a substitute for thinking it
through. In the case of embryonic-stem-cell research, thinking it through
does not require further study or commissions of experts. This is one you
can feel free to try at home. In fact, thinking it through is a moral
obligation, especially if you are on the side of the argument that wants to
stop or slow this research.
It's not complicated. An embryo used in stem-cell research (and fertility
treatments) is three to five days past conception. It consists of a few
dozen cells that together are too small to be seen without a microscope. It
has no consciousness, no self-awareness, no ability to feel love or pain.
The smallest insect is far more human in every respect except potential.
Is destroying that microscopic dot the exact moral equivalent of driving a
knife through the heart of an innocent 6-year-old girl? Some stem-cell
enthusiasts think that even antiabortion absolutists can support stem-cell
research, since it uses surplus embryos that are doomed anyhow. But that
logic would justify Nazi experiments on doomed Jews in the concentration
camps. If the microscopic dot is a human being with full human rights, the
answer is easy: no stem-cell research.
But you don't have to be an abortion-rights advocate to reach the opposite
conclusion. In fact, for abortion opponents whose views fall anywhere short
of fanatical absolutism, the answer ought to be easy as well: full speed
ahead. To the nonabsolutist, it ought to matter a lot that restricting
stem-cell research doesn't actually spare the lives of any embryos. That
means the lives of real people desperately awaiting the fruits of stem-cell
research are being weighed against a purely symbolic message.
It also ought to matter to the nonfanatic that embryos are needed only to
start the research process. Most of the research and all the treatments that
come out of it will use so-called lines developed out of a few initial stem
cells in the laboratory. That makes the stem-cell issue different from — and
easier than — the one about fetal tissues a few years ago. Fetal-tissue
treatments use brain tissue from several aborted fetuses for each patient.
An embryo used in stem-cell research has nothing resembling a brain.
A difficult issue is one in which you hold two or more conflicting values.
Stem cells are not a difficult issue: either you think a microscopic embryo
has the same human rights as you and I, or you don't. Do you believe that a
woman who gets an abortion should be prosecuted for murder, just like a
mother who hires a professional killer to off her teenage son? Are you
picketing around fertility clinics, which kill hundreds of thousands of
unborn children — if that's what you believe a 5-day-old embryo to be — just
like abortion clinics do? If so, you are entitled to oppose stem-cell
research. If not, please get out of the way.
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Out of the mouths of babes:
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Of mice, men and in-between
Scientists debate blending of human, animal forms
By Rick Weiss
The Washington Post
Nov. 20, 2004
In Minnesota, pigs are being born with human blood in their veins.
In Nevada, there are sheep whose livers and hearts are largely human.
In California, mice peer from their cages with human brain cells firing
inside their skulls.
These are not outcasts from "The Island of Dr. Moreau," the 1896 novel by
H.G. Wells in which a rogue doctor develops creatures that are part animal
and part human. They are real creations of real scientists, stretching the
boundaries of stem cell research.
Biologists call these hybrid animals chimeras, after the mythical Greek
creature with a lion's head, a goat's body and a serpent's tail. They are
the products of experiments in which human stem cells were added to
developing animal fetuses.
Living test beds
Chimeras are allowing scientists to watch, for the first time, how nascent
human cells and organs mature and interact — not in the cold isolation of
laboratory dishes but inside the bodies of living creatures. Some are
already revealing deep secrets of human biology and pointing the way toward
new medical treatments.
But with no federal guidelines in place, an awkward question hovers above
the work: How human must a chimera be before more stringent research rules
should kick in?
The National Academy of Sciences, which advises the federal government, has
been studying the issue and hopes to make recommendations by February. Yet
the range of opinions it has received so far suggests that reaching
consensus may be difficult.
During one recent meeting, scientists disagreed on such basic issues as
whether it would be unethical for a human embryo to begin its development in
an animal's womb, and whether a mouse would be better or worse off with a
brain made of human neurons.
"This is an area where we really need to come to a reasonable consensus,"
said James Battey, chairman of the National Institutes of Health's Stem Cell
Task Force. "We need to establish some kind of guidelines as to what the
scientific community ought to do and ought not to do."
Beyond twins and moms
Chimeras (ki-MER-ahs) — meaning mixtures of two or more individuals in a
single body — are not inherently unnatural. Most twins carry at least a few
cells from the sibling with whom they shared a womb, and most mothers carry
in their blood at least a few cells from each child they have born.
Recipients of organ transplants are also chimeras, as are the many people
whose defective heart valves have been replaced with those from pigs or
cows. And scientists for years have added human genes to bacteria and even
to farm animals — feats of genetic engineering that allow those critters to
make human proteins such as insulin for use as medicines.
"Chimeras are not as strange and alien as at first blush they seem," said
Henry Greely, a law professor and ethicist at Stanford University who has
reviewed proposals to create human-mouse chimeras there.
But chimerism becomes a more sensitive topic when it involves growing entire
human organs inside animals. And it becomes especially sensitive when it
deals in brain cells, the building blocks of the organ credited with making
humans human.
In experiments like those, Greely told the academy last month, "there is a
nontrivial risk of conferring some significant aspects of humanity" on the
animal.
Greely and his colleagues did not conclude that such experiments should
never be done. Indeed, he and many other philosophers have been wrestling
with the question of why so many people believe it is wrong to breach the
species barrier.
Does the repugnance reflect an understanding of an important natural law? Or
is it just another cultural bias, like the once widespread rejection of
interracial marriage?
Many turn to the Bible's repeated invocation that animals should multiply
"after their kind" as evidence that such experiments are wrong. Others,
however, have concluded that the core problem is not necessarily the
creation of chimeras but rather the way they are likely to be treated.
Imagine, said Robert Streiffer, a professor of philosophy and bioethics at
the University of Wisconsin, a human-chimpanzee chimera endowed with speech
and an enhanced potential to learn — what some have called a "humanzee."
"There's a knee-jerk reaction that enhancing the moral status of an animal
is bad," Streiffer said. "But if you did it, and you gave it the protections
it deserves, how could the animal complain?"
Unfortunately, said Harvard political philosopher Michael J. Sandel,
speaking last fall at a meeting of the President's Council on Bioethics,
such protections are unlikely.
"Chances are we would make them perform menial jobs or dangerous jobs,"
Sandel said. "That would be an objection."
A research breakthrough
The potential power of chimeras as research tools became clear about a
decade ago in a series of dramatic experiments by Evan Balaban, now at
McGill University in Montreal. Balaban took small sections of brain from
developing quails and transplanted them into the developing brains of
chickens.
The resulting chickens exhibited vocal trills and head bobs unique to
quails, proving that the transplanted parts of the brain contained the
neural circuitry for quail calls. It also offered astonishing proof that
complex behaviors could be transferred across species.
No one has proposed similar experiments between, say, humans and apes. But
the discovery of human embryonic stem cells in 1998 allowed researchers to
envision related experiments that might reveal a lot about how embryos grow.
The cells, found in 5-day-old human embryos, multiply prolifically and —
unlike adult cells — have the potential to turn into any of the body's 200
or so cell types.
Scientists hope to cultivate them in laboratory dishes and grow replacement
tissues for patients. But with those applications years away, the cells are
gaining in popularity for basic research.
The most radical experiment, still not conducted, would be to inject human
stem cells into an animal embryo and then transfer that chimeric embryo into
an animal's womb. Scientists suspect the proliferating human cells would
spread throughout the animal embryo as it matured into a fetus and integrate
themselves into every organ.
Such "humanized" animals could have countless uses. They would almost
certainly provide better ways to test a new drug's efficacy and toxicity,
for example, than the ordinary mice typically used today.
But few scientists are eager to do that experiment. The risk, they say, is
that some human cells will find their way to the developing testes or
ovaries, where they might grow into human sperm and eggs. If two such
chimeras — say, mice — were to mate, a human embryo might form, trapped in a
mouse.
Not everyone agrees that this would be a terrible result.
"What would be so dreadful?" asked Ann McLaren, a renowned developmental
biologist at the University of Cambridge in England. After all, she said, no
human embryo could develop successfully in a mouse womb. It would simply
die, she told the academy. No harm done.
But others disagree — if for no other reason than nothing else out of fear
of a public backlash.
"Certainly you'd get a negative response from people to have a human embryo
trying to grow in the wrong place," said Cynthia B. Cohen, a senior research
fellow at Georgetown University's Kennedy Institute of Ethics and a member
of Canada's Stem Cell Oversight Committee, which supported a ban on such
experiments there.
How human?
But what about experiments in which scientists add human stem cells not to
an animal embryo but to an animal fetus, which has already made its eggs and
sperm? Then the only question is how human a creature one dares to make.
In one ongoing set of experiments, Jeffrey L. Platt at the Mayo Clinic in
Rochester, Minn., has created human-pig chimeras by adding
human-blood-forming stem cells to pig fetuses. The resulting pigs have both
pig and human blood in their vessels. And it's not just pig blood cells
being swept along with human blood cells; some of the cells themselves have
merged, creating hybrids.
It is important to have learned that human and pig cells can fuse, Platt
said, because he and others have been considering transplanting modified pig
organs into people and have been wondering if that might pose a risk of pig
viruses getting into patient's cells. Now scientists know the risk is real,
he said, because the viruses may gain access when the two cells fuse.
In other experiments led by Esmail Zanjani, chairman of animal biotechnology
at the University of Nevada at Reno, scientists have been adding human stem
cells to sheep fetuses. The team now has sheep whose livers are up to 80
percent human — and make all the compounds human livers make.
Zanjani's goal is to make the humanized livers available to people who need
transplants. The sheep portions will be rejected by the immune system, he
predicted, while the human part will take root.
"I don't see why anyone would raise objections to our work," Zanjani said in
an interview.
Mice and men
Perhaps the most ambitious efforts to make use of chimeras come from Irving
Weissman, director of Stanford University's Institute of Cancer/Stem Cell
Biology and Medicine. Weissman helped make the first mouse with a nearly
complete human immune system — an animal that has proved invaluable for
tests of new drugs against the AIDS virus, which does not infect
conventional mice.
More recently his team injected human neural stem cells into mouse fetuses,
creating mice whose brains are about 1 percent human. By dissecting the mice
at various stages, the researchers were able to see how the added brain
cells moved about as they multiplied and made connections with mouse cells.
Already, he said, they have learned things they "never would have learned
had there been a bioethical ban."
Now he wants to add human brain stem cells that have the defects that cause
Parkinson's disease, Lou Gehrig's disease and other brain ailments — and
study how those cells make connections.
Scientists suspect that these diseases, though they manifest themselves in
adulthood, begin when something goes wrong early in development. If those
errors can be found, researchers would have a much better chance of
designing useful drugs, Weissman said. And those drugs could be tested in
the chimeras in ways not possible in patients.
Now Weissman says he is thinking about making chimeric mice whose brains are
100 percent human. He proposes keeping tabs on the mice as they develop. If
the brains look as if they are taking on a distinctly human architecture — a
development that could hint at a glimmer of humanness — they could be
killed, he said. If they look as if they are organizing themselves in a
mouse brain architecture, they could be used for research.
So far this is just a "thought experiment," Weissman said, but he asked the
university's ethics group for an opinion anyway.
"Everyone said the mice would be useful," he said. "But no one was sure if
it should be done."
© 2004 The Washington Post Company
http://www.msnbc.msn.com/id/6534243/
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