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Chapter 21 - Stem Cells and Brain Repair: Ethical Considerations

from Part III - Future Developments

Published online by Cambridge University Press:  29 May 2020

By
Ivar Mendez
Edited by
Stephen Honeybul
Stephen Honeybul
Affiliation:
Sir Charles Gairdner Hospital, Royal Perth and Fiona Stanley Hospitals
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Summary

The rapid advance of research in stem cells has opened the door for their potential use in cell-based therapies to treat neurological conditions some of them incurable to date. Encouraging studies in animal models are moving into early phase clinical trials that hold realistic promise for the future. However, important ethical challenges remain as stem cells are translated from preclinical research to the clinical realm.Translation of stem cell–based therapies must be framed within a rigorous scientific and ethical process. This framework extends to the continuum of basic science in the laboratory, subsequent animal studies to the execution of early and late phase clinical trials in humans.Neurosurgery will play a fundamental role in the stem cell therapies of the future. New neurosurgical techniques and instruments will be developed for the delivery of stem cells to single or multiple targets within the CNS. Neurosurgeon’s roles will expand as stem cells move from clinical trials to effective potential therapies. This chapter will review selected stem cell ethical issues, that may inform and guide the practicing neurosurgeon in a rapidly moving field of great scientific promise, as well as ethical challenges

Keywords

stem cellsbrain repairstem cell ethicsfunctional neurosurgeryreconstructive neurosurgeryneural transplantationneurosurgical ethicsstereotactic neurosurgery
Type
Chapter
Information
Ethics in Neurosurgical Practice , pp. 214 - 223
Publisher: Cambridge University Press
Print publication year: 2020

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References

Evans, M. J., Kaufman, M. H. Establishment in culture of pluripotential cells from mouse embryos. Nature 1981; 292: 154–6.Google Scholar
Thomson, J. A., Itskovitz-Eldor, J., Shapiro, S. S., et al. Embryonic stem cell lines derived from human blastocysts. Science 1998; 282: 1145–7.CrossRefGoogle ScholarPubMed
Mendez-Ferrer, S., Scadden, D. T., Sanchez-Aguilera, A. Bone marrow stem cells: current and emerging concepts. Ann. NY Acad. Sci. 2015; 1335: 32–44.CrossRefGoogle ScholarPubMed
Takahashi, K., Yamanaka, S. Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors. Cell 2006; 126: 663–76.CrossRefGoogle ScholarPubMed
International Society for Stem Cell Research (ISSCR). Guidelines for the conduct of human embryonic stem cell research. 2006. Available at: www.isscr.org/docs/default-source/hesc-guidelines/isscrhescguidelines2006.pdf.Google Scholar
International Society for Stem Cell Research (ISSCR). Guidelines for the clinical translation of stem cells. 2008. Available at: www.isscr.docs/default-source/clin-trans-guidelines/isscrglclinicaltrans.pdf.Google Scholar
International Society for Stem Cell Research (ISSCR). Guidelines for stem cell research and clinical translation. 2016. Available at: www.isscr.org/guidelines2016.Google Scholar
ESHRE Taskforce on ethics and law. The moral status of the pre-implantation embryo. Hum. Reprod. 2001; 17: 1409–19.Google Scholar
Ethics Committee of American Society for Reproductive Medicine. Donating embryos for human embryonic stem cell (hESC) research: a committee opinion. Fertil. Steril. 2013; 100: 935–9.CrossRefGoogle Scholar
Department of Health, and Education and Welfare. Report of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (The Belmont Report). Fed. Reg. 1979; 23: 192.Google Scholar
Berkowitz, A. L., Miller, M. B., Mir, S. A., et al. Glioproliferative lesion of the spinal cord as a complication of ‘stem-cell tourism’. N. Engl. J. Med. 2016; 375: 196–8.CrossRefGoogle ScholarPubMed
Goldman, S. A., Nedergaard, M., Windrem, M. S. Glial progenitor cell-based treatment and modeling of neurological disease. Science 2012; 338: 491–5.Google Scholar
Thompson, L. H., Bjorklund, A. Reconstruction of brain circuitry by neural transplants generated from pluripotent stem cells. Neurobiol. Dis. 2015; 79: 28–40.Google Scholar
Mendez, I., Hong, M., Smith, S., et al. A neural transplantation cannula and microinjector system: experimental and clinical experience. J. Neurosurg. 2000; 92: 493–9.CrossRefGoogle ScholarPubMed
Lindvall, O. Dopaminergic neurons for Parkinson’s therapy. Nat. Biotechnol. 2012; 30: 56–8.Google Scholar
Barker, R. A., Barret, J., Mason, S. L., et al. Fetal dopaminergic transplantation trials and the future of neural grafting in Parkinson’s disease. Lancet. Neurol. 2013; 12: 84–91.CrossRefGoogle ScholarPubMed
Mendez, I., Sanchez-Pernaute, R., Vinuela, A., et al. Cell type analysis of fetal dopamine cell suspension transplants in striatum and substantia nigra of patients with Parkinson’s disease. Brain 2005; 128: 1498–1510.Google Scholar
Mendez, I., Vinuela, A., Astradsson, A., et al. Dopamine neurons implanted into people with Parkinson’s disease survive without pathology for 14 years. Nat. Med. 2008; 14: 507–9.Google Scholar
Master, Z., McLeod, M., Mendez, I. Benefits, risks and ethical considerations in translation of stem cell research to clinical applications in Parkinson’s disease. J. Med. Ethics. 2007; 33: 169–73.Google Scholar

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