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Research articles
- Deciphering Developmental Disorders
- Huntington's disease - PubMed Health
- Huntington's Disease Association
In October last year, it was announced that preimplantation genetic diagnosis had been used successfully to select an embryo that was both free of the genetic disease Fanconi's anaemia (of which both parents were carriers), and a good tissue match for his affected older sister, whose best chance of survival was a cord blood transplant from an HLA-identical donor. The scientific paper reporting this achievement has now been published [Verlinsky, Y. et al (2001) JAMA 285, 3130-3133 (Abstract)]. The couple underwent four IVF cycles, resulting in 33 embryos that were tested for the FANCC gene mutation carried by both parents. 24 were unaffected (19 heterozygous carriers and 5 homozygous normal), of which five heterozygous carriers were HLA-identical to the couple's daughter. Only the single one of these that was transferred in the fourth IVF cycle resulted in a viable pregnancy. Cord blood collected from the baby at birth was transplanted to his older sister, a treatment that appears to have been successful.
Comment: The initial report of this work roused much discussion about its ethical dimension: whether it is right to select a child on the basis of its "usefulness" to another family member. On the other hand, as pointed out by the authors and some commentators, if the technology exists to satisfy simultaneously a couple's desire to have a healthy child and to save a much loved existing child, is it wrong to use it?
- Technology Strategy Board (TSB)
- Royal College of Midwives
- Royal College of Obstetricians and Gynaecologists
Several newspapers recently ran stories with headlines such as "Royal Society condemns human cloning". The report these stories refer to, with the low-key title "Stem cell research - second update", is in fact not focused on reproductive cloning at all. The report does indeed recommend that, on ethical and safety grounds, reproductive cloning should not be allowed, but its main thrust is a discussion of recent advances in stem cell research. There have, for example, been several papers published recently that appeared to show much greater potential for adult stem cells than had previously been thought to be the case, and this work has been cited by those who oppose the use of embryo-derived stem cells. The Royal Society report makes an extremely useful contribution in discussing clearly the claims that have been made for adult stem cells, and explaining their current limitations on both scientific and practical grounds. The report recommends that both adult and embryonic stem cell research should be pursued. In reaching this conclusion, the Royal Society is in tune with recommendations that emerged from a recent US National Academy of Sciences workshop, arguing against placing too much reliance on the potential of adult stem cells and urging legislators to allow stem cell research (see report in Nature 411, page 979).
The Royal Society report, which has been submitted as evidence to the parliamentary committee enquiring into stem cell research and "therapeutic cloning", also deals with questions concerning the effects of globalisation, e-commerce and patenting on the stem cell debate, and the difficulties that would surround any attempt to reach consensus at an international level. These difficulties are highlighted by the deep divisions elsewhere in Europe. The French government proposes allowing research on stem cells derived from "spare" IVF embryos, but has decided not to proceed with proposals to allow therapeutic cloning (see news report in Lancet, 30 June). In Germany, political pressure has forced the main research funding agency to delay further a decision on funding a research project on human embryonic stem cells (see report in Nature, 21 June). For further information on stem cell policy development in the UK and elsewhere, see the stem cells page in the information database. 2/7/01
Note added 3/7/01: The European Science Foundation, a body representing 67 major organisations devoted to scientific research in 24 European countries, has just issued a policy briefing which recommends that research should be allowed on both embryonic stem cells and therapeutic cloning, but that this research should be under strong regulatory control. The document contains a useful summary of the current position with regard to stem cell research across Europe
Developmental biology researchers have warned those who are eager to begin trying to clone human beings that, just as in animals, the success rate would probably be very low and the dangers of producing abnormal babies would be high. Humpherys and colleagues have published evidence, in mice, of some of the sorts of abnormalities that might be expected [Humperys D. et al (2001) Science 293, 95-97]. They looked, in particular, at changes in the expression of imprinted genes: genes that normally show differential expression of the maternal and paternal alleles. Several of these genes are known to be involved in controlling the growth of the embryo and fetus, and changes in their imprinting can lead to excess or restricted growth, along with other abnormalities. Cloned mouse embryos showed widely varying relative levels of expression of several genes that are normally imprinted; variability was also observed in the embryonic stem cells that were used to provide the donor nuclei for the cloning procedure. Cloned mouse pups also tended to be abnormally large, though the degree of overgrowth could not be correlated with the abnormalities in imprinting of any of the genes examined. Even those cloned mice that survived to adulthood showed clear evidence of misregulation of the expression of imprinted genes. There is as yet no way of knowing whether cloned humans would show similar misregulation of imprinted genes, or, if so, what effects these abnormalities might have on their health.
Comment: The potential hazards of human reproductive cloning are, at present, extremely serious, and justify the decision of many governments to ban attempts to carry it out.
