Biomedical Engineering Reference
In-Depth Information
Whether es cells for bone tissue engineering research will rank highest in
the pecking order of medical priorities is arguable.
Multipotent stem cells
multipotent stem cells, in particular mesenchymal stem cells (msc), are
the subject of intense research in bone tissue engineering (salgado
et al
.,
2004; caplan, 2007). msc do not face the ethical objections attached to es
because they can be isolated comparatively easily from the donor without
seriously harming him or her. The number of sources from which msc
can be derived is expanding, including bone marrow, umbilical cord blood,
adipose tissue, peripheral blood and others (Krampera
et al
., 2006). The
easier access and the better understanding of their developmental pathways
make msc in many cases the preferred stem cells for most researchers in
bone tissue engineering.
While the use of msc is not ethically controversial, the derivation of
these cells for allogeneic use gives rise to some challenges because these
cells will be transferred between two parties. This transfer will, however,
not be a direct transfer as it is in whole blood or organ donation, where a
donor gives his/her blood/organs to a recipent who receives this minimally
altered blood/organ. Donation of msc or other multipotent stem cells for
tissue engineering will, on the contrary, be a mediated transfer in which the
intermediaries, be they a cell bank, a tissue engineering company or any other
appropriate organisation, will take on a number of new roles. They will not
only be the primary recipients of the cells but will equally be the custodians
of the cells, guaranteeing their safe manipulation, storage and distribution.
They will most probably also be active in research, altering cells substantially
to reach specific goals and will in some cases become the producers of the
BTePs themselves, presenting them to surgeons who will eventually implant
them in the final recipient. These intermediaries will also be able to hold
intellectual property rights on cell lines and/or production processes, thus
protecting their commercial interests and being able to steer research one
way or another. cells are therefore not purely a biological matter; they are
also exchangeable entities and carriers of transmittable information. if we
look at them from this perspective, these 'ethically naïve cells' gain ethical
relevance because they establish new relationships.
16.2.3 Cells as exchangeable entities
The status of exchanged cells
no BTeP can be produced without cells. Those who provide these cells
are generally referred to as donors and we will use this term here as well.
