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      Ethical and Safety Issues of Stem Cell-Based Therapy

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          Abstract

          Results obtained from completed and on-going clinical studies indicate huge therapeutic potential of stem cell-based therapy in the treatment of degenerative, autoimmune and genetic disorders. However, clinical application of stem cells raises numerous ethical and safety concerns.

          In this review, we provide an overview of the most important ethical issues in stem cell therapy, as a contribution to the controversial debate about their clinical usage in regenerative and transplantation medicine.

          We describe ethical challenges regarding human embryonic stem cell (hESC) research, emphasizing that ethical dilemma involving the destruction of a human embryo is a major factor that may have limited the development of hESC-based clinical therapies. With previous derivation of induced pluripotent stem cells (iPSCs) this problem has been overcome, however current perspectives regarding clinical translation of iPSCs still remain. Unlimited differentiation potential of iPSCs which can be used in human reproductive cloning, as a risk for generation of genetically engineered human embryos and human-animal chimeras, is major ethical issue, while undesired differentiation and malignant transformation are major safety issues.

          Although clinical application of mesenchymal stem cells (MSCs) has shown beneficial effects in the therapy of autoimmune and chronic inflammatory diseases, the ability to promote tumor growth and metastasis and overestimated therapeutic potential of MSCs still provide concerns for the field of regenerative medicine.

          This review offers stem cell scientists, clinicians and patient's useful information and could be used as a starting point for more in-depth analysis of ethical and safety issues related to clinical application of stem cells.

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          Human stem cell research and regenerative medicine--present and future.

          Stem cells are cells with the ability to grow and differentiate into more than 200 cell types. We review here the characteristics and potential of human embryonic stem cells (hESCs), induced pluripotent stem cells (iPSCs) and adult stem cells (ASCs). The differentiation ability of all stem cell types could be stimulated to obtain specialized cells that represent renewable sources of functional cells useful for cell-based therapy. The proof of functional differentiated cells needs to be investigated in more detail using both in vitro and in vivo assays including animal disease models and clinical studies. Much progress has been made in the ASCs-based therapies. Meanwhile hESCs and iPSCs have dramatically emerged as novel approaches to understand pathogenesis of different diseases. A number of new strategies become very important in regenerative medicine. However, we discuss the limitations of stem cells and latest development in the reprogramming research.
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            Author and article information

            Journal
            Int J Med Sci
            Int J Med Sci
            ijms
            International Journal of Medical Sciences
            Ivyspring International Publisher (Sydney )
            1449-1907
            2018
            1 January 2018
            : 15
            : 1
            : 36-45
            Affiliations
            [1 ]University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Microbiology and Immunology, Center for Molecular Medicine and Stem Cell Research;
            [2 ]University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Genetics;
            [3 ]University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Histology and Embryology;
            [4 ]Institute of Genetic Medicine, Newcastle University, UK;
            [5 ]Institute of Anatomy, University of Bern, Bern, Switzerland.
            Author notes
            ✉ Corresponding author: Prof. Vladislav Volarevic, Department of Microbiology and Immunology, Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia. Phone: +38134306800; fax: +38134306800 ext. 112. E-mail: drvolarevic@ 123456yahoo.com

            Competing Interests: The authors have declared that no competing interest exists.

            Article
            ijmsv15p0036
            10.7150/ijms.21666
            5765738
            29333086
            b5a911e8-e808-4bbc-8fc1-d7d931d53e06
            © Ivyspring International Publisher

            This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license ( https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.

            History
            : 28 June 2017
            : 11 October 2017
            Categories
            Review

            Medicine
            embryonic stem cells,induced pluripotent stem cells,mesenchymal stem cells,stem cell-based therapy.

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