Archives of Stem Cell and Research

Practical and Ethical Issues Limiting the Clinical Use of Human Embryonic Stem Cells

Review Article | Open Access | Volume 4 | Issue 1

  • 1. Medical University of Pleven, Bulgaria
+ Show More - Show Less
Corresponding Authors
David Kelly, Sir William Dunn School Of Pathology, Oxford University, Oxford, UK, Tel: 447500212994;

Stem cell research may revolutionise our understanding of how we develop and function and offer potential treatments for debilitating diseases including Parkinson’s disease, spinal cord injury and Huntington’s disease. However, Human Embryonic Stem Cell (HESC) research has been surrounded by both ethical and political controversy. The isolation of these pluripotent stem cells has caused arguments regarding the beginning of human personhood. Along with these ethical issues, several practical issues arise in HESC research including immunogenicity issues after transplantation. Legal restrictions in various countries have also hindered the progress of HESC research, creating a difficult environment for advancement in the field. Induced Pluripotent Stem Cells (IPSCs) have offered a potential replacement to HESC research by avoiding the ethical and practical issues associated with HESC. However more research and trials are required to gain a better understanding of their therapeutic mechanism of action and to assess the potential risks and side effects associated with both HESC and IPSC transplants.


•    Ethical research
•    Embryonic stem cells
•    Limitations
•    Stem cell research


Kelly J (2017) Practical and Ethical Issues Limiting the Clinical Use of Human Embryonic Stem Cells. Arch Stem Cell Res 4(1): 1018.


HESC: Human Embryonic Stem Cells; IPSCs: Induced Pluripotent Stem Cells; UCC: University College Cork; TCD: Trinity College Dublin; RPE: Retinal Pigment Epithelium


The recent breakthrough in stem cell research and the potential of Human Embryonic Stem Cells (HESCs) may lead to many revolutionary procedures and treatments. These potential therapies could be used to help alleviate or possibly cure many degenerative diseases including Parkinson’s disease, Huntington’s disease and motor neuron disease However, the generation of HESCs have been the centre of controversy in the media and in politics, causing a difference in opinion regarding the use of these cell lines. HESCs are in demand for research because of their ability to be replicated infinite numbers of times in vitro and because of their ability to differentiate into any cell type. These characteristics are the cornerstone for development of regenerative medicine and tissue engineering therapies which will be used to replace or repair damaged cells in the human body [1].

Ethical factors affecting HESC research

The removal of pluripotent stem cells from embryos is strongly linked with arguments surrounding the onset of human personhood. Human pluripotent stem cell lines are obtained from the inner cell mass of blastocyst when it is between five and seven days old [1]. However, the removal of these cells often results in the destruction of the embryo. As a result, this is a sensitive and subject which is ethically and politically controversial. Many people believe that an embryo should be considered a person and should be regarded as having the same moral status as any other human being. In religion, for example, the Catholic Church and many other religions believe that “human life begins at conception”. Therefore, with this belief, the embryo has interests and rights which demand respect, just like any other human life. This means that the derivation of HESCs from the inner cell mass of the blastocyst could be regarded as murder. However, some other religions such as Judaism argue that life does not begin until implantation of the embryo; therefore, their views are more favourable towards HESC research.

Further ethical issues which have arisen and that have caused several protests is the fact that if this type of research is given the green light, it may be an opening to a slippery slope on dehumanizing practices such as the production of “designer babies” (In which the genetic make-up of the child has been predetermined to ensure that a particular gene is present), embryo farms and human cloning.

Strict regulations are a necessity in scientific research however; a worrying practice has begun to develop in countries that do not have stringent rules regarding the practical use of stem cell therapy. “Stem Cell Tourism” poses two main threats the advancement of cellular therapy. Firstly, clinics in many locations around the globe are offering patients unregulated “cures” for many debilitating or degenerative diseases with no approval from appropriate agencies such as the U.S FDA or European equivalents. These treatments are dangerous and misleading to the patients who are spending large amounts of money in the promise of receiving effective treatment for their conditions. Most often the case is they receive a “bogus” treatment with no therapeutic benefit whatsoever. Secondly, clinics operating in this fashion are tainting the public and political opinion on legitimate stem cell therapy by authentic scientists in regulated and respected research facilities [2].

Legal issues affecting HESC research

In Ireland HESC research is currently prohibited, this is because there are no clear guidelines under Irish legislation. HESC research falls under a “grey area” of the law regarding the rights of unborn children because of the nature acquisition of the cells from human embryos [3,4]. Despite these restrictions, two Irish Universities; University College Cork (UCC) and Trinity College Dublin (TCD) have conducted HESC research using cells which were acquired from abroad [5-7].

In 2001 Ex-American President George W. Bush introduced a ban on federal funding on newly created HESCS. This restricted the type of research which was performed by scientists and hindered the sharing of information between scientists. The U.S which was once at the forefront of HESC research at the time could no longer contribute sufficiently to the international field of on-going HESCs research [8]. However, in March 2009, President Obama signed an executive order reversing the previous federal opposition to embryonic stem cell research therefore allowing the U.S scientist more opportunities to expand on their research.

Practical reasons affecting the use of HESCs

Along with these ethical issues, there are many practical and safety issues which must be addressed before implanting these cells. HESCs display several properties which are similar to cancer cells. These consist of the ability to proliferate quickly, expression of oncogenic properties (For example the expression of myc , a common oncogene was able to start the embryonic stem cell model but also caused the formation of cancer cells) and a high level of telomerase activity [9]. Therefore, it is extremely important that these factors are taking into consideration and carefully mediated for the development of safe and effective treatment methods.

One of the fundamental tests for pluripotent human stem cells is the formation of teratomas when injected into a laboratory test animal. Because of the nature of the cells, there is a risk that the formation of these cells mass could occur in human patients and form malignant tumours; therefore, it is important that we can control the proliferation and differentiation of these cells before allowing them to be transplanted [9-11].

One major setback with HESCs is that it has been demonstrated experimentally that when implanted ESCs differentiate in vivo, their immunogenicity can be drastically increased [12]. This means that many patients would have to be treated using immune suppressing drugs to fight the body’s attempt to reject these newly transplanted cells. This can increase the risk of liver and renal toxicity and immunodeficiency [13].

Alternatives to HESCs treatment

Due to all the factors whether they are ethical, physical, legal or political regarding the use of HESCs, scientists have pursued other avenues to develop cell based treatments for various diseases. Induced Pluripotent Stem Cells (IPSCs) are pluripotent cells derived from regular somatic cells such as fibroblasts. These cells demonstrate very similar characteristics as seen in HESCs and because these cells are derived from adult donors they are not subject to the ethical scrutiny as HESCs. IPSCs also have practical benefits because a personalised treatment can be theoretically provided for the patient using their own cells eliminating the risk of immune rejection. However there have been some studies which have shown that there is a possibility of an immune response [14].


The use of HESCs in research is still a controversial and sensitive subject with many factors coming into play including ethical, physical, legal and political. These factors have contributed to a hindrance in the progress in HESC research in both the U.S and in Europe. Despite these factors progress is being made in the field and clinical trials are happening for example one study involves the sub-retinal transplantation of HESC-derived retinal pigment epithelium (RPE) in patients with Stargardt’s macular dystrophy and dry age-related macular degeneration. This is the leading cause of blindness in the developing world [15]. Although there has been much progress in alternative methods of creating pluripotent cells through IPSC, there is still much more research needed in this field as many of these cell lines have only been tested in animal test models therefore further research is needed to ensure patients receive a safe and effective treatment.


1. Rippon HJ, Bishop AE. Embryonic stem cells. Cell Prolif. 2004; 37: 23- 34.

2. Kolata G. “A cautionary tale of ‘Stem Cell Tourism’.” The New York Times. 2016.

3. Lo B, Parham L, editors. Ethical issues in stem cell research. Endocr Rev. 2009; 30: 204-213

4. Lenoir N. Europe confronts the embryonic stem cell research challenge. Science. 2000; 287: 1425-1427.

5. Campbell S. Breakthrough in the understanding of Embryonic Stem Cells. Trinity College Dublin; 2012

6. Condon D. UUC to allow controversial stem cell research; Irish health. 2008.

7. Warning over lack of laws on stem cell research; Irish Examiner; 2010.

8. Murugan V. Embryonic Stem Cell Research: A Decade of Debate from Bush to Obama. Yale J Biol Med. 2009; 82: 101.

9. Baker M. Cancer and embryonic stem cells share genetic fingerprints. Nature Reports Stem Cells. 2008.

10. Takahashi K, Yamanaka S. Induction of pluripotent stem cells from mouse embryonic and adult fibroblast cultures by defined factors. Cell. 2006; 126: 663-676.

11. Takahashi K, Tanabe K, Ohnuki M, Narita M, Ichisaka T, Tomoda K, et al. Induction of pluripotent stem cells from adult human fibroblasts by defined factors. Cell. 2007; 131: 861-872.

12. Thomson JA, Itskovitz-Eldor J, Shapiro SS, Waknitz MA, Swiergiel JJ, Marshall VS, et al. Embryonic stem cell lines derived from human blastocysts. Science. 1998; 282: 1145-1147.

13. Swijnenburg R-J, Tanaka M, Vogel H, Baker J, Kofidis T, Gunawan F, et al. Embryonic stem cell immunogenicity increases upon differentiation after transplantation into ischemic myocardium. Circulation. 2005; 112: 66-72.

14. Deshmukh RS, Kovács KnA, Dinnyés As. Drug discovery models and toxicity testing using embryonic and induced pluripotent stemcell-derived cardiac and neuronal cells. Stem cells International. 2012.

15. Zhao T, Zhang Z-N, Rong Z, Xu Y. Immunogenicity of induced pluripotent stem cells. Nature. 2011; 474: 212-215.

16. Schwartz SD, Hubschman JP, Heilwell G, Franco-Cardenas V, Pan CK, Ostrick RM, et al. Embryonic stem cell trials for macular degeneration: a preliminary report. The Lancet. 2012; 379: 713- 720.

Kelly J (2017) Practical and Ethical Issues Limiting the Clinical Use of Human Embryonic Stem Cells. Arch Stem Cell Res 4(1): 1018

Received : 26 Sep 2017
Accepted : 05 Dec 2017
Published : 08 Dec 2017
Annals of Otolaryngology and Rhinology
ISSN : 2379-948X
Launched : 2014
JSM Schizophrenia
Launched : 2016
Journal of Nausea
Launched : 2020
JSM Internal Medicine
Launched : 2016
JSM Hepatitis
Launched : 2016
JSM Oro Facial Surgeries
ISSN : 2578-3211
Launched : 2016
Journal of Human Nutrition and Food Science
ISSN : 2333-6706
Launched : 2013
JSM Regenerative Medicine and Bioengineering
ISSN : 2379-0490
Launched : 2013
JSM Spine
ISSN : 2578-3181
Launched : 2016
Archives of Palliative Care
ISSN : 2573-1165
Launched : 2016
JSM Nutritional Disorders
ISSN : 2578-3203
Launched : 2017
Annals of Neurodegenerative Disorders
ISSN : 2476-2032
Launched : 2016
Journal of Fever
ISSN : 2641-7782
Launched : 2017
JSM Bone Marrow Research
ISSN : 2578-3351
Launched : 2016
JSM Mathematics and Statistics
ISSN : 2578-3173
Launched : 2014
Journal of Autoimmunity and Research
ISSN : 2573-1173
Launched : 2014
JSM Arthritis
ISSN : 2475-9155
Launched : 2016
JSM Head and Neck Cancer-Cases and Reviews
ISSN : 2573-1610
Launched : 2016
JSM General Surgery Cases and Images
ISSN : 2573-1564
Launched : 2016
JSM Anatomy and Physiology
ISSN : 2573-1262
Launched : 2016
JSM Dental Surgery
ISSN : 2573-1548
Launched : 2016
Annals of Emergency Surgery
ISSN : 2573-1017
Launched : 2016
Annals of Mens Health and Wellness
ISSN : 2641-7707
Launched : 2017
Journal of Preventive Medicine and Health Care
ISSN : 2576-0084
Launched : 2018
Journal of Chronic Diseases and Management
ISSN : 2573-1300
Launched : 2016
Annals of Vaccines and Immunization
ISSN : 2378-9379
Launched : 2014
JSM Heart Surgery Cases and Images
ISSN : 2578-3157
Launched : 2016
Annals of Reproductive Medicine and Treatment
ISSN : 2573-1092
Launched : 2016
JSM Brain Science
ISSN : 2573-1289
Launched : 2016
JSM Biomarkers
ISSN : 2578-3815
Launched : 2014
JSM Biology
ISSN : 2475-9392
Launched : 2016
Annals of Clinical and Medical Microbiology
ISSN : 2578-3629
Launched : 2014
JSM Pediatric Surgery
ISSN : 2578-3149
Launched : 2017
Journal of Memory Disorder and Rehabilitation
ISSN : 2578-319X
Launched : 2016
JSM Tropical Medicine and Research
ISSN : 2578-3165
Launched : 2016
JSM Head and Face Medicine
ISSN : 2578-3793
Launched : 2016
JSM Cardiothoracic Surgery
ISSN : 2573-1297
Launched : 2016
JSM Bone and Joint Diseases
ISSN : 2578-3351
Launched : 2017
JSM Bioavailability and Bioequivalence
ISSN : 2641-7812
Launched : 2017
JSM Atherosclerosis
ISSN : 2573-1270
Launched : 2016
Journal of Genitourinary Disorders
ISSN : 2641-7790
Launched : 2017
Journal of Fractures and Sprains
ISSN : 2578-3831
Launched : 2016
Journal of Autism and Epilepsy
ISSN : 2641-7774
Launched : 2016
Annals of Marine Biology and Research
ISSN : 2573-105X
Launched : 2014
JSM Health Education & Primary Health Care
ISSN : 2578-3777
Launched : 2016
JSM Communication Disorders
ISSN : 2578-3807
Launched : 2016
Annals of Musculoskeletal Disorders
ISSN : 2578-3599
Launched : 2016
Annals of Virology and Research
ISSN : 2573-1122
Launched : 2014
JSM Renal Medicine
ISSN : 2573-1637
Launched : 2016
Journal of Muscle Health
ISSN : 2578-3823
Launched : 2016
JSM Genetics and Genomics
ISSN : 2334-1823
Launched : 2013
JSM Anxiety and Depression
ISSN : 2475-9139
Launched : 2016
Clinical Journal of Heart Diseases
ISSN : 2641-7766
Launched : 2016
Annals of Medicinal Chemistry and Research
ISSN : 2378-9336
Launched : 2014
JSM Pain and Management
ISSN : 2578-3378
Launched : 2016
JSM Women's Health
ISSN : 2578-3696
Launched : 2016
Clinical Research in HIV or AIDS
ISSN : 2374-0094
Launched : 2013
Journal of Endocrinology, Diabetes and Obesity
ISSN : 2333-6692
Launched : 2013
Journal of Substance Abuse and Alcoholism
ISSN : 2373-9363
Launched : 2013
JSM Neurosurgery and Spine
ISSN : 2373-9479
Launched : 2013
Journal of Liver and Clinical Research
ISSN : 2379-0830
Launched : 2014
Journal of Drug Design and Research
ISSN : 2379-089X
Launched : 2014
JSM Clinical Oncology and Research
ISSN : 2373-938X
Launched : 2013
JSM Bioinformatics, Genomics and Proteomics
ISSN : 2576-1102
Launched : 2014
JSM Chemistry
ISSN : 2334-1831
Launched : 2013
Journal of Trauma and Care
ISSN : 2573-1246
Launched : 2014
JSM Surgical Oncology and Research
ISSN : 2578-3688
Launched : 2016
Annals of Food Processing and Preservation
ISSN : 2573-1033
Launched : 2016
Journal of Radiology and Radiation Therapy
ISSN : 2333-7095
Launched : 2013
JSM Physical Medicine and Rehabilitation
ISSN : 2578-3572
Launched : 2016
Annals of Clinical Pathology
ISSN : 2373-9282
Launched : 2013
Annals of Cardiovascular Diseases
ISSN : 2641-7731
Launched : 2016
Journal of Behavior
ISSN : 2576-0076
Launched : 2016
Annals of Clinical and Experimental Metabolism
ISSN : 2572-2492
Launched : 2016
Clinical Research in Infectious Diseases
ISSN : 2379-0636
Launched : 2013
JSM Microbiology
ISSN : 2333-6455
Launched : 2013
Journal of Urology and Research
ISSN : 2379-951X
Launched : 2014
Journal of Family Medicine and Community Health
ISSN : 2379-0547
Launched : 2013
Annals of Pregnancy and Care
ISSN : 2578-336X
Launched : 2017
JSM Cell and Developmental Biology
ISSN : 2379-061X
Launched : 2013
Annals of Aquaculture and Research
ISSN : 2379-0881
Launched : 2014
Clinical Research in Pulmonology
ISSN : 2333-6625
Launched : 2013
Journal of Immunology and Clinical Research
ISSN : 2333-6714
Launched : 2013
Annals of Forensic Research and Analysis
ISSN : 2378-9476
Launched : 2014
JSM Biochemistry and Molecular Biology
ISSN : 2333-7109
Launched : 2013
Annals of Breast Cancer Research
ISSN : 2641-7685
Launched : 2016
Annals of Gerontology and Geriatric Research
ISSN : 2378-9409
Launched : 2014
Journal of Sleep Medicine and Disorders
ISSN : 2379-0822
Launched : 2014
JSM Burns and Trauma
ISSN : 2475-9406
Launched : 2016
Chemical Engineering and Process Techniques
ISSN : 2333-6633
Launched : 2013
Annals of Clinical Cytology and Pathology
ISSN : 2475-9430
Launched : 2014
JSM Allergy and Asthma
ISSN : 2573-1254
Launched : 2016
Journal of Neurological Disorders and Stroke
ISSN : 2334-2307
Launched : 2013
Annals of Sports Medicine and Research
ISSN : 2379-0571
Launched : 2014
JSM Sexual Medicine
ISSN : 2578-3718
Launched : 2016
Annals of Vascular Medicine and Research
ISSN : 2378-9344
Launched : 2014
JSM Biotechnology and Biomedical Engineering
ISSN : 2333-7117
Launched : 2013
Journal of Hematology and Transfusion
ISSN : 2333-6684
Launched : 2013
JSM Environmental Science and Ecology
ISSN : 2333-7141
Launched : 2013
Journal of Cardiology and Clinical Research
ISSN : 2333-6676
Launched : 2013
JSM Nanotechnology and Nanomedicine
ISSN : 2334-1815
Launched : 2013
Journal of Ear, Nose and Throat Disorders
ISSN : 2475-9473
Launched : 2016
JSM Ophthalmology
ISSN : 2333-6447
Launched : 2013
Journal of Pharmacology and Clinical Toxicology
ISSN : 2333-7079
Launched : 2013
Annals of Psychiatry and Mental Health
ISSN : 2374-0124
Launched : 2013
Medical Journal of Obstetrics and Gynecology
ISSN : 2333-6439
Launched : 2013
Annals of Pediatrics and Child Health
ISSN : 2373-9312
Launched : 2013
JSM Clinical Pharmaceutics
ISSN : 2379-9498
Launched : 2014
JSM Foot and Ankle
ISSN : 2475-9112
Launched : 2016
JSM Alzheimer's Disease and Related Dementia
ISSN : 2378-9565
Launched : 2014
Journal of Addiction Medicine and Therapy
ISSN : 2333-665X
Launched : 2013
Journal of Veterinary Medicine and Research
ISSN : 2378-931X
Launched : 2013
Annals of Public Health and Research
ISSN : 2378-9328
Launched : 2014
Annals of Orthopedics and Rheumatology
ISSN : 2373-9290
Launched : 2013
Journal of Clinical Nephrology and Research
ISSN : 2379-0652
Launched : 2014
Annals of Community Medicine and Practice
ISSN : 2475-9465
Launched : 2014
Annals of Biometrics and Biostatistics
ISSN : 2374-0116
Launched : 2013
JSM Clinical Case Reports
ISSN : 2373-9819
Launched : 2013
Journal of Cancer Biology and Research
ISSN : 2373-9436
Launched : 2013
Journal of Surgery and Transplantation Science
ISSN : 2379-0911
Launched : 2013
Journal of Dermatology and Clinical Research
ISSN : 2373-9371
Launched : 2013
JSM Gastroenterology and Hepatology
ISSN : 2373-9487
Launched : 2013
Annals of Nursing and Practice
ISSN : 2379-9501
Launched : 2014
JSM Dentistry
ISSN : 2333-7133
Launched : 2013
Author Information X