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Benefits, risks and ethical considerations in translation of stem cell research to clinical applications in Parkinson’s disease
  1. Zubin Master1,
  2. Marcus McLeod2,
  3. Ivar Mendez3
  1. 1W. Maurice Young Centre for Applied Ethics, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2Department of Anatomy and Neurobiology, Cell Restoration Laboratory, Brain Repair Centre, Dalhousie University, Halifax, Nova Scotia, Canada
  3. 3Department of Anatomy and Neurobiology and Surgery (Neurosurgery), Cell Restoration Laboratory
  1. Correspondence to:
 Z Master
 W. Maurice Young Centre for Applied Ethics, University of British Columbia, 6356 Agricultural Road, Room 227, Vancouver, British Columbia, Canada V6T 1Z2; zubin{at}zubsplace.com

Abstract

Stem cells are likely to be used as an alternate source of biological material for neural transplantation to treat Parkinson’s disease in the not too distant future. Among the several ethical criteria that must be fulfilled before proceeding with clinical research, a favourable benefit to risk ratio must be obtained. The potential benefits to the participant and to society are evaluated relative to the risks in an attempt to offer the participants a reasonable choice. Through examination of preclinical studies transplanting stem cells in animals and the transplantation of fetal tissue in patients with Parkinson’s disease, a current set of potential benefits and risks for neural transplantation of stem cells in clinical research of Parkinson’s disease are derived. The potential benefits to research participants undergoing stem cell transplantation are relief of parkinsonian symptoms and decreasing doses of parkinsonian drugs. Transplantation of stem cells as a treatment for Parkinson’s disease may benefit society by providing knowledge that can be used to help determine better treatments in the future. The risks to research participants undergoing stem cell transplantation include tumour formation, inappropriate stem cell migration, immune rejection of transplanted stem cells, haemorrhage during neurosurgery and postoperative infection. Although some of these risks are general to neurosurgical transplantation and may not be reduced for participants, the potential risk of tumour formation and inappropriate stem cell migration must be minimised before obtaining a favourable potential benefit to risk calculus and to provide participants with a reasonable choice before they enrol in clinical studies.

  • DBS, deep brain stimulation
  • FVM, fetal ventral mesencephalic
  • IRB, institutional review board

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Footnotes

  • Competing interests: None.

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