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Moral obligations in conducting stem cell-based therapy trials for autism spectrum disorder
  1. Nicole Shu Ling Yeo-Teh1,
  2. Bor Luen Tang1,2
  1. 1 Research Compliance and Integrity Office, National University of Singapore, Singapore
  2. 2 Department of Biochemistry, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore, Singapore
  1. Correspondence to Dr Nicole Shu Ling Yeo-Teh, Research Compliance and Integrity Office, National University of Singapore, Singapore; dprysln{at}; Dr Bor Luen Tang; bchtbl{at}


Unregulated patient treatments and approved clinical trials have been conducted with haematopoietic stem cells and mesenchymal stem cells for children with autism spectrum disorder (ASD). While the former direct-to-consumer practice is usually considered rogue and should be legally constrained, regulated clinical trials could also be ethically questionable. Here, we outline principal objections against these trials as they are currently conducted. Notably, these often lack a clear rationale for how transplanted cells may confer a therapeutic benefit in ASD, and thus, have ill-defined therapeutic outcomes. We posit that ambiguous and unsubstantiated descriptions of outcome from such clinical trials may nonetheless appeal to the lay public as being based on authentic scientific findings. These may further fuel caregivers of patients with ASD to pursue unregulated direct-to-consumer treatments, thus exposing them to unnecessary risks. There is, therefore, a moral obligation on the part of those regulating and conducting clinical trials of stem cell-based therapeutic for ASD minors to incorporate clear therapeutic targets, scientific rigour and reporting accuracy in their work. Any further stem cell-based trials for ASD unsupported by significant preclinical advances and particularly sound scientific hypothesis and aims would be ethically indefensible.

  • stem cell research
  • clinical trials
  • research ethics
  • clinical ethics
  • research on special populations

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  • Correction notice This paper has been updated since first published to update author details for author 'Bor Luen Tang'.

  • Contributors BLT conceived, drafted and reviewed the manuscript. NY drafted and reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.