Business on hope: a case study on private cord blood stem cell banking.

Traditionally, medical practice has been recognized as one of the professional practices with high honors. The interaction between physicians and patients is to provide health care services without the profit orientation. In modernized economy and in today's world of business, the relationship between doctors and patients has been dramatically changed. This transformation is very obvious in the private sector. Health care providers sell their services. Patients have been approached as customers. Decisions to make an investment on new medical technologies or new services would accompany with careful consideration on cost-benefit ratio, on marketing and also on short and long term return of the investment. However most of the medical services available in the past were focusing on the "real" and "tangible" products. This means that the patients or the customers would obtain diagnosis, treatment, palliation or prevention for the fees they paid. They can at least obtain and can feel some direct or indirect health benefits from the services. With the advancement of science and technology, there is recently a new model of business that sells only the hope for future use. Private cord blood stem cell banking is a good example for this business model. Actually, business on hope is not the brand new business model. Insurance is a well-known classical prototype of business on hope. However, when this kind of business model is applied for medical services, there should be some precautions and also intervention including an oversight system from the government sector to make sure that all the information delivered to the clients and family is accurate and unbiased. From the public policy perspective, this business of hope should be appropriately regulated to preserve consumer rights while promoting the advancement of science and technology through sustainable business development.

Science and society: a stem cell technology model.

Stem cell technology has been recognized as an emerging technology that could transform current supportive approach toward curing many chronic disorders and degenerative conditions. Regenerative medicine is the promising area of medical practice in the coming decade. However, stem cell technology also brings up controversial issues from the bioethical perspective such as the destruction of human embryos to derive embryonic stem cells or putting the egg donors at risk when retrieving oocytes used in somatic cell nuclear transfer technique. Recently, scientists have discovered a novel method to derive human embryonic stem cell-like cells (iPS; induced pluripotent stem cells) from human skin cells. This innovative approach would not only be a breakthrough discovery to advance the knowledge of stem cell research and the landmark for future stem cell-based therapy but will also provide viable solutions for social concerns on bioethical issues.

Policy roadmap for stem cell technology in Thailand.

Policy and technology roadmaps have been long and widely used in industry and business sectors. The primary objective of the roadmap is to be a policy and technology planning tool helping to deal with an increasingly competitive environment. The obvious benefit of roadmapping is to provide information to make better technology investment decisions by identifying critical technologies and technology gaps and identifying methods to improve research and development (R&D) investments. It can also be used as a marketing tool. Roadmapping is critical and necessary when the technology investment decision is not straightforward. This occurs when it is not clear which alternative to pursue, how soon the technology is needed, or when there is a need to coordinate the development of multiple technologies. Stem cell technology is still in its nascent stage and one of the technologies with obvious uncertainties. Moreover it involves many issues from bioethical, legal and public policy perspectives. Then, development of national policy and technology roadmap for stem cell technology is definitely required and crucial to make most benefit from this promising technology for Thailand. The present article will provide perspectives on stem cell policy roadmap and propose critical action plans for the next five-year period.

From embryonic stem cells to functioning germ cells: science, clinical and ethical perspectives.

Embryonic stem cells have been well recognized as cells having a versatile potential to differentiate into all types of cells in the body including germ cells. There are many research studies focusing on the differentiation processes and protocols to derive various types of somatic cells from embryonic stem cells. However, germ cells have unique differentiation process and developmental pathway compared with somatic cells. Consequently, they will require different differentiation protocols and special culture techniques. More understanding and established in vitro systems for gametogenesis will greatly contribute to further progression of knowledge and technology in germ cell biology, reproductive biology and reproductive medicine. Moreover if oocytes can be efficiently produced in vitro, this will play an important role on progression in nuclear transfer and nuclear reprogramming technology. The present article will provide concise review on past important discoveries, current ongoing studies and future views of this challenging research area. An ethical perspective has also been proposed to give comprehensive summary and viewpoint for future clinical application.

Intellectual property and patent in stem cell research era.

Stem cell therapy has obtained much attention, not only for its exceptional promise for curing many chronic disorders and degenerative conditions but also for its great economic potential. Apart from expenses in research laboratories and ongoing clinical trials, intellectual properties, patent of stem cell differentiation protocols, and stem cell-derived medical products for cell and tissue therapy are of very high cost. Intellectual properties and patents are inevitably important issues for stem cell researchers. Stem cell researchers in most countries have a chance to develop affordable stem cell therapy, scientific progression, and innovations for their patients. However, for this to be done, appropriate solutions for international patent barrier must be created so that the owner of the original stem cell protocols and techniques can be acknowledge, build his reputation and reap reasonable financial benefits. International patent barriers will be a crucial step to move the whole stem cell research community forward.

International trends in bioethics for embryonic stem cell research.

Embryonic stem cell (ESC) has been recognized as one of the most promising therapeutic tools for the next decade. However, there are many controversial issues in bioethics for this challenging research area. Each country has its own distinct regulations and policies for ESC research due to their differences in cultural background, religious belief and political influence. These differences will eventually play an important role on international ESC research collaboration. The present article will provide a concise summary of the different policies and regulations regarding bioethical points for ESC research worldwide and show current progress towards establishing standard bioethical guidelines for ESC research on the international level.

Future cancer management with stem cell knowledge and technology.

Cancer has been proposed as a result of abnormal control of growth and development of stem cells for more than century. This is the "cancer stem cell hypothesis". Both cancer and stem cells share many common especial properties. They are immortal and have good differentiation potential. In addition, organogenesis and carcinogenesis are very similar processes. Recently, more evidence and convincing data from stem cell biology research are supporting this concept. Furthermore, the research provides new promising approaches for cancer diagnosis and treatment based on stem cell knowledge and technology. Upcoming data and evidence may revolutionize cancer management, making it more effective and safer.

Embryonic stem cell bank.

Embryonic stem cell bank is a cornerstone for stem cell research. It is providing essential resources to support advances in research in this challenging field that promises broad-ranging cell and tissue therapy. It is important to make good quality and well characterized embryonic cell lines that will be available for both research and clinical purposes. This article provides a concise summary on embryonic stem cell banking processes from cell line characterization, storage, quality assurance, safety testing, distribution, and post-distribution monitoring. It also states the importance of an international network and collaboration for technology and knowledge transfer Moreover, the Bank should play a substantial role as a national reference and a training center for stem cell research.

Conventional and novel methods for embryonic stem cell line derivation.

Cell therapy is the promising therapeutic tool for the next decade. "Regenerative Medicine" based on cell and tissue replacement therapy is proposed as a revolutionary approach to various chronic and incurable conditions. The first key step for successful cell therapy is the establishment of clinical grade human Embryonic Stem Cell (hESC) lines. This article provides a concise summary on conventional and novel methods for hESC line derivation. There is also discussion on progression, future direction and problems in hESC line development. In Thailand, more advance knowledge, skill, and technology are required to develop the first human embryonic stem cell line and step forward to make cell therapy a reality.

Cell therapy: hype or hope.

Cell therapy is a promising therapeutic tool for the next decade. It has a potential to cure a number of chronic diseases and conditions related to aging processes or degenerative changes. In addition, it could be used to replace cells and tissues in injured organs. Furthermore, it may provide a novel approach to congenital anomalies and genetic disorders where current therapeutic options are limited However, many crucial questions need answers to ensure a safe, effective and successful solution in the field of cell therapy. In Thailand, innovative knowledge and expertise in stem cell biology and technology are required as the key elements to make cell therapy a "real" hope.

International stem cell research; networking and collaboration.

Stem cell research has obtained more attention during the last decade because of its strong potential as a new tool to cure many chronic diseases. In addition, stem cell knowledge is an important basis for understanding pathophysiology at the cellular level and developing disease models for experimental research. There are different limitations on resources, budget, policy and regulation among countries. As a result, each country has particular advantages and disadvantages in stem cell research. This result in the establishment of international networks and collaborations to coordinate and promote stem cell research aimed at medical applications.

Introduction to stem cell medicine.

Embryonic stem cell is the promising novel therapeutic tool for various degenerative diseases and tissue injuries. With the concept of cell and tissue therapy, many chronic disorders will be curable. The present article provides basic knowledge of stem cell in areas of definition, classification and future clinical applications. In addition, stem cell application is not only focusing on regenerative purpose, but also concentrating on more understanding about the early human development and the pathophysiology of genetic diseases at the cellular level. However, there are some technical problems and ethical concern that should be resolved before applying stem cells into clinical practice.