[Ethics of stem cell therapy for heart failure]. / Terapia con células madre e insuficiencia cardiaca: aspectos éticos.

Heart failure is one of the first diseases in which stem cells were used for regenerative medicine. Since 2001, many publications have shown that stem cell therapy has the potential to mitigate heart diseases, but there is no solid scientific evidence to fully support its clinical application at present. The future of regenerative medicine requires validated clinical trials with standardized platforms and transdisciplinary efforts to enable the development of safe and effective regenerative therapies to protect patients and to promote the ethical application of this new and highly promising therapy. Doctors and scientists have a responsibility to discuss with patients the current reality of regenerative therapies. They also have a responsibility to discourage the indiscriminate and commercial use of these therapies, which are sometimes based on false hopes, since their inappropriate use can harm vulnerable patients as well as research efforts. Although regenerative medicine may be the medicine of the future and might bring the hope of cure for chronic diseases, it is not yet ready for its wide clinical application.

Terapia con células madre e insuficiencia cardiaca: aspectos éticos / Ethics of stem cell therapy for heart failure

Heart failure is one of the first diseases in which stem cells were used for regenerative medicine. Since 2001, many publications have shown that stem cell therapy has the potential to mitigate heart diseases, but there is no solid scientific evidence to fully support its clinical application at present. The future of regenerative medicine requires validated clinical trials with standardized platforms and transdisciplinary efforts to enable the development of safe and effective regenerative therapies to protect patients and to promote the ethical application of this new and highly promising therapy. Doctors and scientists have a responsibility to discuss with patients the current reality of regenerative therapies. They also have a responsibility to discourage the indiscriminate and commercial use of these therapies, which are sometimes based on false hopes, since their inappropriate use can harm vulnerable patients as well as research efforts. Although regenerative medicine may be the medicine of the future and might bring the hope of cure for chronic diseases, it is not yet ready for its wide clinical application.

Stem cells: sources and therapies.

The historical, lexical and conceptual issues embedded in stem cell biology are reviewed from technical, ethical, philosophical, judicial, clinical, economic and biopolitical perspectives. The mechanisms assigning the simultaneous capacity to self-renew and to differentiate to stem cells (immortal template DNA and asymmetric division) are evaluated in the light of the niche hypothesis for the stemness state. The induction of cell pluripotency and the different stem cells sources are presented (embryonic, adult and cord blood). We highlight the embryonic and adult stem cell properties and possible therapies while we emphasize the particular scientific and social values of cord blood donation to set up cord blood banks. The current scientific and legal frameworks of cord blood banks are reviewed at an international level as well as allogenic, dedicated and autologous donations. The expectations and the challenges in relation to present-day targeted diseases like diabetes mellitus type I, Parkinson's disease and myocardial infarction are evaluated in the light of the cellular therapies for regenerative medicine.

[Hybrid embryos as a source of embryonic stem cells]. / Embriones híbridos como fuente de células troncales embrionarias.

The HFEA (Human Fertilisations & Embryology Authority) recently accepted to perform research in hybrid embryos generated by transferring human somatic cell nucleus to cow enucleated oocytes, named cytoplasmatic hybrids. The aim is to obtain a source of embryonic stem cells without the use of human oocytes. The arguments for the approval are to avoid the risk of obtaining human oocytes and that these embryos will not be transferred to a female's womb for its development. Those who oppose the technique argue that it is a manipulation of the beginning of life and a disrespect to the dignity of human life because of the destruction of embryos. Nevertheless, the real nature of this new entity has not been established. Biologically it is an embryo with 99% of human genome and animal's cytoplasm, not generated from human gametes, it is not a new genome and it will be used only to cultivate stem cells. It does not seem possible to define its nature beyond any doubts. If it were considered as a human embryo it should be respected and protected as every human being. Once more, scientific progress opens new ethical and legal questions that we cannot answer in a definitive way. Researchers are exploring new roads to obtain pluripotential stem cells which should favor the development of innovative therapies. The main objection is the unavoidable destruction of human embryos, although in this case its origin and nature are not clear.

[Spinal cord injury and regenerative medicine]. / Lesión de médula espinal y medicina regenerativa.

Spinal cord injury (SCI) is a trauma problem striking mainly working age adults, therefore affecting society beyond the victims family circle. Most of the victims of SCI will never recover; therapy for this type of injury consists basically on spinal cord support and stabilization. With the discovery of stem cells (SC), SCI treatment has been given another chance. Stem cells are responsible for tissue renewal throughout the individuals life, as well as tissue repair when needed. From the therapeutic point of view, the most appealing SC are those capable of generating a variety of tissues, those easily harvested, and finally, those ethically unquestioned. This article summarizes some studies carried with SC of various origins and their application to SCI treatment.

[Biotechnology and relevant aspects of the New Biosafety law]. / Biotecnología y aspectos relevantes de la Nueva ley de Bioseguridad.

On 24 March 2005, the President of the Federative Republic of Brazil approved the New Law on Biosecurity. This law has very diverse aspects, ranging from the genetically modified organisms to the genetic manipulation of human embryos or the liberalisation of the transgenic soy crops during 2004-2005. This article tries to analyse and criticise the content of the law, highlighting the genetic research and experimentation, the GMOs and their effect in the environment and the criminal responsibility derived from such actions. Likewise, it leaves rooms for the reader to reach his/her own conclusions. The author poses the moral dilemma on whether it is legitimate to make governmental decisions solely taking into account the economic and political interests, leaving aside the opinion of society.

Reflexiones acerca de células troncales obtenidas mediante la utilización de embriones humanos / Reflections about steam cells obtained by means of the utilization of human embryos

Se comentan los aspectos éticos de la obtención de células troncales de embriones humanos.