Advances in Experimental Medicine and Biology 1247 Cell Biology and Translational Medicine Kursad Turksen Editor Cell Biology and Translational Medicine, Volume 8 Stem Cells in Regenerative Medicine Advances in Experimental Medicine and Biology Cell Biology and Translational Medicine Volume 1247 SubseriesEditor KursadTurksen Moreinformationaboutthissubseriesathttp://www.springer.com/series/15838 Kursad Turksen Editor Cell Biology and Translational Medicine, Volume 8 Stem Cells in Regenerative Medicine Editor KursadTurksen(Retired) OttawaHospitalResearchInstitute Ottawa,ON,Canada ISSN0065-2598 ISSN2214-8019 (electronic) AdvancesinExperimentalMedicineandBiology ISSN2522-090X ISSN2522-0918 (electronic) CellBiologyandTranslationalMedicine ISBN978-3-030-45892-8 ISBN978-3-030-45893-5 (eBook) https://doi.org/10.1007/978-3-030-45893-5 #SpringerNatureSwitzerlandAG2020 The chapter “Future Cell and Gene Therapy for Osteoarthritis (OA): Potential for Using Mammalian Protein Production Platforms, Irradiated and Transfected Protein Packaging Cell Linesfor Over-Production ofTherapeuticProteins andGrowth Factors” islicensedunder the termsoftheCreativeCommonsAttribution4.0InternationalLicense(http://creativecommons. org/licenses/by/4.0/).Forfurtherdetailsseelicenseinformationinthechapter. 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Thepublisher,theauthors,andtheeditorsaresafetoassumethattheadviceandinformationin thisbookarebelievedtobetrueandaccurateatthedateofpublication.Neitherthepublishernor the authors or the editors give a warranty, expressed or implied, with respect to the material containedhereinorforanyerrorsoromissionsthatmayhavebeenmade.Thepublisherremains neutralwithregardtojurisdictionalclaimsinpublishedmapsandinstitutionalaffiliations. ThisSpringerimprintispublishedbytheregisteredcompanySpringerNatureSwitzerlandAG Theregisteredcompanyaddressis:Gewerbestrasse11,6330Cham,Switzerland Preface InthisnextvolumeintheCellBiologyandTranslationalMedicineseries,we continuetoexplorethepotentialutilityofstemcellsinregenerativemedicine. Chapters in this volume cover advances and challenges in applications of particular stem cell populations in a variety of diseases and conditions, and certaingovernanceandpolicyissuesandoptions. I remain very grateful to Gonzalo Cordova, the Associate Editor of the seriesandacknowledgehiscontinuoussupport. I would also like to acknowledge and thank Sara Germans-Huisman, Assistant Editor, for her outstanding efforts in helping to get this volume to theproductionstages. A special thank you goes to Rathika Ramkumar and Anand Venkatachalam fortheiroutstandingeffortsintheproductionofthisvolume. Finally,sincerethankstothecontributorsnotonlyfortheirsupportofthe series, but also for their insight and effort to capture both the advances and remaining obstacles in their areas of research. I trust readers will find their contributionsasinterestingandhelpfulasIhave. Ottawa,ON,Canada KursadTurksen v Contents TheFutureofStemCellResearchanditsClinicalTranslation inCanada:ExploringQuestionsofGovernanceandPolicy Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 AmyZarzeczny FutureCellandGeneTherapyforOsteoarthritis(OA): PotentialforUsingMammalianProteinProductionPlatforms, IrradiatedandTransfectedProteinPackagingCellLinesfor Over-ProductionofTherapeuticProteinsandGrowthFactors. . . 17 AliMobasheri TheHorizonofGeneTherapyinModernMedicine:Advances andChallenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 BabakArjmand,BagherLarijani,MotaharehSheikhHosseini, MoloudPayab,KambizGilany,ParisaGoodarzi, PeyvandParhizkarRoudsari,MobinaAmanollahiBaharvand, andNeginsadatHoseiniMohammadi DevelopmentsinArtificialPlateletandErythroidTransfusion Products. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 NeslihanMeric,GulenGuneyEsken,MerveUslu, andFatihKocabas AdvancingMesenchymalStemCellTherapywith CRISPR/Cas9forClinicalTrialStudies. . . . . . . . . . . . . . . . . . . . 89 AliGolchin,ForoughShams,andFarshidKarami MesenchymalStemCellsinAsthma. . . . . . . . . . . . . . . . . . . . . . . 101 TuncAkkoc OocyteAging:TheRoleofCellularandEnvironmentalFactors andImpactonFemaleFertility. . . . . . . . . . . . . . . . . . . . . . . . . . . 109 TokaA.Ahmed,SaraM.Ahmed,ZaynabEl-Gammal, ShaimaaShouman,AshrakatAhmed,RagaaMansour, andNagwaEl-Badri vii viii Contents TargetingCancerMetabolismandCellCyclebyPlant-Derived Compounds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 EsraAydemirÇoban,DidemTecimel,FikrettinŞahin, andAyşenAsl{H{zl{Deniz DifferentiationPotentialofMesenchymalStemCellsinto Pancreaticβ-Cells. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 SafaAydin,DeryaSağraç,andFikrettinŞahin ZoominginacrosstheSkin:AMacro-to-MolecularPanorama. . . 157 AyşenAslıHızlıDeniz,EzgiAvşarAbdik,HüseyinAbdik, SafaAydın,FikrettinŞahin,andPakizeNeslihanTaşlı Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 AdvExpMedBiol-CellBiologyandTranslationalMedicine(2020)8:1–16 https://doi.org/10.1007/5584_2019_450 #SpringerNatureSwitzerlandAG2019 Publishedonline:21November2019 The Future of Stem Cell Research and its Clinical Translation in Canada: Exploring Questions of Governance and Policy Options Amy Zarzeczny Abstract context is particularly timely at present given theemergingdomesticprivatemarketforstem Stem cell research is a promising area of bio- cell-basedinterventionscoupledwithscientific medicalresearchwithtremendouspotentialfor developments in the field that are highlighting increasing our understanding of human devel- ambiguities and other challengeswith ourcur- opment and for improving clinical treatment rentregulatoryframework. options across a range of serious conditions. However,ithashistoricallyalsobeenacomplex Keywords field, both scientifically and ethically. It raises numerous policy tensions including those Stemcell·Policy·Ethics·Regulation· relatedtotheacceptabilityofdifferentformsof Governance·Unproveninterventions researchinthefieldand,morerecently,regard- inghowtorespondtotherapidlygrowingpri- vate market for clinical applications that lack 1 Introduction broadly accepted forms of evidence of safety and efficacy. Using the Canadian market for Regulating fast moving fields of science, like unproven stem cell interventions as a case stem cell research, is no simple feat. One chal- study,thisreviewpaper identifiesquestions of lengepolicymakersfaceisthatitcanbedifficult governanceandpolicyoptionsastheyrelateto to predict with any accuracy both the potential the future of stem cell research and its clinical benefits and also the potential risks of new translation in Canada. Key areas of inquiry technologies and avenues of research (Butenko include the roles and influence of evidence, and Larouche 2015; Harmon et al. 2013). How- scientific and clinical imperatives, and public ever,understandingbenefitsandrisksiscritically pressure on policy decisions, as well as the important when it comes to trying to balance roleofregulationinmanagingrisksanduncer- diverse and sometimes competing policy tainty in fast moving fields of biomedicine. priorities. For example, in the stem cell field Examining these questions in a Canadian (as is true in others), there are a number of both pushes and pulls relevant to policy choices including, though certainly not limited to, the A.Zarzeczny(*) desiretostimulateeconomicgrowth,createjobs, JohnsonShoyamaGraduateSchoolofPublicPolicy, encourage biomedical developments likely to UniversityofRegina,Regina,Canada improve clinical treatment options, respond to e-mail:[email protected] 1 2 A.Zarzeczny pressure from the public, patients or other stake- 2 Stem Cells: Promises, Pitfalls holder groups, address ethical, moral, and/or and Policy Challenges otherconcerns,andberesponsivetointernational pressures.Althoughnotalwaysclearlydelineated 2.1 Context – Regulation or directly acknowledged, it is important to be and Governance of Stem Cell cognizant of these various potential influences Research in Canada on decision-making with respect to science and innovation policy (Phillips and Schmeiser 2017) Stemcellresearchisapromisingareaofbiomed- –includinginthecontextofstemcellresearch– ical research with tremendous potential for whenidentifyingandconsideringpolicyoptions. increasing our understanding of human develop- Itcanalsobedifficultforregulatorstoidentify mentandforimprovingclinicaltreatmentoptions whattoolsorstrategiesarethebestfitforagiven acrossarange ofseriousconditions.However,it area or issue in order to achieve their desired has historically also been a complex field, both objectives while limiting negative or unintended scientifically and ethically. It raises numerous effects.Inmanycases,hardlawapproachessuch policy tensions including those related to differ- as criminalization are ill-suited to regulate fields ent avenues of stem cell research. For example, thatarechangingquickly.Theirinflexiblenature early debates about the acceptability – or lack can make it difficult to adapt to unanticipated thereof–ofresearchinvolvingthedestructionof developments intheregulated field,risking legal human embryos and concerns about different ambiguityand/orunintendedconsequenceswhen kinds of applications such as reproductive clon- thelawdoesnotkeeppacewithscientificrealities ing,shapedmuchoftheearlypolicydiscoursein (Ogbogu et al. 2018b). Legal authority is also the field and featured prominently in public generally restricted by jurisdiction. Indeed, lim- forums including the media (Caulfield et al. ited jurisdictional reach for regulators is a grow- 2010) and Canadian parliamentary debates ingconcern,particularlywhenconsideringissues (CaulfieldandBubela2007). withinternationalimplicationsthatincludecross- Inmanyways,thecurrentgovernanceofstem border and internet-based activities, such as cellresearchinCanadaisaproductofthoseearly marketsforstemcell-basedinterventions(Shalev debates, with a long history of controversy. It is 2010;Sippetal.2017). beyond the scope of this paper to provide a ful- In this review paper, I will identify questions some account of that history here (see Cattapan ofgovernanceandpolicyoptionsastheyrelateto and Snow 2017). The work of the Royal Com- the future of stem cell research and its clinical mission on New Reproductive Technologies, translation in Canada, using the market for established in 1989, was particularly influential. unprovenstemcellinterventionsasacasestudy. Its1993report,ProceedwithCare–FinalReport Tosetthestageforthisdiscussion,Iwillbeginby of the Royal Commission on New Reproductive framing the relevant regulatory context and by Technologies(Baird1993),calledfortheregula- introducing what I suggest are governance tionofawiderangeofactivitiesrelatedtorepro- challenges in this space, drawing on current ductive technologies, including research using examples from the field of stem cell research to human embryos. This report was followed by a highlight specific issues. I will then use the mar- numberoffailedlegislativeinitiatives,ultimately ketforunprovenstemcellinterventionsasacase leading to the passing of the Assisted Human study to illustrate these governance challenges, Reproduction Act (S.C. 2004, c. 2) (AHRA) in and to serve as a foundation for an exploration 2004. The AHRA was federal legislation that offuturestrategies.Thepaperwillconcludewith purported to govern aspects of reproductive a brief discussion of policy options and gover- technologies as well as particular avenues of nance strategies, with a view to contributing to research. It did so by way of creating two futureresearchstrategiesinthisarea. categories of activities – those that were