The University of Southampton

Chimera Concerns

World First:

The first human/animal chimera was a human/rabbit chimera documented in Cell Research 2003 where the scientists from Shanghai Second Medical University fused human skin cells with rabbit eggs and allowed them to develop in laboratory dishes for several days before their human embryonic stem cells were harvested. This raises many ethical issues, specifically with embryonic stem cell harvesting as many people see the destruction of the embryo to retrieve these cells to be ending a human life, and some scientists even argue the research is not necessary in the first place.

Primate Chimeras:

A simplified diagram of the processed used to produce the human/monkey chimera cells.

The negative reaction to the 2003 paper did not deter a team of researchers from China, Spain and the USA from creating the first human/monkey chimera in 2021, who injected human epithelial pluripotent stem cells (hEPSCs) into macaque blastocysts.

This video shows the growth of one of the chimeric embryos, with the human cells highlighted in orange where you can see them migrating and undergoing mitosis.

Images of the chimera cells under different staining

In over half of the injected embryos TD+ human cells were found within the embryonic disc which is responsible for detaching embryonic cells from the blastocyst walls and forms a trilaminar embryo- an important step in embryonic development.

Ethical Considerations:

As it stands at the embryonic stage of development there are already ethical concerns with regard to the harvesting of embryonic stem cells from these chimera embryos, as some consider this to be killing a living organism, however if these cells were allowed to grow and able to produce an adult organism the concerns become even more sinister- organ farming.

Growing human organs in animals for the sole purpose of transplanting them into awaiting human patients is a conflicted topic for many reasons. Jehovah’s Witnesses famously refuse blood transfusions, and many more would likely object to receiving an organ grown inside an animal. The possibility of growing human organs using the patient’s own cells may persuade more, but many would still object to receiving an organ grown inside of an animal. Furthermore, there are research limitations on primates due to their similarity with humans, but it is this very similarity which could make them one of the best candidates for organ farming.

On the other side of the fence, you could argue that harvesting organs from animals like monkeys and pigs is no different than farming any other sort of animal product, with the added benefit of saving lives. One of the considerations with chimera organ harvesting is which animals we create chimeras from. Monkeys are typically thought in the west to be too intelligent to eat, and many religions disallow the consumption of pork so would likely refuse organs from one too, however pigs and monkeys are typically viewed as the best vessels for growing human organs. If the animal used is already farmed en masse, how bad is it really?

According to the HRSA website, there are 104,234 people in the US on the national transplant waiting list as of 24/03/23, and 17 people die every day waiting for an organ transplant. over 42,000 organ transplants were performed in the US in 2022. If human/monkey chimera technology advanced to the point of transplanting mature organs into human recipients, it could help to alleviate the organ crisis we face in the world today.

Human/animal chimeras for organ harvesting could save thousands in the future, but is it worth sacrificing animals to play God?

Commercial Autogenic Cell Therapy Evolution at a Glance.

The lectures I recently received about tissue engineering piqued my interest, specifically with the commercial availability of autogenic cells such as CarticelTM and as I looked further the development of such products was very interesting.

The 4 generations of autogenic chondrocyte implantation (ACI):

First Generation:

A 1st generation ACI procedure is shown in the video below where you can see the harvesting of periosteal tissue from the tibia, suturing of the periosteum into the knee joint, securing with fibrin glue and finally the injection of chondrocytes below this periosteal patch. Genzyme is a company which delivers this service and has reported success rates of 70-90%. Problems with this procedure include overgrowth of the implanted cells which can degrade joint function and cause pain; however this can be easily fixed by the shaving away of excess cartilage. Procedures of this type cost around $40,000, far too expensive for many people, especially in countries without nationalised healthcare such as America where insurance may not cover the procedure.

Second Generation:

Carticel is an example of 2nd generation ACI. A biopsy of cartilage is taken from lesser weight bearing areas so that chondrocyte cells can be isolated and expanded over a period of 4-6 weeks. The expanded cells are reinserted into the damaged joint to form new, healthy cartilage. On their website, Carticel states that their product is intended for the repair of “symptomatic cartilage defects of the femoral condyle caused by acute or repetitive trauma, in patients who have had an inadequate response to a prior arthroscopic or other surgical procedure”. According to the Bioinformant, Carticel autologous chondrocyte implantation costs between $15,000 and $35,000. This cost raises ethical questions because a large subset of people who would benefit from this procedure cannot afford it.

Third Generation:

Spherox is a company which offers 3rd generation ACI with a £10,000 price tag, however the Royal Orthopaedic Hospital (ROH) in Birmingham has provided this procedure and it is now eligible for patients on the NHS according to the ROH website. Spherox works in a different way to Carticel, by taking chondrocytes and producing spheroids of neocartilage composed of expanded autologous chondrocytes and their associated matrix. A sample of healthy tissue is taken from the patient in keyhole surgery and the sample is grown into chondrocyte spheroids. When the spheroids are implanted into the patient’s knee cartilage, they bind to the defective tissue and produce new cartilage tissue. For NHS patients in the UK, Spherox has far fewer ethical concerns regarding cost because the price of the operation is less than the cost caused by such injuries if left untreated to both the NHS and the patient’s quality of life.

The Future:

4th generation ACI therapy has not yet entered mainstream medicine, however various trials are underway. Some research is investigating the role of gene therapy in cartilage repair producing “temporarily and spatially defined delivery of therapeutic molecules to sites of cartilage damage”. According to this paper, the use of elastin as a scaffold is being investigated, as well as the use of a nonviral gene delivery system to allow mesenchymal stem cells to produce osteogenic growth factors.