Lab-grown sperm and eggs: ‘epigenetic’ reset in human cells paves the way

Heidi Ledford

Nature

https://doi.org/10.1038/d41586-024-01404-x

Here is an excerpt:

Growing human sperm and eggs in the laboratory would offer hope to some couples struggling with infertility. It would also provide a way to edit disease-causing DNA sequences in sperm and eggs, sidestepping some of the technical complications of making such edits in embryos. And understanding how eggs and sperm develop can give researchers insight into some causes of infertility.

But in addition to its technical difficulty, growing eggs and sperm in a dish — called in vitro gametogenesis — would carry weighty social and ethical questions. Genetic modification to prevent diseases, for example, could lead to genetic enhancement to boost traits associated with intelligence or athleticism.

Epigenetic reprogramming is key to the formation of reproductive cells — without it, the primordial cells that would eventually give rise to sperm and eggs stop developing. Furthermore, the epigenome affects gene activity, helping cells with identical DNA sequences to take on unique identities. The epigenome helps to differentiate a brain cell, for example, from a liver cell.

Researchers know how to grow mouse eggs and sperm using stem-cell-like cells generated from skin. But the protocols used don’t work in human cells: “There is a big gap between mice and humans,” says Saitou.

The article is here.

Here are some moral/ethical issues:

The ability to derive human gametes (sperm and eggs) from reprogrammed somatic cells raises profound ethical questions that must be carefully considered:

Reproductive Autonomy

Deriving gametes from non-traditional cell sources could enable third parties to create human embryos without the consent or involvement of the cell donors. This raises concerns over violations of reproductive autonomy and the potential for coercion or exploitation, especially of vulnerable groups.

Access and Equity

If allowed for reproductive purposes, access to lab-grown gamete technology may be limited due to high costs, exacerbating existing disparities in access to assisted reproductive services. There are also concerns over the creation of "designer babies" if the technology enables extensive genetic selection.

Safety Considerations

Subtle epigenetic errors during reprogramming or gametogenesis could lead to developmental abnormalities or diseases in resulting children. Extensive research is needed to ensure the safety and efficacy of lab-grown gametes before clinical use.

Social and Cultural Implications

The ability to derive gametes from non-traditional sources challenges traditional notions of parenthood and kinship. The technology's impact on family structures, gender roles, and social norms must be carefully examined.

Robust public discourse, ethical guidelines, and regulatory frameworks will be essential to navigate the profound moral questions surrounding lab-grown human gametes as this technology continues to advance.

Groundbreaking Court Ruling Against Insurer Offers Hope in 2020

Katherine G. Kennedy
Psychiatric News
Originally posted 9 Jan 20

Here is an excerpt:

In his 106-page opinion, Judge Spero criticized UBH for using flawed, internally developed, and overly restrictive medical necessity guidelines that favored protecting the financial interests of UBH over medical treatment of its members.

“By a preponderance of the evidence,” Judge Spero wrote, “in each version of the Guidelines at issue in this case the defect is pervasive and results in a significantly narrower scope of coverage than is consistent with generally accepted standards of care.” His full decision can be accessed here.

As of this writing, we are still awaiting Judge Spero’s remedies order (a court-ordered directive that requires specific actions, such as reparations) against UBH. Following that determination, we will know what UBH will be required to do to compensate class members who suffered damages (that is, protracted illness or death) or their beneficiaries as a result of UBH’s denial of their coverage claims.

But waiting for the remedies order does not prevent us from looking for answers to critical questions like these:

• Will Wit. v. UBH impact the insurance industry enough to catalyze widespread reforms in how utilization review guidelines are determined and used?

• How will the 50 offices of state insurance commissioners respond? Will these regulators mandate the use of clinical coverage guidelines that reflect the findings in Wit. v. UBH? Will they tighten their oversight with updated regulations and enforcement actions?

The info is here.

Crispr Fans Fight for Egalitarian Access to Gene Editing

Megan Molteni
Wired.com
Originally posted June 6, 2018

Here is an excerpt:

Like any technology, the applications of gene editing tech will be shaped by the values of the societies that wield it. Which is why a conversation about equitable access to Crispr quickly becomes a conversation about redistributing some of the wealth and education that has been increasingly concentrated in smaller and smaller swaths of the population over the past three decades. Today the richest 1 percent of US families control a record-high 38.6 percent of the country’s wealth. The fear is that Crispr won’t disrupt current inequalities, it’ll just perpetuate them.

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CrisprCon excels at providing a platform to raise these kinds of big picture problems and moral quagmires. But in its second year, it was still light on solutions. The most concrete examples came from a panel of people pursuing ecotechnologies—genetic methods for changing, controlling, or even exterminating species in the wild (disclosure: I moderated the panel).

The information is here.

Apple’s Move to Share Health Care Records Is a Game-Changer

Aneesh Chopra and Safiq Rab
wired.com
Originally posted February 19, 2018

Here is an excerpt:

Naysayers point out the fact that Apple is currently displaying only a sliver of a consumer’s entire electronic health record. That is true, but it's largely on account of the limited information available via the open API standard. As with all standards efforts, the FHIR API will add more content, like scheduling slots and clinical notes, over time. Some of that work will be motivated by proposed federal government voluntary framework to expand the types of data that must be shared over time by certified systems, as noted in this draft approach out for public comment.

Imagine if Apple further opens up Apple Health so it no longer serves as the destination, but a conduit for a patient's longitudinal health record to a growing marketplace of applications that can help guide consumers through decisions to better manage their health.

Thankfully, the consumer data-sharing movement—placing the longitudinal health record in the hands of the patient and the applications they trust—is taking hold, albeit quietly. In just the past few weeks, a number of health systems that were initially slow to turn on the required APIs suddenly found the motivation to meet Apple's requirement.

The article is here.