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BUILDING A BABY: ARE STEM CELL-
BASED, EMBRYO-LIKE MODELS THE
KEY TO UNLOCKING THE SECRETS OF
HUMAN DEVELOPMENT?
Developments in stem-cell technology have presented researchers
with a powerful method with which to examine why things go
wrong in early embryonic development, yet with this advance in
research ability comes a polarizing ethical dilemma.
It is estimated that one in four pregnancies will end in
miscarriage [1]. Most cases of miscarriage occur in
the first 12 weeks of pregnancy and are due to errors
in embryonic formation. The consequences of developmental
errors are not limited to miscarriage; one in 33 babies will be born
with a birth defect due to the incorrect formation of the embryo
[2]. Worldwide, 240,000 babies die within 28 days of birth due to
birth defects, and a further 170,000 children will die between the
ages of 1 month and 5 years old [3]
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Both miscarriage and the development of defects most
commonly occur in the gastrulation period of development. During
this phase, which occurs 15 days post fertilization, the blastula-
a single-layered, hollow sphere of cells-folds inwards on itself
and is reorganized into a multilayered structure called a gastrula.
The three distinct layers of the gastrula will each give rise to a
group of the body's major organ systems; the ectoderm becomes
the nervous system, the endoderm the gut and the mesoderm
the muscles [4].
Miscarriage or the death of a child is a devastating
experiences for mother and father; however, these areas
remain vastly under researched. Limitations on research that
utilizes human embryos means that our understanding of the
developmental process of humans remains unclear-known as
the 'black box' period of development, gastrulation is a particular
mystery as restrictions have prevented the culture of human,
Vol. 73 No. 1 2022 Future Science Ltd
embryos in a lab for longer than 14 days [4]. Existing knowledge
in the field has been gleaned from histological specimens,
medical images or cultured non-human mammalian embryos.
Interspecies differences and limitations in imaging technology
have thus impeded our understanding of human development
(Figure 1) [5].
RELAXING THE 14-DAY RULE
What became known as the 14-day rule is internationally upheld.
and in some countries, the UK included, is now enshrined in law.
However, in 2021, the International Society for Stem Cell Research.
(ISSCR; IL, USA) released guidelines proposing a relaxation in
the rule, replacing the restriction with a suggestion that studies.
growing human embryos beyond the 14-day period be assessed
on a case-by-case basis, with reviewers determining the point of
embryo termination [6].
The ISSCR research committee had good reason for proposing
a relaxation of the 14-day rule: stem cell models. In the past.
decade, scientists have developed increasingly complex models
of the human embryo from human stem cells- enabling further
study of human development while avoiding the controversial
use of fertilized human embryos (Figure 2). Such structures lack.
the ability to grow into a human, though provide a more accurate
model for human development than can be offered by a mouse.
or other non-human mammalian model [6].
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E5.5
Mature
Early blastocyst
Tresfor
881
Post-implantation Gastrulation
embryo
Mouse
E3.0 E3.5
Human
blastocyst
Zygote Morula
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Figure 2. An early human embryo.
Courtesy of Dr Yorgos Nikas/SPL [12]
Vol. 73 No.10 2022 Future Science Ltd
E6.5
MODELING THE FIRST WEEKS OF DEVELOPMENT
Stem cell-based embryo models are organized 3D structures
that mimic the developmental processes of the early-stage
human embryo, offering insight into the critical stages required
for a successful pregnancy: implantation, gastrulation and
neurulation [5].
In 2020, a collaborative group of researchers from the
University of Cambridge (UK) and the Hubrecht Institute (The
Netherlands) developed a model of human gastrulation, mimicking
the key elements of a human embryo at around days 18-21 post
conception (4,7).
E14
Publishing their work in Nature, the researchers used human
embryonic stem cells to generate a 3D-assembly of cells, known
as gastruloids, which differentiate into the three distinct layers
seen in a human gastrula (Figure 3). To generate the gastruloids,
defined numbers of cells were placed into small wells, in which they
formed tight cellular aggregates. Following chemical treatment,
Figure 1. Overview of human
and mouse development up
to the onset of gastrulation.
The interspecies differences
limit the understanding of
human development that
may be gained from mouse
models.
Reproduced with permission
from [11]
the gastruloids lengthened along the anteroposterior axis and
genes were up-regulated in patterns that reflected elements of
a mammalian body plan. When studying the genes expressed,
the researchers were able to identify a clear signature of the
developmental event that gives rise to key bodily structures, such
as thoracic muscles, bone and cartilage [7].
In creating this black box' stage of development in vitro, it
is possible to observe processes never before seen, potentially
shedding light on the causes of birth defects that develop during
this period. This is a hugely exciting new model system, which will
allow us to reveal and probe the processes of early human embryonic
development in the lab for the first time," commented first author
Dr Naomi Moris (University of Cambridge): "Our system is a first
step towards modeling the emergence of the human body plan, and
could prove useful for studying what happens when things go wrong
such as in birth defects" [4].
These lab-grown gastruloids are unable to develop into fully-
formed embryos as they lack both brain cells and the ability to
implant into the womb, therefore do not run afoul of the 14-day rule
that remains law in the UK. When judging the age of their models,
the researchers compared them to those found in the Carnegie
Collection of Embryology (DC, USA), an official continuum of human
embryos that includes day-by-day growth over the first 8 weeks
of development [7]
Prior to the relaxation of the 14-day rule, this was the only method
for aging such models; however, with the extension allowed by the
ISSR, researchers are now able to compare their stem-cell based
models with real embryos, and test them as feasible stand-ins for
research, noted Robin Lovell-Badge, Chair of the ISSCR steering
committee and researcher at the Francis Crick Institute (London,
UK) [6]. Whether the model developers take advantage of this
development remains to be seen.
INDUCING GASTRULATION
A limitation of the Cambridge group's model is the requirement for
human embryonic stem cells. While research on human embryos
is vital for understanding human development, the use of such
cells in research is controversial and can be challenging to access.
To overcome these barriers, in 2021 a group of researchers
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Transcribed Image Text: from the California Institute of Technology (Caltech; CA, USA)
developed similar models from induced pluripotent stem cells
(iPSCS) [8, 9].
Originally derived from human embryonic tissue, the iPSCS
retain the ability to develop embryonic structure, if exposed
to the right environmental conditions. "The ability to assemble
the basic structure of the embryo seems to be a built-in property
of these earliest embryonic cells that they are simply unable to
"forget","explained lab leader Magdalena Zernicka-Goetz (Caltech).
"Nevertheless, either their memory is not absolutely precise or we
don't yet have the best method of helping the cells recover their
memories. We still have further work to do before we can get human
stem cells to achieve the developmental accuracy that is possible
with their equivalent mouse stem cell counterparts" [8].
As these second-generation models do not require the use of
donated embryonic stem cells for each future iteration, they can
be developed more easily and in larger quantities than previous
versions. Thus, the model system may open up more doors in the
understanding of embryonic development, mitigating the need
for human embryos as a starting point [8].
All of the models developed to date are rudimentary; however,
they hold vast untapped potential. Modeling the human embryo
could allow researchers to answer questions that until now have
been legally, and ethically, unanswerable: how does the embryo
implant into the uterus? How do drugs affect the developing
embryo? And how does the embryo ensure that cells are in the
right position? [2].
ALL MODELS ARE WRONG, YET SOME ARE USEFUL
As with the development of any new technique or model, success
brings with it more questions than answers. With new doors now
open, the fields of birth defects, infertility, in vitro fertilization.
protocols and drug screening all look set to advance from the
development of this research technique, potentially impacting
wider society in a myriad of ways [10]. The core principles of
early-stage embryonic development also provide signposts for
tissue engineering and regenerative medicine [5,11].
That being said, such models come with concerns. The
extent to which such models accurately mimic in vivo human
development remains to be seen [10] and while the relaxation of
the 14-day rule will allow for comparison with human embryos,
it will still not shed light on the in vivo process. Further, current
models require improvements of their controllability, scalability,
Vol 73 No. 1 2022 Future Science Ltd
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n
Figure 3. A growing human
gastruloid at 24 hours (left),
48 hours (middle) and
72 hours (right). Blue marks
DNA, magenta marks neural
cells, green marks
mesodermal cells.
Reprinted from University
of Cambridge [4].
reproducibility and standardization protocols before they may
be rolled out for widespread reproducible research [11]. The
inclusion of bioengineering tools to biodynamically control the
cellular environment will be an essential development in the
next few years, and will allow for the improvement of embryoid
models and help researchers to glean new insights in their
developments [11].
However, further advances raise a paradoxical dilemma; stem
cell-based embryo-like models should aim to be as human-like
as possible in order to be useful research models and yet, should
remain sufficiently different as to preserve the distinction.
between model and human and thus evade an ethical quandary.
As models become closer and closer to the real thing, the line
between human and research tool begins to blur, raising the
question: what does it mean to be human?
WHAT IT MEANS TO BE HUMAN
"We will have to confront ourselves with the question of what is a
human embryo, and whether these models really have the potential
to develop into one, noted Zernicka-Goetz in a 2019 Nature article
that discussed this emerging technology [12].
Is an embryo more valuable if it is formed from the union of
sperm and egg, or does its lab-grown counterpart, which can
perform the same biological processes, hold the same legal
rights? Who is qualified to answer such a question may also be
up for discussion. In the battle of science against ethical beliefs,
the matter of what it means to be human is a hotly contested
and polarizing issue, with each side firmly set in their opinions
and beliefs.
For some the question is moot; "It's like putting four wheels
on a frame and saying it's a car, even though there is no engine,"
commented Eric Siggia (Rockefeller University, NY, USA) [12]. The
synthetic embryos lack a placenta and other core components
required for human development, therefore lack the ability to grow
into people. However, in this ever-advancing field the development.
of a more human-like model may not be too far away. As models
approach a more human-like state, we then veer into cloning
territory and the ethical minefield continues to grow.
CONCLUSION
The development of our complex human selves from the unity of
a singular sperm and egg pairing remains one of the wonders of
nature, the intricate process having been fine tuned over millenia
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via the process of evolution. Yet despite nature's best efforts, the
process still goes wrong and often in the most devastating of
ways. With these stem-cell models, we have the opportunity to
explain and potentially correct these developmental abnormalities.
However, this field is still in its infancy and there are still hurdles
to overcome.
Written by Jennifer Straiton
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(2021) www.mited.co.uk/article/stem cell science pregnancy
3. World Health Organization Birth defects (2022) www.who.int/news.room/fact sheets/
detail/birth defects
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