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BMJ No 7085 Volume 314

Editorial Saturday 29 March 1997


The promise of cloning for human medicine

Not a moral threat but an exciting challenge

The production of a sheep clone, Dolly, from an adult somatic cell(1) is a stunning achievement of British science. It also holds great promise for human medicine. Sadly, the media have sensationalised the implications, ignoring the huge potential of this experiment. Accusations that scientists have been working secretively and without the chance for public debate are invalid. Successful cloning was publicised in 1975,(2) and it is over eight years since Prather et al published details of the first piglet clone after nuclear transfer.(3)

Missing from much of the debate about Dolly is recognition that she is not an identical clone. Part of our genetic material comes from the mitochondria in the cytoplasm of the egg. In Dolly's case only the nuclear DNA was transferred. Moreover, we are a product of our nurture as much as our genetic nature. Monovular twins are genetically closer than are artificially produced clones, and no one could deny that such twins have quite separate identities.

Dolly's birth provokes fascinating questions. How old is she? Her nuclear DNA gives her potentially adult status, but her mitochondria are those of a newborn. Mitochrondia are important in the aging process because aging is related to acquired mutations in mitochondrial DNA, possibly caused by oxygen damage during an individual's life.(4) Experimental nuclear transfer in animals and in human cell lines could help elucidate mechanisms for many of these processes.

Equally extraordinary is the question concerning the role of the egg's cytoplasm in mammalian development. Once the quiescent nucleus had been transferred to the recipient egg cell, developmental genes expressed only in very early life were switched on. There are likely to be powerful factors in the cytoplasm of the egg that make this happen. Egg cytoplasm is perhaps the new royal jelly. Studying why and how these genes switch on would give important information about both human development and genetic disease.

Research on nuclear transfer into human eggs has immense clinical value. Here is a model for learning more about somatic cell differentiation. If, in due course, we could influence differentiation to give rise to targeted cell types we might generate many tissues of great value in transplantation. These could include skin and blood cells, and possibly neuronal tissue, for the treatment of injury, for bone marrow transplants for leukaemia, and for degenerative diseases such as Parkinson's disease. One problem to be overcome is the existence of histocompatibility antigens encoded by mitochondrial DNA,(5) but there may be various ways of altering their expression. Cloning techniques might also be useful in developing transgenic animals-for example, for human xenotransplantation.

There are also environmental advantages in pursuing this technology. Mention has been made of the use of these methods to produce dairy herds and other livestock. This would be of limited value because animals with genetic diversity derived by sexual reproduction will always be preferable to those produced asexually. The risk of a line of farm animals prone to a particular disease would be ever present. However, cloning offers real prospects for preservation of endangered or rare species.

In human reproduction, cloning techniques could offer prospects to sufferers from intractable infertility. At present there is no treatment, for example, for those men who exhibit total germ cell failure. Clearly it is far fetched to believe that we are now able to reproduce the process of meiosis, but it may be possible in future to produce a haploid cell from the male which could be used for fertilisation of female gametes. Even if straight cloning techniques were used, the mother would contribute important constituents-her mitochondrial genes, intrauterine influences, and subsequent nurture.

Regulation of cloning is needed, but British law already covers this. Talk of "legal loopholes"(6) is wrong. The Human Fertilisation and Embryology Act may need modification, but there is no particular urgency. A precipitate ban on human nuclear transfer would, for example, prevent the use of in vitro fertilisation and preimplantation diagnosis for those couples at risk of having children who have appalling mitochondrial diseases.(7) Self regulation and legislation already work well. Apart from any other consideration, it seems highly unlikely that doctors would transfer human clones to the uterus out of simple self interest. Many of the animal clones that have been produced show serious developmental abnormalities,(8) and, apart from ethical considerations, doctors would not run the medicolegal risks involved. Transgenic technology has been with us for 20 years, but no clinician has been foolish enough to experiment with human germ cell therapy. The production of Dolly should not be seen as a moral threat, but rather as an exciting challenge. To answer this good science with a knee jerk political reaction, as did President Clinton recently,(9) shows poor judgment. In a society which is still scientifically illiterate, the onus is on researchers to explain the potential good that can be gained in the laboratory.

References

1 Wilmut T, Schnieke A K, McWhir J, Kind A J, Campbell K H S. Viable offspring derived from fetal and adult mammalian cells. Nature 1997;385:810-3.

2 Gurdon J B, Laskey R A, Reeves O R. The developmental capacity of nuclei transplanted from keratinised skin cells of adult frogs. J Embryol Exp Morph 1975;34:93-112.

3 Prather R S, Simms M M, First N L. Nuclear transplantation in early pig embryos. Biol Reprod 1989;41:414-8.

4 Ozawa T. Mitochondrial DNA mutations associated with aging and degenerative diseases. Exp Gerontol 1995;30:269-90.

5 Dabhi V M, Lindahl K F. MtDNA-encoded histocompatibility antigens. Methods Enzymol 1995;260:466-85.

6 Masood E. Cloning technique "reveals legal loophole." Nature 1997;385:757.

7 Winston R M, Handyside A H. New challenges in human in vitro fertilization. Science 1993;260:932-6.

8 Campbell K H S, McWhir J, Ritchie W A, Wilmut I. Sheep cloned by nuclear transfer from a cultured cell line. Nature 1996;380:64-6.

9 Wise J. Sheep cloned from mammary gland cells. BMJ 1997;314:623.

Robert Winston
Professor of fertility studies

Institute of Obstetrics and Gynaecology,
Hammersmith Hospital,
London W12 0HS


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