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J Thorac Cardiovasc Surg 2006;131:937-940
© 2006 The American Association for Thoracic Surgery

Editorial

Controversies in cardiothoracic surgery: Should therapeutic cloning be supported to provide stem cells for cardiothoracic surgery research and treatment?

Department of Surgery and Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada.

Received for publication November 28, 2005; accepted for publication December 12, 2005.

^_* Address for reprints: Dr. Martin F. McKneally, 77 Forest Grove Drive, Toronto, ON M2K 1Z4, Canada. (Email: martin.mcneally@utoronto.ca).

The first 300 words of the full text of this article appear below.

The excitement and controversy surrounding the use of embryonic stem cells were captured by 2 outstanding scholars who presented their arguments in a brilliant debate, genially and thoughtfully moderated by Bob Guyton of Atlanta, Chief of Cardiothoracic Surgery at Emory University. Their arguments are summarized here using the words of the debaters as much as possible. Both have reviewed and approved this condensed version.

Pro: Paul Berg, Cahill Professor of Cancer Research at Stanford, won the Nobel Prize in Chemistry in 1980 for developing methods that make it possible to analyze the structure and function of DNA and its role in the development of genetic engineering. Professor Berg opened the debate by expressing his hope, as a patient who has survived a heart attack, that stem cells could one day be used to repair the injured myocardium. He then described the origin and capabilities of stem cells. There is 1 tissue-specific stem cell in every 25,000 bone marrow cells, and one of these stem cells can rescue a mouse after lethal marrow ablation. They cannot differentiate into other somatic cells such as cardiac, neural, or pancreatic cells. In contrast, embryonic stem cells are derived from a blastocyst, a relatively undifferentiated structure of 100 to 150 cells that develops 4 to 6 days after fertilization of an oocyte—an egg cell. About 30 cells, comprising the inner cell mass of the blastocyst, are pluripotent embryonic stem (ES) cells; they give rise to all of the cell types of the adult organism. ES cells can be propagated in tissue culture, and they retain their pluripotentiality during long periods of frozen storage. These attributes have made them an attractive starting point for therapies aimed at tissue regeneration. Furthermore, ES cells can be induced to differentiate by manipulation of the medium into neurons that can . . . [Full Text of this Article]