tag:theconversation.com,2011:/us/topics/in-vitro-14728/articlesIn vitro – The Conversation2024-02-01T17:20:54Ztag:theconversation.com,2011:article/2220782024-02-01T17:20:54Z2024-02-01T17:20:54ZAir pollution: we recreated the deepest sections of your lung in a laboratory to understand how polluted air can affect your health<figure><img src="https://images.theconversation.com/files/571943/original/file-20240129-15-d2jfov.jpg?ixlib=rb-1.1.0&rect=5%2C0%2C3790%2C2595&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/black-ink-on-white-background-form-1774078307">Oleg Krugliak / shutterstock</a></span></figcaption></figure><p>Even today, in a world increasingly powered by renewable energy and clean technologies, air pollution poses a real risk to human health. In the UK alone, it is estimated to be responsible for <a href="https://www.gov.uk/government/publications/air-pollution-applying-all-our-health/air-pollution-applying-all-our-health">28,000 to 36,000 deaths every year</a>, and can vastly increase the risk of developing many lung and heart-related diseases, such as asthma or lung cancer.</p>
<p>Polluted air forms a complex mixture that changes depending on where the pollution is coming from, and what the local weather is doing at the time. People in towns and cities are more at risk since they live closer to most cars, factories and other sources of emissions.</p>
<p>Although there are many different types of pollutants within the air we breathe, two in particular are detrimental to our health: the gas nitrogen dioxide (NO₂) and particulate matter (specifically, PM₂.₅), formed of floating, microscopic solid or liquid particles smaller than 2.5 micrometres in diameter (for reference, a human hair is about 70 micrometres in diameter).</p>
<p>In 2017, a <a href="https://airqualitynews.com/2019/10/11/london-commits-to-who-guidelines-for-pm2-5-by-2030/#:%7E:text=guidelines%20for%20PM2.-,5%20by%202030,(WHO)%20guidelines%20by%202030.">report</a> found that all areas of London exceeded World Health Organisation recommended levels for PM₂.₅, with many areas being more than double the recommended levels. Scenarios like these have allowed researchers to investigate the dangers of breathing in really polluted air. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/572457/original/file-20240131-21-wonco7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Congestion charge sign and traffic at night" src="https://images.theconversation.com/files/572457/original/file-20240131-21-wonco7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/572457/original/file-20240131-21-wonco7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=363&fit=crop&dpr=1 600w, https://images.theconversation.com/files/572457/original/file-20240131-21-wonco7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=363&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/572457/original/file-20240131-21-wonco7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=363&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/572457/original/file-20240131-21-wonco7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=456&fit=crop&dpr=1 754w, https://images.theconversation.com/files/572457/original/file-20240131-21-wonco7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=456&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/572457/original/file-20240131-21-wonco7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=456&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Cars are a big source of air pollution in the UK capital.</span>
<span class="attribution"><span class="source">Sampajano_Anizza / shutterstock</span></span>
</figcaption>
</figure>
<p><a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(21)00350-8/fulltext">One study</a> found that, across the world, 86% of people who live in urban areas are exposed to PM₂.₅ at levels higher than even the World Health Organisation’s more lenient 2005 guidelines, resulting in 1.8 million excess deaths in 2019. <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(21)00255-2/fulltext">Another</a> found NO₂ to be responsible for 1.85 million cases of childhood asthma worldwide in 2019.</p>
<p>These figures come from studies on large populations of people, which take public health data and compare it to pollution data to look for correlations between pollution and disease. These are known as epidemiological studies. Although these studies can provide great insight into the risks associated with air pollution exposure, they do have their limitations.</p>
<p>For example, NO₂ and PM₂.₅ are emitted from the same sources, so you’d expect that when levels of one pollutant are high, levels of the other are high too. Therefore, without some very complicated maths, it’s sometimes hard to use epidemiological data to fully tease out the health effects of one pollutant compared to another.</p>
<p>For this reason, research needs to take place in a more controlled environment. This can be achieved in a laboratory setting either by using invasive animal testing strategies, or by implementing cell-based systems of human cells that represent the organ in a <a href="https://www.sciencedirect.com/science/article/pii/S1084952122003676">dish</a>.</p>
<h2>Lungs in a lab</h2>
<p>In our lab at Swansea University Medical School, we are trying to replicate the layer of cells known as the alveolar epithelium, which lines the deepest part of your lungs where oxygen enters your bloodstream and carbon dioxide leaves as you breathe in and out. This means it’s also a key area that air pollution can target and damage. We therefore want to understand how pollution affects this specific and very delicate body part.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/572451/original/file-20240131-19-dwxfzc.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="illustration of the research described in the article" src="https://images.theconversation.com/files/572451/original/file-20240131-19-dwxfzc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/572451/original/file-20240131-19-dwxfzc.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=441&fit=crop&dpr=1 600w, https://images.theconversation.com/files/572451/original/file-20240131-19-dwxfzc.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=441&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/572451/original/file-20240131-19-dwxfzc.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=441&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/572451/original/file-20240131-19-dwxfzc.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=554&fit=crop&dpr=1 754w, https://images.theconversation.com/files/572451/original/file-20240131-19-dwxfzc.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=554&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/572451/original/file-20240131-19-dwxfzc.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=554&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Lung cells can be grown in the lab and exposed to air pollutants in a way that is similar to how humans are exposed.</span>
<span class="attribution"><span class="source">Joshua Bateman</span></span>
</figcaption>
</figure>
<p>The alveolar epithelium is made up of several different types of cells, each with a specific job. Some allow movement of gases into and out of the blood, some produce surfactant (a biological fluid that maintains the structure of the lower lung as one breathes in and out) and some help remove inhaled microbes and particles. </p>
<p>By mixing all these cells together at specific ratios, we can produce single layers of cells that look very much like the alveolar epithelium of healthy humans. Then, once we’ve grown these anatomically relevant alveolar models, we can expose them to various pollutants to investigate what effect they may have. </p>
<p>We use “standardised” urban or indoor dust particles, which allows us to compare results with those from other labs who might also be using these particles (although realistic particles taken straight from the air around us are also sometimes used). We then put them in an aerosol cloud that deposits the particles onto the cells in a way that mimics the inhalation of particles in real life. </p>
<p>We’ve also devised a state-of-the-art NO₂ chamber that we can put the cells into. This allows us to see what happens to the cells when grown in differing NO₂ concentrations.</p>
<p>By investigating the effects of NO₂ and PM₂.₅ separately, we can fill in the gaps left by epidemiological studies to find out how individually hazardous each particle is – and whether being exposed to both at once is worse than being exposed separately.</p>
<p>Initially, we are finding that NO₂ and PM may <a href="https://academic.oup.com/annweh/article/67/Supplement_1/i46/7159401">work in tandem</a> to damage important cells within the lower lung. Our results will hopefully improve our knowledge of how air pollution may damage the important cell types within the human (lower) lung, contributing to the onset or exacerbation of disease. Such findings would contribute to the human health assessment of exposure to air pollution, helping to develop future, relevant guidelines.</p><img src="https://counter.theconversation.com/content/222078/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joshua Bateman receives funding from the COLT Foundation and UKHSA.</span></em></p><p class="fine-print"><em><span>Martin Clift receives funding from UKHSA, the EU (H2020 funding scheme) and UKRI (NERC and MRC) to assess the human health effects of air pollutants. He also receives funding from UKHSA and the COLT Foundation on this area of research. He is affiliated with the UK Government Committee on the Effects of Air Pollutants, and has an honorary contract with UKHSA. </span></em></p>Researchers created a layer of human lung cells and exposed them to different pollutants.Joshua Bateman, Postdoctoral Research Officer, Inhalation Toxicology, Swansea UniversityMartin Clift, Professor, Biomedical Sciences, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1733962021-12-09T13:34:54Z2021-12-09T13:34:54ZFiguring out omicron – here’s what scientists are doing right now to understand the new coronavirus variant<figure><img src="https://images.theconversation.com/files/436465/original/file-20211208-137612-ikwh0c.jpg?ixlib=rb-1.1.0&rect=686%2C0%2C7210%2C5150&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A researcher works with COVID-19 samples from patients.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/laboratory-operator-handles-positive-covid-19-samples-to-be-news-photo/1237075524">Thomas Samson/AFP via Getty Images</a></span></figcaption></figure><p><em>Scientists around the world have been racing to learn more about the new omicron strain of SARS-CoV-2, first declared a <a href="https://www.who.int/news/item/26-11-2021-classification-of-omicron-(b.1.1.529)-sars-cov-2-variant-of-concern">“variant of concern” on Nov. 26, 2021</a> by the World Health Organization. Officials cautioned that it would take several weeks before they’d know whether the recently emerged coronavirus variant is more contagious and causes more or less serious COVID-19 than delta and other earlier variants, and whether current vaccines can ward it off.</em></p>
<p><em><a href="https://scholar.google.com/citations?user=OQ7vzu0AAAAJ&hl=en&oi=ao">Peter Kasson is a virologist and biophysicist</a> at the University of Virginia who studies how viruses such as SARS-CoV-2 enter cells and what can be done to stop them. Here he explains what lab-based scientists are doing to help answer the outstanding questions about omicron.</em></p>
<h2>Does prior immunity protect against omicron?</h2>
<p>These are the key lab results everyone is waiting for: How effective are the antibodies people already have at fighting off omicron? If you got the booster shot, are you protected? Or if you had COVID-19 and then were vaccinated?</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/436467/original/file-20211208-25-152atd7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="artist's rendition of a virus with antibodies surrounding it" src="https://images.theconversation.com/files/436467/original/file-20211208-25-152atd7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436467/original/file-20211208-25-152atd7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436467/original/file-20211208-25-152atd7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436467/original/file-20211208-25-152atd7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436467/original/file-20211208-25-152atd7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436467/original/file-20211208-25-152atd7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436467/original/file-20211208-25-152atd7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Will the antibodies people already have recognize and thwart omicron?</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/antibodies-attacking-sars-cov-2-virus-corona-virus-royalty-free-image/1328466445">Dr_Microbe/iStock via Getty Images</a></span>
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</figure>
<p>The goal is to see how well antibodies from real people who have had COVID-19 or have been vaccinated against it can hold off omicron in petri dishes in the lab. Scientists expect that antibodies from people exposed to other variants won’t work as well against omicron because of its mutations, but they need to measure how much less well and whether it’s still enough to stop the virus. </p>
<p>To answer these questions, most researchers first make a version of the SARS-CoV-2 virus that can <a href="https://doi.org/10.3390/v12050513">enter cells but not reproduce</a>. A few specialized labs with <a href="https://theconversation.com/we-work-with-dangerous-pathogens-in-a-downtown-boston-biocontainment-lab-heres-why-you-can-feel-safe-about-our-research-163197">extra levels of biosecurity</a> use the actual virus. Scientists add antibodies from the blood of people vaccinated against or recovered from COVID-19 to the virus. They then mix this with human lung cells to see whether the antibodies can stop the virus from infecting the cells.</p>
<p>My laboratory performs this kind of work with <a href="https://doi.org/10.1038/s41541-021-00399-0">SARS-CoV-2</a> and other <a href="https://doi.org/10.1021/acscentsci.8b00494">emerging viruses</a>. Researchers have used these well-established techniques to test out <a href="https://doi.org/10.1038/s41586-021-03696-9">antibodies after COVID-19 recovery</a>, as well as different vaccines and <a href="https://doi.org/10.1056/NEJMc2113468">different variants</a>. </p>
<p>If antibodies people made against prior variants can’t stop omicron from infecting lung cells in the lab, then those antibodies probably won’t protect people out in the world either.</p>
<p>The very first early results are starting to come back, and it looks like <a href="https://www.ahri.org/wp-content/uploads/2021/12/MEDRXIV-2021-267417v1-Sigal.pdf">antibodies against earlier variants are less successful at blocking omicron</a>. Researchers took antibodies from six people who each had two doses of vaccine and from six other people who each had two doses of vaccine and had also recovered from an earlier COVID-19 infection. Antibodies from both groups of people were about 40 times worse at stopping omicron than original SARS-COV-2 strains, based on how much antibody was needed to prevent infection. But the people whose immune systems had seen the virus three times – that is, were doubly vaccinated and had also recovered from COVID-19 – had antibody levels that were high enough to still stop infection.</p>
<p>I’d expect people who have received booster vaccines will have similar or greater levels of immunity and will be at least moderately protected from omicron. But it will need to be tested. <a href="https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-provide-update-omicron-variant">Pfizer has said their early results agree with this prediction</a>, but the data is not yet publicly available. All of this work is not yet peer reviewed and still very preliminary.</p>
<p>Scientists will need to determine how a drop in “neutralization titer,” or how good antibodies are at blocking the virus in the lab, corresponds to a drop in “<a href="https://www.who.int/news-room/feature-stories/detail/vaccine-efficacy-effectiveness-and-protection">vaccine effectiveness</a>” or how likely a vaccinated person is to get COVID-19 compared to an unvaccinated one. Scientists know that <a href="https://doi.org/10.1038/s41591-021-01377-8">better antibodies correspond to more effective vaccines</a>, but the precise numerical relationships need to be determined.</p>
<p><iframe id="ikaxY" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/ikaxY/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<h2>How contagious is omicron compared to delta?</h2>
<p>The past pandemic year has shown that contagiousness, or transmissibility, has been the key factor in determining whether a coronavirus variant becomes dominant. Delta’s transmissibility has made it the current dominant variant because it simply outran others. But that situation may change with time.</p>
<p>The basic elements of the viral “life” cycle are getting into cells, making more virus, and getting out. Scientists can measure each of these stages in the lab and <a href="https://www.science.org/doi/10.1126/science.abl6184">report what aspects of a variant</a> make it more or less transmissible. In addition to binding to human cells better, some mutations enhance the packaging of new virus and the delivery of its genes once the virus gets into the cell.</p>
<p>While lab-based science can help people understand the biology behind just why a variant is more or less contagious, right now nature is doing a much bigger real-world experiment. Disease surveillance data from the <a href="https://twitter.com/_nickdavies/status/1466204363110633476?s=20">U.K.</a> and <a href="https://files.ssi.dk/covid19/omikron/statusrapport/rapport-omikronvarianten-07122021-1t6o">other countries</a> where delta has been dominant suggest that omicron is gaining share and may eventually displace delta.</p>
<p>Exactly how this plays out may differ from one country to another, depending on factors like the number of vaccinated people and which variants were previously in circulation, but this news about how good omicron is at spreading is concerning.</p>
<h2>Does omicron make people more or less sick?</h2>
<p>This is again a question that will be answered much more quickly by the thousands of people infected with omicron than by work in the lab. It’s important to remember, though, that nature’s experiments are not as carefully controlled as lab experiments. Precise lab work will help explain why omicron might be different, but the first answers here will come from hospitals.</p>
<p>Lab-based scientists will be working with hospitals to analyze what makes some patients more or less sick once they contract omicron. Some early numbers suggest that the <a href="https://www.samrc.ac.za/news/tshwane-district-omicron-variant-patient-profile-early-features">first omicron cases are mostly mild</a>, but public health officials urge caution: Most cases of all COVID-19 variants are mild, and <a href="https://www.samrc.ac.za/news/tshwane-district-omicron-variant-patient-profile-early-features">many of those infected so far with omicron are younger</a>. Hospitalization counts tend to increase somewhat after the initial increase in cases. So this question will take time to answer.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/436468/original/file-20211208-25-5qjw44.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="nurse attends a COVID-19 patient on a hospital ward" src="https://images.theconversation.com/files/436468/original/file-20211208-25-5qjw44.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436468/original/file-20211208-25-5qjw44.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436468/original/file-20211208-25-5qjw44.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436468/original/file-20211208-25-5qjw44.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436468/original/file-20211208-25-5qjw44.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436468/original/file-20211208-25-5qjw44.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436468/original/file-20211208-25-5qjw44.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Epidemiological data about how real patients are faring will fill in the picture.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/registered-nurse-attends-a-patient-with-covid-19-at-the-news-photo/1235025034">Apu Gomes/AFP via Getty Images</a></span>
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<h2>How are lab data and public health data complementary?</h2>
<p>Laboratories will provide the first results on immune protection against omicron, although this will be followed up with public health data that will likely confirm the lab results. Public health data will bring the first results on contagiousness and disease severity, which will then be explained by laboratory results.</p>
<p>Once the initial answers from public health data are in, laboratory results are still important to understand why these changes happened and to help predict what future variants will do. How do officials declare a variant of concern in the first place? It’s a combination of public health data and understanding from the lab.</p>
<h2>What do we know already?</h2>
<p>Variants of SARS-CoV-2 don’t change the laws of physics and biology. They cannot leap tall buildings in a single bound. Physical barriers like high-grade masks and good ventilation will still stop the virus. And, very likely, vaccines will continue to provide some amount of protection. The question is how much, and whether the world needs to <a href="https://theconversation.com/how-can-scientists-update-coronavirus-vaccines-for-omicron-a-microbiologist-answers-5-questions-about-how-moderna-and-pfizer-could-rapidly-adjust-mrna-vaccines-172943">change the current vaccines</a> or just provide more of them.</p>
<p>[<em>Research into coronavirus and other news from science</em> <a href="https://theconversation.com/us/newsletters/science-editors-picks-71/?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=science-corona-research">Subscribe to The Conversation’s new science newsletter</a>.]</p><img src="https://counter.theconversation.com/content/173396/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Peter Kasson has received funding from the National Institutes of Health, the National Science Foundation, the Knut and Alice Wallenberg Foundation, the Swedish Research Council, and TG Therapeutics. He is affiliated with the University of Virginia and Uppsala University. </span></em></p>Careful lab work will complement public health data as researchers worldwide focus on omicron, asking questions about contagiousness, severity of disease and whether vaccines hold up against it.Peter Kasson, Associate Professor of Molecular Physiology and Biomedical Engineering, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1616162021-05-27T16:00:53Z2021-05-27T16:00:53ZStem cell research community drops 14-day limit on human embryo research<figure><img src="https://images.theconversation.com/files/403003/original/file-20210526-17-rsjl91.jpg?ixlib=rb-1.1.0&rect=0%2C16%2C3600%2C2376&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Human embryo research is used to understand foetal development and its applications in treating or eliminating disease.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>The International Society for Stem Cell Research (ISSCR), which bills itself as “<a href="https://www.isscr.org/about-isscr">the voice of the stem cell research community</a>,” has announced that it no longer endorses the prevailing international standard limiting human embryo research to 14 days after fertilization. </p>
<p>Human embryo research has long been a thorny ethical issue because of <a href="https://scholarsarchive.library.albany.edu/cgi/viewcontent.cgi?article=1001&context=cas_philosophy_scholar">competing views about the moral status of the developing embryo</a>. Some people argue that human embryos have the moral status of persons and are considered protectable human life — that embryos should not be used for research, especially research that results in their destruction. </p>
<p>Other people reject such claims, highlighting the potential scientific and therapeutic benefits of research involving human embryos. These benefits include investigation of human development, cancer cell growth, congenital diseases and the causes of miscarriages. Applications of this research include <a href="https://doi.org/10.1002/9781444367072.wbiee691">developing contraceptives, diagnosing genetic diseases, treating infertility and other maladies</a>.</p>
<p>The earlier <a href="https://www.isscr.org/docs/default-source/all-isscr-guidelines/guidelines-2016/isscr-guidelines-for-stem-cell-research-and-clinical-translationd67119731dff6ddbb37cff0000940c19.pdf">ISSCR guidelines from 2016</a> prohibit the cultivation and use of embryos beyond 14 days.</p>
<p>The <a href="https://www.isscr.org/policy/guidelines-for-stem-cell-research-and-clinical-translation">updated guidelines</a> announced May 26 eliminate this prohibition. Instead, the ISSCR recommends that “national academies of science, academic societies, funders and regulators” engage the public in conversation about the scientific, societal and ethical issues associated with the 14-day limit, and whether this should be extended depending on the research objectives.</p>
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<p><a href="https://theconversation.com/growing-human-embryos-in-the-lab-and-why-scientists-just-tweaked-the-rules-podcast-161611"><img src="https://images.theconversation.com/files/403160/original/file-20210527-15-1crjmoe.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=212&fit=crop&dpr=1" alt="Promotional image for podcast" width="100%"></a>
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<h2>A history of the 14-day rule</h2>
<p>The 14-day rule, also known as the 14-day limit, “<a href="https://www.nature.com/news/embryology-policy-revisit-the-14-day-rule-1.19838">became a standard part of embryo-research oversight through the convergence of deliberations of various national committees over decades</a>.”</p>
<p>Today, different countries have different rules more or less closely aligned with one of the competing perspectives on the moral status of human embryos. Some countries — such as <a href="https://www.ris.bka.gv.at/GeltendeFassung.wxe?Abfrage=Bundesnormen&Gesetzesnummer=10003046">Austria</a>, <a href="https://www.gesetze-im-internet.de/eschg/">Germany</a>, <a href="https://www.camera.it/parlam/leggi/04040l.htm">Italy</a>, <a href="http://www.gratanet.com/up_files/biomedical_cell_products_russia_june2016_eng.pdf">Russia</a> and <a href="https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=20085&MevzuatTur=7&MevzuatTertip=5">Turkey</a> — do not permit research involving human embryos. </p>
<p>Other countries — including <a href="https://www.laws-lois.justice.gc.ca/eng/acts/A-13.4/FullText.html">Canada</a>, <a href="https://drive.google.com/file/d/1hYFmm2rRnhRdvxPiWR5vQh7Y5I9BCwxk/view">China</a>, <a href="http://dbtindia.gov.in/sites/default/files/National_Guidelines_StemCellResearch-2017.pdf">India</a>, <a href="https://www.lifescience.mext.go.jp/files/pdf/n743_00.pdf">Japan</a>, <a href="https://www.boe.es/buscar/pdf/2007/BOE-A-2007-12945-consolidado.pdf">Spain</a> and the <a href="https://www.legislation.gov.uk/ukpga/1990/37/contents">United Kingdom</a> — permit limited human embryo research up to (and not beyond) 14 days. Still other countries permit such research without stipulating any kind of time limit, for example, <a href="http://www.planalto.gov.br/ccivil_03/_Ato2004-2006/2005/Lei/L11105.htm">Brazil</a> and <a href="https://www.legifrance.gouv.fr/codes/id/LEGISCTA000006171138/">France</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/403005/original/file-20210526-15-o38mcc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="An illustration of a foetus floating in a bubble on a blue background" src="https://images.theconversation.com/files/403005/original/file-20210526-15-o38mcc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/403005/original/file-20210526-15-o38mcc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/403005/original/file-20210526-15-o38mcc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/403005/original/file-20210526-15-o38mcc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/403005/original/file-20210526-15-o38mcc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/403005/original/file-20210526-15-o38mcc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/403005/original/file-20210526-15-o38mcc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A 3D illustration of a one-month-old fetus. The primitive streak is the precursor to the spinal cord.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>In 1979, following extensive public consultation, the Ethics Advisory Board of the United States Department of Health, Education and Welfare issued a report in support of limited human embryo research. The board concluded that research involving human embryos should be allowed, provided the embryos were not “<a href="https://repository.library.georgetown.edu/bitstream/handle/10822/559350/HEW_IVF_report.pdf">sustained in vitro beyond the stage normally associated with the completion of implantation (14 days after fertilization)</a>.”</p>
<p>Five years later, also following extensive public consultation, the <a href="https://www.hfea.gov.uk/media/2608/warnock-report-of-the-committee-of-inquiry-into-human-fertilisation-and-embryology-1984.pdf">Warnock Report of the Committee of Inquiry into Human Fertilisation and Embryology</a> in the U.K. reached a similar conclusion. The emphasis in this report, however, was on a different biological phenomenon: the appearance of the primitive streak (a precursor to the brain and spinal cord), which appears on the 14th or 15th day after fertilization.</p>
<p>The first national law entrenching the proposed ethical limit of 14 days was introduced in the U.K. in the <a href="https://www.legislation.gov.uk/ukpga/1990/37/contents">Human Fertilisation and Embryology Act of 1990</a>. Since then other countries (but not the U.S.) have followed suit and introduced similar legislation. </p>
<p>In Canada, the <a href="https://laws-lois.justice.gc.ca/eng/acts/a-13.4/fulltext.html">Assisted Human Reproduction Act of 2004</a> stipulates that no person shall knowingly “maintain an embryo outside the body of a female person after the 14th day of its development following fertilization or creation, excluding any time during which its development has been suspended.”</p>
<p>Until now, the ISSCR guidelines have been in lockstep with laws, regulations and guidelines endorsing the 14-day limit. No more.</p>
<h2>Merits of the prohibition</h2>
<p>The decision to jettison the established 14-day rule is a mistake. <a href="https://dx.doi.org/10.1002/hast.1215">There is good reason</a> to recommend public discussion and debate on the merits of this rule. There is no legitimate reason, however, for this discussion to focus narrowly on extending the research time limit. For example, an equally legitimate public conversation could be had about shortening instead of lengthening the time frame for permitted research. </p>
<p>More importantly, there is no legitimate reason to have removed the 14-day rule in advance of any public engagement that might endorse the existing limit or advocate an alternative policy. Doing so changes the facts on paper and potentially also in practice.</p>
<p>For example, countries without relevant legislation, regulations or guidelines risk becoming havens for ethically controversial human embryo research beyond 14 days.</p>
<p>Indeed, the authors of the 2021 ISSCR guidelines boast that in jurisdictions where there is no legislation or where there are “substantial gaps and ambiguities” in the legislation “carefully constructed guidelines can play a critical role, for scientists and clinicians conducting research and treating patients.” The revised guidelines can no longer play this role for embryo research beyond 14 days.</p>
<h2>Changing science, limits</h2>
<p>Until recently, researchers were not able to maintain the human embryo in the lab beyond 14 days, and so the established limit had no practical effect. But in 2016, two research teams — one at the <a href="https://www.nature.com/articles/ncb3347">University of Cambridge in the U.K.</a> and the other at <a href="https://www.nature.com/articles/nature17948">Rockefeller University in the U.S.</a> — succeeded in maintaining human embryos in vitro for 12 to 13 days. They could have continued their experiments, but ended them in accordance with the 14-day rule. </p>
<p>The research conducted in the U.K. referenced the relevant legislation as the reason for concluding the experiments. The research conducted in the United States, where there is no relevant legislation, explicitly referenced the ISSCR guidelines. </p>
<p>Since then, debate in academic circles about the merits of the 14-day rule have intensified. Now that it is possible to overcome the technical limitations, some are intent on shifting the ethical limitations.</p>
<p>One suggestion is to “<a href="https://www.nature.com/articles/d41586-018-05586-z">keep the 14-day rule in place and have a special petition to make an exception</a>.” Another suggestion is to <a href="https://dx.doi.org/10.15252/emmm.201809437">extend the time limit to 28 days</a> to allow researchers to learn more about embryonic developmental processes.</p>
<p>My suggestion, as an ethicist who works at the intersection of policy and practice, is to have <a href="https://impactethics.ca/2016/05/05/pushing-the-14-day-limit-on-human-embryo-research/">project specific time limits</a> based on the minimum amount of time required to address the stated research objectives. This could mean that some human embryo research would not be allowed to continue to day 14, while other research might be allowed to continue beyond day 14. </p>
<p>Research categories with different time limits might be described in international or national research ethics guidelines and entrenched in national legislation. Alternatively, national regulations and guidelines might only stipulate the general intent, and project-specific decision-making might be at the discretion of a national specialized research ethics committee.</p>
<p>These suggestions for ethical limits on human embryo research — and others — require the public’s input. And while it is good to see the ISSCR promote public engagement, it is disappointing that this support should come at the price of the established international norm.</p><img src="https://counter.theconversation.com/content/161616/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Françoise Baylis is a member of the WHO Expert Advisory Committee on Developing Global Standards for Governance and Oversight of Human Genome Editing, a member of a Working Group to inform the development of the WHO Global Guidance Framework to Harness the Responsible Use of the Life Sciences, May to July 2021, and a member of Planning Committee for the Third International Summit on Human Genome Editing’, London, 7-9 March 2022.</span></em></p>In most countries, scientific research that uses human embryos has to halt after the 14th day. New guidelines recommend the public’s input in extending the time period.Françoise Baylis, Research Professor, Philosophy, Dalhousie UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/796762017-07-24T23:56:44Z2017-07-24T23:56:44ZThe next pharmaceutical revolution could be 3D bioprinted<figure><img src="https://images.theconversation.com/files/177674/original/file-20170711-21764-fxgyap.JPG?ixlib=rb-1.1.0&rect=400%2C34%2C2479%2C1496&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">3D bioprinted channel, representing a blood vessel within a hydrogel that mimics human tissue.</span> <span class="attribution"><span class="source">Forget, Heiny, Derme, Mitterberger, Shastri</span></span></figcaption></figure><p>Body organs such as kidneys, livers and hearts are incredibly complex tissues. Each is made up of many different cell types, plus other components that give the organs their structure and allow them to function as we need them to. </p>
<p>For 3D printed organs to work, they must mimic what happens naturally – both in terms of arrangement and serving a biological need. For example, a kidney must process and excrete waste in the form of urine. </p>
<p><a href="http://onlinelibrary.wiley.com/doi/10.1002/adhm.201700255/full">Our latest paper</a> shows a new technique for 3D printing of cells and other biological materials as part of a single production process. It’s another step towards being able to print complex, living structures. </p>
<p>But it’s not organ transplants we see as the most important possible consequence of this work. </p>
<p>There is already evidence that 3D cell printing is a technology useful in drug development, something that may reduce the burden on animals for testing and bring new treatments to market more quickly and safely.</p>
<h2>How we 3D bioprint</h2>
<p>3D printing was first developed for <a href="http://patents.google.com/patent/FR2567668A1/en">rapid fabrication of industrial parts</a> using methods known as <a href="http://patents.google.com/patent/US5236637A/en?inventor=Charles+W.+Hull">sterolithography</a> and <a href="http://www.google.de/patents/US5121329">fuse deposition modelling</a>. </p>
<p>Add “biology” (that is, cells) to the printing technique and it becomes an entirely new process: 3D bioprinting. </p>
<p>3D bioprinting requires sterile conditions to avoid contamination of the bioprinted sample, and an appropriate temperature and humidity so the cells don’t die. Also, the plastic materials traditionally used in 3D printing cannot be used in bioprinting, as they require high temperatures or toxic solvents.</p>
<p>We and other researchers around the world are developing materials that can be manipulated in a 3D printer while causing minimal harm to the cells. </p>
<p>However, each cell type that makes up the different tissues of the human anatomy requires a unique mechanical environment. Each requires unique structural supports to function normally.</p>
<p>As an example, bones are a resistant and brittle material, muscles of the heart are elastic, tough materials, and internal organs such as the liver are soft and compressible. </p>
<p>In a <a href="http://onlinelibrary.wiley.com/doi/10.1002/adhm.201700255/full">recent publication</a>, we and our colleagues show that new materials extracted from marine algae can be used to 3D bioprint human stem cells in distinct environments, and without harming the cells. We believe that these findings pave the way toward the printing of complex tissue structures.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/176508/original/file-20170702-8214-1oydz3n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/176508/original/file-20170702-8214-1oydz3n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/176508/original/file-20170702-8214-1oydz3n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=336&fit=crop&dpr=1 600w, https://images.theconversation.com/files/176508/original/file-20170702-8214-1oydz3n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=336&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/176508/original/file-20170702-8214-1oydz3n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=336&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/176508/original/file-20170702-8214-1oydz3n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=422&fit=crop&dpr=1 754w, https://images.theconversation.com/files/176508/original/file-20170702-8214-1oydz3n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=422&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/176508/original/file-20170702-8214-1oydz3n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=422&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The bioprinting process is performed under sterile conditions and using milder temperatures than are used in 3D plastics printing.</span>
<span class="attribution"><span class="source">Steffen Harr</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>Hoping for new organs</h2>
<p>Currently, patients needing replacement organs must wait for availability (from living or deceased donors) and are then required to be on immunosuppressive drugs for <a href="http://www.webmd.com/a-to-z-guides/organ-transplants-antirejection-medicines-topic-overview#1">most of the rest of their lives</a>, causing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4618138/">side effects</a> and creating a tremendous cost for the <a href="https://www.ncbi.nlm.nih.gov/books/NBK225248/">healthcare system</a>. </p>
<p>The development of 3D-printed biological tissues for organ replacement hopes to <a href="https://www.nature.com/nbt/journal/v32/n8/full/nbt.2958.html">offer a new solution</a> for the <a href="http://transplant.org.au/statistics/">1,500 patients</a> on the organ receiver waiting list every year in Australia. </p>
<p>But printing of entire organs is an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189697/">incredibly complex process</a>, one that takes weeks of time that a patient may not have up his or her sleeve. </p>
<p>Also, while this process is somewhat advanced for relatively simple tissues such as <a href="http://iopscience.iop.org/article/10.1088/1758-5090/9/1/015006">skin</a>, the next phase of the technology requires <a href="https://www.nature.com/nbt/journal/v32/n8/full/nbt.2958.html">incorporation of nerves, blood vessels and lymphatic vessels</a> that would integrate with the host system to create transplantable whole organs such as kidneys, lungs, hearts or livers. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/176567/original/file-20170703-32591-100f65h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/176567/original/file-20170703-32591-100f65h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/176567/original/file-20170703-32591-100f65h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=336&fit=crop&dpr=1 600w, https://images.theconversation.com/files/176567/original/file-20170703-32591-100f65h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=336&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/176567/original/file-20170703-32591-100f65h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=336&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/176567/original/file-20170703-32591-100f65h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=422&fit=crop&dpr=1 754w, https://images.theconversation.com/files/176567/original/file-20170703-32591-100f65h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=422&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/176567/original/file-20170703-32591-100f65h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=422&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">How to print whole organs for transplantation: cells from the patient are extracted and cultured in the laboratory. An organ is printed with several type of cells, then grown and transplanted into the same patient.</span>
<span class="attribution"><span class="source">Steffen Harr</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>We’re probably many many years and millions of dollars away from being able to bioprint whole, functional human organs. </p>
<p>But there’s another way bioprinted cells can be used: for testing new drugs in the laboratory. </p>
<h2>Bioprinted cells for drug testing</h2>
<p>Using current methods, bringing a new drug to market has been estimated to cost <a href="http://csdd.tufts.edu/news/complete_story/tufts_csdd_rd_cost_study_now_published">US$2.5 billion</a>, and can take more than ten years from start to finish. </p>
<p>Even if you manage to identify a new candidate drug, the likelihood of regulatory approval is low: in 2016, <a href="https://www.bio.org/sites/default/files/Clinical%20Development%20Success%20Rates%202006-2015%20-%20BIO,%20Biomedtracker,%20Amplion%202016.pdf">less than 10%</a> were approved. </p>
<p>When starting human clinical trials, the probability of a drug to make it to the market is between <a href="http://www.nature.com/nbt/journal/v32/n1/abs/nbt.2786.html">10 and 15%</a> depending on the type of molecule , with illness or even death for participants. We know that these drugs mainly fail due to poor <a href="http://www.nature.com/nbt/journal/v32/n1/abs/nbt.2786.html">efficacy</a> in humans despite promising results in animals. This disconnect is due to the different physiology between species: rodents and other trial animals are very different from humans in many key ways. </p>
<p>3D printing technology allows us to print more complex 3D models that reproduce aspects of the <a href="http://organovo.com/science-technology/publications/">liver, kidneys</a> or <a href="https://www.regenhu.com/3d-bioprinting-bionic-heart-patches/">heart muscles</a> that are suitable to test and identify novel pharmaceutical molecules. These models are already starting to be used by <a href="http://organovo.com/merck-bio-inks-deal-to-use-organovos-3d-printed-liver-for-preclinical-studies/">multinational pharmaceutical companies</a>. </p>
<p>While the use of <a href="http://www.huffingtonpost.com.au/2016/02/17/animal-testing-australia-primates_n_9247608.html">animals in research</a> is still inevitable, the regulatory agency <a href="https://www.statnews.com/2017/05/11/fda-drug-testing-safety-animals/">the Food and Drug Administration</a> and its <a href="https://www.c-span.org/video/?426502-1/fda-commissioner-nominee-scott-gottlieb-defends-accusations-conflicts-interest">new director</a> have already started to consider integrating alternatives for drug safety and efficacy assessment. </p>
<p>The idea that bioprinted tissues have promise for drug development is already recognised, with funding agencies here in <a href="https://www.challenge.gov/challenge/nei-3-d-retina-organoid-challenge-3-d-roc/">Australia</a> and <a href="https://gcgh.grandchallenges.org/challenge/develop-novel-platforms-accelerate-contraceptive-drug-discovery-round-17">globally</a> supporting projects. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/176568/original/file-20170703-32631-1kiqulh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/176568/original/file-20170703-32631-1kiqulh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/176568/original/file-20170703-32631-1kiqulh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=336&fit=crop&dpr=1 600w, https://images.theconversation.com/files/176568/original/file-20170703-32631-1kiqulh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=336&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/176568/original/file-20170703-32631-1kiqulh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=336&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/176568/original/file-20170703-32631-1kiqulh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=422&fit=crop&dpr=1 754w, https://images.theconversation.com/files/176568/original/file-20170703-32631-1kiqulh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=422&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/176568/original/file-20170703-32631-1kiqulh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=422&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">3D bioprinting could revolutionising drug discovery: cells from one patient are extracted and cultured in the laboratory. A tissue sample is printed, on which new molecules can be tested as treatments for whole populations.</span>
<span class="attribution"><span class="source">Steffen Harr</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>Toward the end of the animal testing?</h2>
<p>In 2013 the European Union passed a new <a href="https://ec.europa.eu/growth/sectors/cosmetics/animal-testing_en">law</a> prohibiting the use of animal testing for cosmetic development on its territory, and of retailing products tested abroad on animals. </p>
<p>This regulation has accelerated the development of human-based <a href="http://www.henkel.de/blob/23978/f177175beb1ce4c0ee7100fba0945685/data/phenion-full-thickness-skin-model-flyer.pdf">3D models of skin</a> for the testing of new cosmetic formulations. These resolutions were accepted because the technology was available and has enabled a reduction in the number of research animals. This is about to be translated in <a href="https://theconversation.com/australia-will-finally-ban-cosmetic-testing-on-animals-78768">Australia</a> as well. </p>
<p>The changes operated in other industries combined with the exciting technological advances let us have a glance at how 3D bioprinting may be able to contribute to faster and cheaper ways to create effective new drugs.</p><img src="https://counter.theconversation.com/content/79676/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Aurelien Forget receives funding from The Bill & Melinda Gates Foundation</span></em></p><p class="fine-print"><em><span>Tim Dargaville receives funding from The Australian Research Council. </span></em></p>3D bioprinting of living cells and materials may contribute to faster and cheaper ways to create effective new drugs - and even reduce animal testing.Aurelien Forget, Associate Lecturer in Macromolecular Chemistry, Queensland University of TechnologyTim Dargaville, ARC Future Fellow, A/Prof Polymer Chemistry, Queensland University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/723722017-02-21T19:11:57Z2017-02-21T19:11:57ZNo animal required, but would people eat artificial meat?<p>Futurists <a href="https://futurism.com/grow-groceries-test-tube/">tell us</a> that we will be eating in vitro meat (IVM) – meat grown in a laboratory rather than on a farm – within five to ten years. </p>
<p>IVM was first investigated in the early years of this <a href="https://theconversation.com/worlds-first-lab-grown-burger-dont-forget-the-semi-living-steak-16941">century</a> and since then criticisms of farm animal production systems, particularly intensive ones, have escalated.</p>
<p>They <a href="http://www.cabi.org/cabebooks/ebook/20103000595">include</a> the excessive use of land, energy and water resources; local and global pollution; poor animal welfare; a contribution to <a href="https://www.chathamhouse.org/sites/files/chathamhouse/field/field_document/20141203LivestockClimateChangeForgottenSectorBaileyFroggattWellesleyFinal.pdf">climate change</a>; and a <a href="http://www.livescience.com/21426-global-zoonoses-diseases-hotspots.html">unhealthy eating habits and disease in humans</a>. </p>
<p>At the same time, human (and livestock) <a href="http://www.nature.com/nature/journal/v466/n7306/full/466531a.html">population growth continues</a>, farming land is requisitioned for urban expansion and meat consumption per person is rising. </p>
<p>So we want a new source of meat – or do we?</p>
<h2>Reaction to artificial meat</h2>
<p>Growing meat artificially, under laboratory-type conditions, is not impossible on a large scale. But people’s concerns about eating IVM have rarely been explored. </p>
<p>In a recent survey, <a href="http://dx.doi.org/10.1371/journal.pone.0171904">published this month in PLOS One</a>, we investigated the views of people in the United States, a country with <a href="https://data.oecd.org/agroutput/meat-consumption.htm">one of the largest appetites for meat</a> and an equally large appetite for adopting new technologies.</p>
<p>A total of 673 people responded to the survey, done online via <a href="https://www.mturk.com/mturk/welcome">Amazon Mechanical Turk</a>, in which they were given information about IVM and asked questions about their attitudes to it.</p>
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<p>Although most people (65%), and particularly males, were willing to try IVM, only about a third said they would use it regularly or as a replacement for farmed meat.</p>
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<p>But many people were undecided: 26% were unsure if they would use it as a replacement for farmed meat and 31% unsure if they would eat it regularly. This suggests there is scope to persuade consumers that they should convert to IVM if a suitable product is available. As an indication of this potential, 53% said it was seen as preferable to soy substitutes. </p>
<h2>The pros and cons of IVM</h2>
<p>The biggest concerns were about IVM’s taste and lack of appeal, particularly in the case of meats seen as healthy, such as fish and chicken, where only two-thirds of people that normally ate them said that they would if it was produced by <em>in vitro</em> methods. </p>
<p>By contrast, 72% of people who normally eat beef and pig products would still do so if they were produced as IVM. Interestingly, about 4% of people said they would try IVM products of horse, dog or cat – despite these being meats that they would not currently eat.</p>
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<p>The perceived advantages of IVM were that it was environmentally and animal-welfare friendly, ethical, and less likely to carry diseases. It could increase the proportion of happy animals on Earth if it replaced intensive farm animal production. By happy, we mean well nourished, comfortable, healthy, free from pain, and able to perform. </p>
<p>The disadvantages were that IVM was perceived as unnatural, potentially less tasty and likely to have a negative impact on farmers, by putting them out of business. </p>
<h2>The IVM consumer</h2>
<p>So who would be most likely to use IVM, and hence dictate the focus of advertisers’ pitch? </p>
<p>Gender was the biggest predicting factor, with men more likely on average to say they would try IVM, whereas women were less sure. Men also had more positive views of its benefits. </p>
<p>Recognising that meat-eating men are often viewed as <a href="http://dx.doi.org/10.1016/j.appet.2011.01.018">more masculine</a>, it is not clear whether this prevailing attitude would change if men converted to eating IVM. </p>
<p>Those with liberal political views rather than conservative ones were also much more receptive to the idea, confirming their more progressive viewpoints generally, as well as their traditionally stronger focus on fairness and avoiding harm to others. </p>
<p>Vegetarians and vegans were more likely to support the benefits of IVM but least likely to try it. People who ate little meat were also more supportive, compared with big meat eaters. </p>
<h2>IVM on the menu</h2>
<p>While a reasonably large proportion of the sample reported willingness to try IVM in the future, there appears to be hesitation around the idea of incorporating it into a daily diet. </p>
<p>Resistance came primarily from practical concerns, such as taste and price. But these are factors that are largely under the control of the manufacturers.</p>
<p>The concerns – about taste, price and impact on farmers – could all be effectively dealt with if there was sufficient financial advantage in producing IVM. </p>
<p>As tissue engineering techniques improve, culturing meat <em>in vitro</em> also brings the opportunity to introduce health-promoting ingredients, such as polyunsaturated fats, more easily than in living animals. </p>
<p>Another commonly cited concern was the perception that the product was unnatural. This may be similar to people’s concerns about genetically modified (GM) foods – some of those who oppose GM foods are <a href="http://dx.doi.org/10.1177%2F1745691615621275">moral absolutists</a> who would not be influenced by any argument in favour. </p>
<p>By expressing concern about the naturalness of IVM, some people were suggesting that there are fundamental issues that would cause them to reject it.</p>
<p>But with a little investigation into the processing and production of some meat products today, they might soften their attitudes towards IVM. </p>
<p>If IVM doesn’t take your fancy, <a href="https://www.scientificamerican.com/article/tissue-engineered-leather-could-be-mass-produced-by-2017/">lab-grown leather</a> is actively being developed by a company that was dissuaded from producing IVM because it thought only 40% of people would even try it. </p>
<p>That was back in 2012 and now our survey has found that 65% of people surveyed in the United States said that they would definitely or probably try IVM. So maybe people are becoming more responsive to the idea as opposition to conventional animal farming grows. </p>
<p>Although ours was a relatively small survey in a developed country (with a huge appetite for meat!), one can speculate that people in developing countries might be less concerned about issues like the taste and natural appeal of IVM. They might view it as a valuable source of protein they would not otherwise get. </p>
<p>Perhaps the futurists are right and IVM will be what fills our dinner plates in the near future.</p><img src="https://counter.theconversation.com/content/72372/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clive Phillips has received funding from a variety of government, industry and not-for-profit organisations, including Meat and Livestock Australia (Livecorp), Australian and New Zealand Government, Open Philanthropy and the Morris Animal Foundation, He is on the scientific panel for the Voiceless not-for-profit organisation and a director of Minding Animals. </span></em></p><p class="fine-print"><em><span>Matti Wilks does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We might be able to grow artificial meat but are people really prepared to eat such produce over meat from farmed animals?Clive Phillips, Professor of Animal Welfare, Centre for Animal Welfare and Ethics, The University of QueenslandMatti Wilks, PhD Candidate in psychology, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/581832016-05-04T12:53:17Z2016-05-04T12:53:17ZTesting drugs on animals could soon be a thing of the past<figure><img src="https://images.theconversation.com/files/119962/original/image-20160425-22378-68rq6i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Rats are commonly used in animal testing</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-68440837/stock-photo-rat-in-laboratory-tests-on-animal-experiments.html?src=9XOxfxI_HlUB--6P27QedA-1-25">FikMik</a></span></figcaption></figure><p>Before a drug can be tested on humans, it has to be tested on animals. The drugs regulators <a href="http://www.efpia.eu/topics/innovation/animal-welfare">demand it</a>. Nobody – including researchers – likes testing on animals, which is why the race is on to find <a href="http://www.neavs.org/alternatives/in-testing">alternatives</a>. </p>
<p>For this reason – as well as the fact that animal models are often unable to correctly predict how a drug will react in humans – scientists are actively considering alternatives. Fortunately, rapid progress is being made in a number of areas which may soon, hopefully, render animal testing obsolete.</p>
<p>One promising alternative to animal testing is computer models. This “<a href="http://www.oapublishinglondon.com/article/1119"><em>in silico</em></a>” technique simulates the workings of human biology to predict how a new drug will behave in the body, where it will end up – and even what side effects might occur. </p>
<p>This helps researchers refine drug structures before they are tested in animals. It can reduce the number of animals that are tested on by weeding out compounds that are overly toxic or not likely to be effective. Almost all pharmaceutical companies now routinely use computer models in drug development as the database of background knowledge of how drugs interact with biological systems has expanded significantly in recent years. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/119964/original/image-20160425-22383-1f49c7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/119964/original/image-20160425-22383-1f49c7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/119964/original/image-20160425-22383-1f49c7c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/119964/original/image-20160425-22383-1f49c7c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/119964/original/image-20160425-22383-1f49c7c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/119964/original/image-20160425-22383-1f49c7c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/119964/original/image-20160425-22383-1f49c7c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">It can take up to 12 years and £1.15 billion for a drug to be ready for use.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/en/pic.mhtml?irgwc=1&utm_campaign=Pixabay&tpl=44814-43068&utm_medium=Affiliate&id=298303490&utm_source=44814">VonaUA</a></span>
</figcaption>
</figure>
<p>Another alternative to animal testing is <a href="http://mpkb.org/home/patients/assessing_literature/in_vitro_studies">“<em>in vitro</em>” testing</a>. These are biological and chemical mimics that recreate particular parts of the body. They include mimics of the <a href="http://www.scientificamerican.com/article/brain-in-a-dish-could-replace-toxic-animal-tests/">brain</a>, heart, lungs and a variety of other body systems. Although these systems may look nothing like the original organ, they will consist of cells or molecules that have been made in the lab and behave in a similar way to those found in actual biological systems. For example, the surface of the skin can be recreated to measure how fast drugs get through and how much can be delivered by this route. </p>
<p>These in vitro studies have become so advanced that it’s now possible to predict how drugs will behave in almost any part of the body or any disease state. This has been achieved through an accumulation of knowledge about the science behind each disease, from how the body behaves in a healthy situation to how it changes when unwell and then how drugs can cure the disease. </p>
<p>Using clinical data available for existing drugs allows scientists to compare real-life results with their mimics to prove their suitability before they are validated as a potential alternative.</p>
<p>Once the test system has been validated using known drugs, it can be used to analyse potential new drugs. Basically, once a new test method has proven effective it can begin the process of approval as a legal alternative for testing a specific property of a drug. In the EU these test methods are organised through EURL-ECVAM (the European Union Reference Laboratory for alternatives to animal testing), an organisation based in northern Italy.</p>
<h2>We’re getting there</h2>
<p>These alternatives to animal studies still need refining. Although they are used in some laboratories today, they can only help narrow down potential drug candidates or confirm results already obtained from animals. Unfortunately, at this time it is not possible to recreate all of the intricacies of the human body. The models we use are often overly simplified. This can sometimes make it hard to predict everything we need to know about a drug and we can miss out on noticing the more subtle biological interactions. </p>
<p>In some situations these simplified systems can work well, especially when ranking a series of potential drugs against each other, or looking for one particular interaction.</p>
<p>We are now in an incredibly exciting period of scientific progress. It is imaginable that all the information needed to understand how drugs behave can be determined without the need for animal testing. And it’s entirely plausible that in the next decade or two, animal testing will no longer be needed in the pharmaceutical industry.</p><img src="https://counter.theconversation.com/content/58183/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laura Waters does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Why are animals still being used in drug development and what are the alternatives that could end their use altogether?Laura Waters, Principal Enterprise Fellow, University of HuddersfieldLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/363442015-02-02T19:04:04Z2015-02-02T19:04:04ZSpot the snake oil: telling good cancer research from bad<figure><img src="https://images.theconversation.com/files/70802/original/image-20150202-13074-1krqyx3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There are ways non-scientists can assess if the research underlying big claims about cancer cures stacks up.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/andercismo/2349098787">Rafael Anderson Gonzales Mendoza/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span></figcaption></figure><p>Cancer is big news; we often hear of some kind of cure for some version of the illness. But whether it’s a “natural cure” or a promising molecule on its way to becoming a new medicine, there are ways non-scientists can assess if the research underlying the big claims stacks up.</p>
<p>Here are some tips to help you evaluate whether a cure claim is justifiable (spoiler: the evidence is rarely robust enough).</p>
<h2>Cell line testing</h2>
<p>As a minimum, any cure claim needs to demonstrate that the new molecule or natural therapy can stop the growth of cancer cells in what you might think of as test-tube experiments. Scientists call these <em>in vitro</em> tests (Latin for “in glass”).</p>
<p>These types of tests are the first in a long line because they’re cheap, easy, don’t require ethics approval and can be completed in one or two days. </p>
<p>The most important thing to look for in the results is whether an approved drug is used for comparison. The new cure needs to stop cancer growth at a dose lower than the comparison drug. And it needs to stop cancer cell growth at doses ten to 100 times lower than the approved drug to be really exciting.</p>
<p>Unfortunately, it’s very easy to get a good result in these kinds of tests and many hundreds of drugs are found to be just as effective as approved drugs. If curing cancer was simply a matter of getting a pass at this point, then we would indeed have cured it ten of thousands of times over. </p>
<p>Much of the evidence cited by non-scientists for natural cure claims are based solely on these <em>in vitro</em> tests. In reality, these experiments are only used as a screening (stop-or-go) test to determine whether the next level of testing is justified.</p>
<h2>Animal testing</h2>
<p>The next level is animal testing – and by animal, 99% of the time we mean <a href="http://www.medicinenet.com/script/main/art.asp?articlekey=33771">specially bred mice</a>. Animal experiments are known as <em>in vivo</em> tests (Latin for “within the living”). </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/70800/original/image-20150202-13049-14hw3w6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/70800/original/image-20150202-13049-14hw3w6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=426&fit=crop&dpr=1 600w, https://images.theconversation.com/files/70800/original/image-20150202-13049-14hw3w6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=426&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/70800/original/image-20150202-13049-14hw3w6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=426&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/70800/original/image-20150202-13049-14hw3w6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=536&fit=crop&dpr=1 754w, https://images.theconversation.com/files/70800/original/image-20150202-13049-14hw3w6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=536&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/70800/original/image-20150202-13049-14hw3w6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=536&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Specially bred mice, called nude mice, are usually used for <em>in vivo</em> tests.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/parksdh/15201585979">Daniel Parks</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>So what do you look for here? First, beware of tests that use more exotic or less established animal models, such as <a href="http://www.microtestlabs.com/zebrafish-embryos-testing/">zebra fish embryos</a> as the correlation of the results in these animals to humans is less certain. </p>
<p>And, again, make sure it has been compared to an approved drug, and that the drug is used in humans to treat the type of cancer the tested animal had. Experiments that use the incorrect drug for the cancer they are testing against will make the “cure” look better.</p>
<p>Look out for how often the animals are given the treatment. Most tests use a single treatment early in the study, but some use a schedule of multiple treatments. There can be valid reasons for using multiple treatments, but more treatments do make it a positive result more likely. </p>
<p>Also look out for <em>in vivo</em> tests where the approved drug is given one way (like an injection) but the new drug is given a different way (swallowed or inhaled). It’s hard to compare them accurately in these circumstances.</p>
<p>Next, look for how well it delays cancer growth compared with the approved drug. Is the difference only small or is the delay quite evident? Have the scientists shown a <a href="https://www.statpac.com/surveys/statistical-significance.htm">statistical difference</a> in cancer growth (they’ll mention this somewhere in the research paper) under the two treatment regimes? </p>
<p>Remember, these tests are just another stop-or-go checkpoint to warrant further testing. By themselves, they don’t indicate the new cure will work for humans. And many that do work in these tests go on to have no effectiveness in people.</p>
<h2>Clinical trials</h2>
<p><a href="http://medicinesaustralia.com.au/issues-information/clinical-trials/">Clinical trials</a> are really the point where you can start to pay attention to cure claims. This is when the first testing on humans takes place. But not all clinical trials are created equal. </p>
<p>There are three main levels. Phase I is only for determining side effects and effectiveness is not of primary concern. But it’s not uncommon for one or two patients to have cancers that respond to treatment. A positive result at this stage doesn’t indicate it will work for all patients, so beware of any study that claims a cure based only on phase I tests.</p>
<p>Phase II and phase III trials, where the drug is tested in specific cancer types and compared alongside approved drugs, are the important ones.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/70804/original/image-20150202-13057-13uyo9n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/70804/original/image-20150202-13057-13uyo9n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/70804/original/image-20150202-13057-13uyo9n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/70804/original/image-20150202-13057-13uyo9n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/70804/original/image-20150202-13057-13uyo9n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/70804/original/image-20150202-13057-13uyo9n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/70804/original/image-20150202-13057-13uyo9n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The key for understanding the results of many of the tests is ensuring the right things are compared.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/picturesofthings/2395065912">nikki/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
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</figure>
<p>The key thing to look for in the results is the overall survival rate (how many patients live for five years after the start of treatment) or the improvement in time-to-disease progression (the amount of time from the start of treatment until the cancer spreads or gets bigger). </p>
<p>Phase II, and more importantly phase III, trials are highly regulated. Any positive results claimed in the findings are reliable and indicative of real potential to make a difference in cancer treatment.</p>
<p>You can find details of cancer clinical trials in Australia <a href="http://www.australiancancertrials.gov.au/">here</a>, in the United States <a href="https://www.clinicaltrials.gov/">here</a> and in the European Union <a href="https://www.clinicaltrialsregister.eu/ctr-search/search">here</a>.</p>
<h2>Anecdotes are not evidence</h2>
<p>There’s a saying among scientists, “the plural of anecdote is not data”. And you’ve undoubtedly heard one of a hundred stories of how John or Jane Smith down the street was cured when treated with oil-of-something. </p>
<p>Many possible explanations for such “cures” may have nothing to do with their miracle substance. First, there could be a strong <a href="https://theconversation.com/to-understand-placebo-first-take-it-out-of-medicines-black-box-11004">placebo effect</a>; just the belief that what they’re using works can sometimes have an effect on someone’s health. But while a placebo may work for one person, we can’t know it will work for another.</p>
<p>Next, if the Smiths were using the untested “drugs” alongside normal treatment, it could be just the regular treatment that was working. </p>
<p>And, although rare, some cancers can go into spontaneous remission. In these cases, the cancer would have been cured regardless of what John or Jane was taking.</p>
<p>Finally, it’s important to remember when reading about cancer cures from less stringent sources that there can be <a href="http://skepdic.com/selectionbias.html">selection bias</a>. For every miracle cure story you read on a website (<a href="http://www.royalqueenseeds.com/blog-can-you-use-medical-marijuana-for-cancer-treatment--n56">like this one</a>) or on social media, there are thousands of stories of where it didn’t work that don’t make the cut. People don’t write about the failures.</p>
<p>So before you get excited about claims of a cancer cure, make sure you do your homework and determine whether the results are reliable, significant and not biased.</p><img src="https://counter.theconversation.com/content/36344/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nial Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible and the Scottish Universities Life Sciences Alliance for research into anticancer drugs. He is a current committee member of the Royal Australian Chemical Institute's NSW Pharmaceutical Science Group.</span></em></p>Cancer is big news; we often hear of some kind of cure for some version of the illness. But whether it’s a “natural cure” or a promising molecule on its way to becoming a new medicine, there are ways non-scientists…Nial Wheate, Senior Lecturer in Pharmaceutical Chemistry, University of SydneyLicensed as Creative Commons – attribution, no derivatives.