Ethics and Clinical Considerations (8,12,13,20)

Question 1

What best describes recent community attitudes towards stem cells in research?

a. 90% of people think it is unacceptable to use human embryonic stem cells
b. 17% of people think it is unaccapetable to use stem cells in general
c. 6% of people are unsure about using general stem cells or human ES cells
d. 88% of people are in favour of the use of human embryonic stem cells

Answer 1

c. 6% of people are unsure about using general stem cells or human ES cells

Question 2

What is involved in harvesting human ES cells?

a. IVF embryos are deliberately made in excess as supplies for stem cell research
b. Cells are derived from the inner cell mass at the 6 day stage
c. The embryo needn’t be destroyed for ES cells to be harvested
d. ES cells are derived directly from the fertilised egg on day 1

Answer 2

b. Cells are derived from the inner cell mass at the 6 day stage

Question 3

What is not a feature of stem cell use regulation in Australia?

a. Applications are considered under the Research involving Use of human embryos act 2002 and Prohibition of human cloning act 2002
b. The project is considered based on obtaining consent, likelihood of significant findings, number embryos needed
c. Once a license is received, embryos generated by human ES cells can be implanted in an animal uterus, but not human
d. Human ES stem cells may not be used but research can utilise iPS cells as an ethical alternative

Answer 3

c. Once a license is received, embryos generated by human ES cells can be implanted in an animal uterus, but not human

Question 4

What was not involved in the creation of the mouse ‘Tiny’?

a. A tetraploid blastocyst was created from somatic cell nuclear transfer
b. iPS cells were injected into a tetraploid blastocyst and fully contributed to the genetic makeup of Tiny
c. The developing embryo was implanted into a surrogate mother
d. The process was very inefficient in generating offspring

Answer 4

a. A tetraploid blastocyst was created from somatic cell nuclear transfer

Question 5

• The most stringent research restrictions apply to the use of iPS cells rather than IVF and hESC.

Answer 5

F

Question 6

What is not a property of a pluripotent stem cell?

a. Grows indefinitely in vitro
b. Maintains normal genetic makeup
c. Can differentiate into a range of somatic and extra embryonic tissue in vivo
d. Can colonise all tissue except that of the germ line

Answer 6

d. Can colonise all tissue except that of the germ line

Question 7

What is not a practical application of iPSC?

a. Reprogramming blood cells of someone with liver disease to form hepatocytes
b. Screening induced cells to make disease and patient specific drugs
c. Creating human embryos without the need for a uterus
d. Implanting hepatocytes with corrected gene mutations into a patient with liver disease

Answer 7

c. Creating human embryos without the need for a uterus

Question 8

What is not an advantage of iPSC?

a. Material and technology is readily accessed
b. Complex multigenic diseases can be modelled in vitro and in vivo
c. Individual variations in tissue regeneration and repair pathways can be examined and biomarkes can be developed
d. Unlike ESC, the effects of a single gene mutation on different genetic backgrounds can be analysed

Answer 8

b. Complex multigenic diseases can be modelled in vitro and in vivo (in vitro)

Question 9

What is a consideration when using iPSC?

a. The gene must be delivered in a viral vector that integrates into the host genome to ensure full efficiency and safety
b. There are variations in differentiation capacity for ES and iPS cells in culture
c. The type of cell used to five rise to iPSC should be chosen carefully as stem cells lack somatic tissue memory
d. Genetic lesions and chromosome aberrations can only be observed in hESCS

Answer 9

b. There are variations in differentiation capacity for ES and iPS cells in culture

Question 10

What would not be observed as a result of variation in differentiation capacity of pluripotent cells?

a. Variation in TALEN cleavage sites
b. Transcriptional variation
c. Variation in differentiation efficiency
d. Disease variation in contributing to phenotype

Answer 10

a. Variation in TALEN cleavage sites

Question 11

What is a way for genetic lesions to arise during the development of pluripotent stem cells?

a. The somatic origin of an iPSC will not influence genetic lesions
b. iPSCs can develop aberrations due to their somatic origin, the reprogramming process and culture conditions
c. iPSCs are resistant to aberrations that could arise in cell culture
d. hESCs can develop aberrations during the induced reprogramming stage

Answer 11

b. iPSCs can develop aberrations due to their somatic origin, the reprogramming process and culture conditions

Question 12

How do ESC and iPSC compare?

a. They have different gene expression patterns
b. They show varying degrees of susceptibility to genetic change
c. They have similar patterns of DNA methylation and histone modification
d. They have a similar capacity for differentiating into specific linages

Answer 12

d. They have a similar capacity for differentiating into specific linages

Question 13

• ESCs are the only kinds of human pluripotent stem cells.

Answer 13

F (iPS)

Question 14

• iPS cells can be used to create cardiomyocytes of people with long Q-T syndrome and demonstrate how their heart beat rhythm is affected and influenced by drugs.

Answer 14

T

Question 15

• Cell replacement of neurons is more critical than enhancing plasticity.

Answer 15

F

Question 16

• TALENS are simpler to make and more efficient than CRISPR.

Answer 16

F

Question 17

• TALEN endonucleases can be used to genetically manipulate human pluripotent stem cells.

Answer 17

T

Question 18

• Most ES cell lines are very unstable.

Answer 18

F

Question 19

• It may be possible to make germline modifications in humans and produce iPS cell gametes.

Answer 19

T

Question 20

What is not a challenge for stem cell therapy?

a. Safety due to the possibility of tumour formation
b. Delivery method and which cell to use
c. Funding and business models
d. Finding enough donor embryos to harvest ESCs

Answer 20

d. Finding enough donor embryos to harvest ESCs

Question 21

What is involved in the framework of stem cell product development in Japan?

a. The main goal is to bridge the valley of death
b. Clinical trials in mice occur after marketing
c. After safety has been established, a marketing stage occurs and patients can be recruited
d. There is no marketing stage and the process is streamlined

Answer 21

c. After safety has been established, a marketing stage occurs and patients can be recruited

Question 22

What is not involved in forming neural tissue in vitro?

a. Embryonic heads are treated with noggin
b. Resulting neural tissue secretes Sox2 and noggin
c. Primitive neural tissue is marked by nestin and Sox2
d. The eye forms as an outgrowth of the embryonic brain

Answer 22

b. Resulting neural tissue secretes Sox2 and noggin

Question 23

Why is macular degeneration a promosing target for stem cell therapy?

a. Many cells are required to replace the tissue
b. The epithelium is functional when derived from ES cells
c. The eye is accessible despite being difficult to image
d. There is no requirement for immunosuppression

Answer 23

b. The epithelium is functional when derived from ES cells

Question 24

Which is not a clinical trial for pluripotent stem cell therapy?

a. Breast cancer
b. Type 1 diabetes
c. Parkinson’s disease
d. Spinal cord injury

Answer 24

a. Breast cancer

Question 25

What is a consideration for using iPS stem cell therapy? a. Reprogramming to pluripotency is always complete b. Genetic lesions cannot occur from iPS cells c. Differentiation capacity can vary between cells d. Tumour formation can only arise from bone marrow derived iPSC

Answer 25

c. Differentiation capacity can vary between cells

Question 26

What is an issue for the regulation of stem cell therapies? a. Cell therapies have a short half life b. Risk benefit assessment is critical c. Treatment requires a small dose of specifically designed cells d. The main focus for therapy should be how much profit can be gained

Answer 26

b. Risk benefit assessment is critical

Question 27

What is not a feature of unfounded stem cell therapies (i.e. stem cell slinics) ? a. They can successfully cure metabolic diseases b. Treatments are often costly c. Treatment lacks scientific rational d. Evidence for treatment is anecdotal

Answer 27

a. They can successfully cure metabolic diseases

Question 28

• In the past 10 years there have been about 2500 clinical trials and 50% are in phase 2-3.

Answer 28

T

Question 29

• To prevent mitochondrial disease, the egg of a mum with mitochondrial disease can receive exogenous DNA before being fertilised with the fathers sperm.

Answer 29

F (need maternal DNA and donor egg. Egg has mtDNA)

Question 30

• Chromosomal changes in ESC and iPSC are not similar to those changes shown by cancer.

Answer 30

F

Question 31

What is a trend seen in the source of haematopoietic stem cells? a. Peripheral blood stem cells are now rarely used b. Bone marrow is still the preferred source c. The use of cord blood is increasing d. iPS derived haematopoietic stem cells are the preferred source

Answer 31

c. The use of cord blood is increasing

Question 32

What is an example of a clinical trial for novel application of stem cells? a. Mesenchymal stem cells used to regenerate retinal epithelium after macular degeneration b. Foetal stem cells used to derive oligodendrocyte precursors in the case of spinal cord injury c. hESCs used to engineer neural stem cells following stroke d. Foetal stem cells used to repair damage due to osteoarthritis

Answer 32

b. Foetal stem cells used to derive oligodendrocyte precursors in the case of spinal cord injury

Question 33

How does the public perceive risks associated with stem cell therapy? a. 90% believe risks are high b. 64% are unsure if there are risks c. 50% are unsure if there are risks d. 64% believe there are no risks

Answer 33

d. 64% believe there are no risks

Question 34

What is not a concern of stem cell tourism? a. Marketing is based on testimonials b. The treatments are often successful but not linked with existing care c. Treatments are expensive and invasive d. One treatment is often marketed as being able to fix multiple conditions

Answer 34

b. The treatments are often successful but not linked with existing care

Question 35

• The use of haematopoietic stem cells is considered a novel application.

Answer 35

F