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人类胚胎研究的政治因素以及实现植入前基因诊断的动机。

The politics of human embryo research and the motivation to achieve PGD.

作者信息

Theodosiou Anastasia A, Johnson Martin H

机构信息

Anatomy School and Trophoblast Research Centre, Department of Physiology, Development and Neuroscience, Downing Street, Cambridge CB2 3DY, UK.

出版信息

Reprod Biomed Online. 2011 May;22(5):457-71. doi: 10.1016/j.rbmo.2011.01.008. Epub 2011 Jan 24.

Abstract

This article reports a historical study of factors influencing the achievement of clinical preimplantation genetic diagnosis (PGD) in 1990, 22 years after its first demonstration in animals. During the 1970s, research on PGD continued in large farm animals, but serious interest in human PGD was not evident until 1986. First, interest in PGD during the 1970s waned with the advent of prenatal testing, which for gynaecologists was clinically more familiar, technically simpler and ethically less challenging than IVF. Indeed, IVF was viewed with widespread suspicion until the first IVF births in 1978. Second, interest in clinical PGD was stimulated by the UK Parliamentary reaction against human embryo research that greeted the Warnock Report in 1984. This hostility led scientists to initiate a pro-research campaign, further galvanized in 1985 by MP Enoch Powell's bid to ban such research. However, while Powell abhorred embryo research, he approved of PGD, a stance that divided the anti-research lobby. Accordingly, the campaigners for research emphasized that it was needed to achieve PGD. Powell demanded evidence of such projects and PGD research increased from 1986. It is concluded that UK political debates on embryo research played a critical role in stimulating the achievement of clinical PGD. Human pregnancies following preimplantation genetic diagnosis (PGD) for embryo sex were announced in 1990, 22 years after the technique was pioneered in animals. PGD in humans required not only technological advances, such as IVF and sensitive diagnostic tests, but also the motivation to develop and apply them. Our historical analysis shows that, although research on PGD continued in large farm animals during the 1970s, and techniques of the required sensitivity were developed on mouse embryo models, interest in clinical PGD was not evident until 1986. Two factors stimulated this sudden change in motivation. First, interest in PGD was depressed during the 1970s by the advent of prenatal diagnostic techniques, which for gynaecologists were clinically, technically and ethically less challenging than IVF. IVF was then regarded with a suspicion that only started to wane in the early 1980s following the first IVF births. Second, the UK Parliamentary reaction against human embryo research that greeted the Warnock Report in 1984 provided a positive stimulus to clinical PGD by prompting scientists to form a pro-research lobby, which was further galvanized in early 1985 by MP Enoch Powell's almost-successful bid to ban human embryo research. We show that while Powell abhorred embryo research, he approved of PGD, a stance that fractured the unity of the anti-research lobby. Accordingly, the pro-research lobby emphasized that embryo research was needed to achieve PGD. Powell demanded evidence of such projects, thereby, we argue, stimulating PGD research from 1986. Our evidence shows that UK political debates about PGD played a critical role in stimulating the achievement of PGD clinically.

摘要

本文报道了一项关于影响1990年临床胚胎植入前基因诊断(PGD)实现因素的历史研究,此时距离其在动物身上首次得到证实已过去22年。在20世纪70年代,对PGD的研究在大型农场动物中持续进行,但直到1986年,人们才对人类PGD产生浓厚兴趣。首先,20世纪70年代对PGD的兴趣随着产前检测的出现而减弱,对于妇科医生来说,产前检测在临床方面更为熟悉,技术上更简单,且在伦理上比体外受精(IVF)更具挑战性。事实上,在1978年首例IVF婴儿出生之前,IVF受到了广泛怀疑。其次,1984年英国议会对人类胚胎研究的反应引发了对临床PGD的兴趣,当时议会对《沃诺克报告》做出了回应。这种敌意促使科学家发起了一场支持研究的运动,1985年议员伊诺克·鲍威尔试图禁止此类研究,这进一步推动了该运动。然而,尽管鲍威尔憎恶胚胎研究,但他赞成PGD,这一立场使反对研究的游说团体产生了分歧。因此,支持研究的人士强调实现PGD需要进行研究。鲍威尔要求提供此类项目的证据,从1986年起PGD研究有所增加。结论是,英国关于胚胎研究的政治辩论在推动临床PGD的实现方面发挥了关键作用。1990年宣布了针对胚胎性别的植入前基因诊断(PGD)后的人类妊娠,此时距离该技术在动物中开创已过去22年。人类的PGD不仅需要技术进步,如IVF和灵敏的诊断测试,还需要开发和应用这些技术的动力。我们的历史分析表明,尽管20世纪70年代对PGD的研究在大型农场动物中持续进行,并且在小鼠胚胎模型上开发出了所需灵敏度的技术,但直到1986年,对临床PGD的兴趣才变得明显。有两个因素激发了这种动机上的突然转变。首先,20世纪70年代产前诊断技术的出现降低了对PGD的兴趣,对于妇科医生来说,产前诊断技术在临床、技术和伦理上比IVF更具挑战性。当时IVF受到怀疑,直到20世纪80年代初首例IVF婴儿出生后这种怀疑才开始减弱。其次,1984年英国议会对《沃诺克报告》中人类胚胎研究的反应为临床PGD提供了积极刺激,促使科学家组成了一个支持研究的游说团体,1985年初议员伊诺克·鲍威尔几乎成功禁止人类胚胎研究,这进一步推动了该团体。我们表明,尽管鲍威尔憎恶胚胎研究,但他赞成PGD,这一立场打破了反对研究游说团体的团结。因此,支持研究的游说团体强调需要进行胚胎研究以实现PGD。鲍威尔要求提供此类项目的证据,我们认为,从而促使1986年起PGD研究的开展。我们的证据表明,英国关于PGD的政治辩论在推动临床PGD的实现方面发挥了关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cc9/3101706/2fad2f408a8e/gr1.jpg

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