Showing posts with label NED. Show all posts
Showing posts with label NED. Show all posts

Naїve Human Pluripotency & The Broad Shoulders of Science

Stevenage, UK BioScience Campus
Scientific debate in the pursuit of knowledge by way of accumulated evidential data is fundamental, just as socio-economic competition is needed to spur innovation, product development & growth in commercial business. Distinct and largely operating on their own, these two worlds have now collided and become integrated in a synthetic process that is driving 21st century evolution.

As a pillar of progress and community success, medical science is a central focus of tomorrow’s design. One in which the health and well-being of society can be calculated and factored into the spreadsheets of sustainability. The footnotes in such macros are bolded as requirements to achieve, yet are a challenge to deliver.  

Salk iPS_Ruiz-StemCell
Given this backdrop the nature of a pluripotent cell, with its ability to generate all tissue types, has been a hot topic of debate and investigation for many years. Its potential is often cited but the field remains a few steps away with many questions still to be answered. 

Source, Stability and Scale – the trinity of our destiny caught in a matrix of possibilities where clarity of method is needed. 

Science knows no bounds when it comes to unresolved issues of definition and process, so the discussion continues. However, with advents in genomic analysis the cell systems of our inner being are becoming clearer and these new insights are helping to provide the answers. 

The human "naїve" cell state in the earliest stages of human embryogenesis is one such focus. The identification and establishment of cell lines along the pluripotent continuum has been a foundational endeavor of the community. Ever since the mouse modelling proved the existence of these powerful engines of growth have the leading labs sought to isolate and engineer the human equivalents. This ongoing work has inspired the field to challenge each other to discover and answer the unresolved questions that will unlock the full potential of pluripotency. 


Whitehead Institute MIT
In its so called "naїve" state the pre-programming of the early cell development machinery hasn't kicked off yet and committed to its natural tissue generating pathways, hence the terminology. The use of cells at this early moment in the cycle could alleviate some of the drawbacks of the standard later stage "primed" version, allowing for more efficient homologous recombination in a therapeutic setting using reprogramming technologies. The naїve state also has a greater proliferation capability and can differentiate more effectively into all desired tissue types. In addition, these cells are able to form inter species chimeras for research and tissue engineering, a highly valuable addition to the toolbox.    

Over the years I have looked for data on early stage embryonic states, specifically any variations in the genetic profiles of pre-compaction blastomeres and ICM hESCs. The Galan, Á. et al (2010) Valencia paper was one such document I found. Of note here in the more recent research done on early human development was that the variation in profiling was correlated to naїve at a specific stage of human embryogenesis at around the 8 cell stage (referred to in Q&A). This moment evidently coincides to the withdrawal of maternal influence yet prior to the blastocyst wave of fate expression.  

Benjamin Dodsworth
I touched on the pluripotent topic during my interviews in Sweden during this year’s annual ISSCR 2015 conference and followed up by reading a then just published paper entitled “The Current State of Naїve HumanPluripotency¹.Benjamin Dodsworth of Oxford co-authored the work with his colleagues Rowan Flynn and Sally Cowley (team leader and head of the James Martin Stem Cell Facility, affiliated to the Oxford Stem Cell Institute, at the Sir William Dunn School of Pathology, University of Oxford).

Sally Cowley Ph.D
The passage in the paper's abstract about the naïve state not being an “artifact” caught my attention and intrigued me given the differing opinions on the subject, the extent to which mouse modelling is representative of human developmental biology and the evolving genetic data analysis of early stage embryonic cell states.

I connected with Ben in a Twitter exchange and he was open to doing a Q&A on the topic, which we started prior to some subsequent developments in the area (iPS “2C” totipotent reprogramming² and the Karolinska paper³ on early human development). Comments on the 2C paper are included in the interview below in [brackets]. 

Thank you Ben for your feedback & good luck with your research.

Cheers

Q&A:

M - With regard to the human Naive state generally and attempts made to create hNaïve cell lines, are we really mainly discussing iPS reprogramming techniques to revert to an earlier point of embryogenesis or would you envision a new methodology for ICM hESC cell lines with them being converted backwards post extraction also? If so do you envision any technical issues associated with than or in their maintenance?

B - Very good point. There are clear parallels to iPS reprogramming techniques. We are currently looking at a method to convert already established human pluripotent stem cell (hPSC) lines to the naïve state. However, if the naïve state is indeed as useful as we anticipate and becomes our new standard, I would expect the emergence of protocols to generate naïve induced pluripotent stem cells directly from primary cells (such as fibroblasts) which skip the primed state. If this holds true, I do expect technical issues. Many protocols for handling hPSCs have been optimised for cells in the primed state. These will not be ideal for naïve cells. Maintenance of naïve human cells might also be challenging and current standard operating procedures will have to be adapted.

M - You mention hESC differentiation pathways that are unreachable - which are those?

B - Endodermal and germline lineages are difficult to access with our current primed hPSCs. This means that although possible, it is inefficient. The Hanna lab have actually used naïve cells to generate primordial germ cells (PGCs) very efficiently. In comparison, primed cells do not efficiently differentiate into PGCs.

Just as important as accessing these differentiation pathways is the maturity of the cells we then produce. Maturity is the extent to which their functions resemble the in vivo cell type. Naïve hPSCs might increase the level of achievable maturity (for example of hepatocytes).

But what I find a lot more interesting is that we have excellent protocols for the differentiation into cells (for example dopaminergic neurons) which work robustly with some hPSC lines but not with others. This heterogeneity could be removed with a protocol which uses cells that are developmentally at the same starting point and without epigenetic bias. The naïve state could deliver on both of these aspects.

M - Has there been any focus on comparative analysis done using hESCs derived from various cell stages of the early human embryonic Blastomere cell stages 2, 4, 8, 16?

B - To my knowledge this has not been performed using hESCs derived from different developmental time points. However, a very useful direct comparison of current naïve and primed hES lines to early human embryonic blastomere cell stages has been performed using single cell transcriptomics by Huang, Maruyama, and Fan (go directly to Figure 2B). They used datasets from Vassena et al., 2011, Xie et al., 2010 and Yan et al., 2013 and compared gene expression to various naïve cells.

M - Why is the Naive state also referred to as Ground State? Is there any technical reason? 

B - Ground state and naïve state both describe the earliest accessible and unbiased cellular state. These terms are interchangeable.

M - Do you believe the reprogramming concept being studied will ultimately be pursued to the point where reversion produces a Totipotent state in order to fully map the process?

B - Possibly, but there are many technical hurdles to overcome and ethical issues to consider.

[M - Do you have a as follow-up comment on this point with regard to the recent Inserm Totipotent development?

B - The 2C paper is indeed a very interesting piece of work which I have been following closely. However, I would like to see more evidence for totipotency, in particular higher efficiency differentiation down difficult lineages such as PGCs. There is not enough evidence to show that these cells are indeed totipotent. For our lab, totipotent cells are unnecessary and we won’t be using these.]

M - Do existing techniques adequately result in Pluripotent cells able to be scaled and applied effectively to therapeutic programs?

B - Current techniques allow the production of induced pluripotent cells to be scaled up. However, before iPS cells can be used therapeutically, the field needs to overcome some fundamental issues. Two main challenges revolve around the host eliciting an immune response to hES or iPS cells even when sourced from the same individual and on the other hand, pluripotent cells have been changed to allow proliferation. This raises concern that these cells could be more susceptible to becoming cancerous. There is a lot of preclinical work to be done.

M - In your conclusion you point to the protocols yielding different results which has yet to be interpreted conclusively, as well as the transient nature of the actual biological moment in-vivo which it may occur. In addition you point to the possibility of a scale of different states along the defined continuum. In that respect would you say any in-vitro activity to reproduce these embryo-genesis states are by defacto man made events and the best we can expect ultimately is a "like" status?

B - Absolutely. Any cell grown into the lab is unlikely to be exactly the same as the in vivo counterpart. As long as we keep this in mind and factor it into our data interpretation, this is not a problem.

M - The data you cite regarding the primate transcript HERVH indicates that mouse systems are distinct to that of primates in this specific area (at least that monkey species). This would indicate that aspects of the human embryo-genesis system are biologically different to that of mouse, in certain ways. Does that perhaps also apply to cell prodigy behavior in your opinion?

B - The paper discussing HERVH is an excellent piece of work which shows compellingly that pluripotency networks are indeed different between human and mouse. And you are right, we can also see these differences in the cellular behaviour. Mouse and human ES cells cannot be cultured in vitro in the same way. The networks which allow capture of naive pluripotency in mouse are not identical to the human system.

M - The utility advantages you mention of Naive versus Primed indicate manufacturing bias towards use of Naive in the future. Can you outline the utility issues specifically for naive cell use and do you view this for specific clinical purposes or for certain discovery processes.

B - Although some labs are currently working on clinical applications, we are focusing on using hPSCs for modelling only. The human naive state promises a lot of benefits – if it is indeed similar to the naive state in mouse. Extrapolating from the mouse, homogeneity would be expected to be improved in naive cell populations. This means that cells are held not in a spectrum of states but all at exactly the same developmental time point. Differentiation protocols could be a lot more effective when applied to a uniform starting point. Other benefits include higher cell yields due to faster doubling times and easier handling.

M - The statement that "TGFβ might not be essential in the human system" caught my attention. Can you elaborate on that in light of published data.

B - In the past, TGFβ signalling was required to maintain hPSCs in culture. However, the requirement of TGFβ signalling is a trait associated with the primed state. In addition, the inhibition of TGFβ signalling increases efficiency of mouse iPSC reprogramming. This is why it would be interesting if we can culture hPSCs without TGFβ.
##

[Follow-up Q relating to the Karolinska analysis paper³ on early human development was left unanswered prior to publishing]

Q&A Refs:

1. Dodsworth, B. et al. (2015). The Current State of Naïve Human Pluripotency. Stem Cells. doi: 10.1002/stem.2085

2. Ishiuchi, T. et al (2015). Early embryonic-like cells are induced by downregulating replication-dependent chromatin assembly. Nature Structural & Molecular Biology 22, 662–671 (2015) doi:10.1038/nsmb.3066

3. Töhönen, V. et al. Novel PRD-like homeodomain transcription factors and retrotransposon elements in early human development. Nat. Commun. 6:8207 doi: 10.1038/ncomms9207 (2015).

4. Huang, K. et al. (2014). The Naïve State of Human Pluripotent Stem Cells: A Synthesis of Stem Cell and Preimplantation Embryo Transcriptome Analyses. Cell Stem Cell 15(4): 410-415.

5. Vassena, R. et al. (2011). Waves of early transcriptional activation and pluripotency program initiation during human preimplantation development Development 138, 3699–3709

6. Xie, D. et al. (2010). Rewirable gene regulatory networks in the preimplantation embryonic development of three mammalian species" Genome Res. 20, 804–815.

7. Yan, L. et al. (2013). Single-cell RNA-Seq profiling of human pre-implantation embryos and embryonic stem cells. Nat. Struct. Mol. Biol. 20, 1131–1139.

Selected Other Refs (in no particular order):

Takahashi/Yamanaka review of the iPS reprogramming pluripotency

Takahashi,K., et al. A developmental framework for induced pluripotency. Development 2015 142: 3274-3285; doi: 10.1242/dev.114249 
______
Salk paper on region specific PSCs (2015):

Wu, J. et al. An alternative pluripotent state confers interspecies chimaeric competency. Nature 521, 316–321 (21 May 2015) doi:10.1038/nature14413
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Genomic analysis using single cell RNA (2013)

Xue, Z. et al. Genetic programs in human and mouse early embryos revealed by single-cell RNA sequencing. Nature 500, 593–597 (29 August 2013) doi:10.1038/nature12364
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Naive cells in hESC culture using a HERVH promoter & gene analysis of ICM & early embryo cells

Wang, J. et al. (2014). Primate-specific endogenous retrovirus-driven transcription defines naive-like stem cells. Nature 516, 405–409, doi:10.1038/nature13804
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1st Naive Paper MIT (w/ Hanna now in Israel, Weizmann)

Hanna, J. et al. (2010). Human embryonic stem cells with biological and epigenetic characteristics similar to those of mouse ESCs. Proc Natl Acad Sci U S A. 2010 May 18; 107(20): 9222–9227.
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A.Smith Cambridge downstream transcription factor Tfcp2l1 in Naive conversion

Martello, G. et al (2013). Identification of the missing pluripotency mediator downstream of leukaemia inhibitory factor. EMBO J. 2013 Oct 2; 32(19): 2561–2574. doi: 10.1038/emboj.2013.177
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Singapore use of 3iL creates a closer native epiblast state of pluripotency "Naive" (rewiring of regulatory circuitry)

Chan, Y-S. et al. (2013). Induction of a Human Pluripotent State with Distinct Regulatory Circuitry that Resembles Preimplantation Epiblast. Cell Stem Cell. 2013 Dec 5; Vol 13, Issue 6. doi:10.1016/j.stem.2013.11.015
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Hanna Weizmann Institute use of 2iL & in-vitro derivation of mouse like naive cells capable of forming inter-species mouse–human chimeric embryos

Gafni, O. et al (2013). Derivation of novel human ground state naive pluripotent stem cells. Nature. 2013 Dec 12;504(7479):282-6. doi: 10.1038/nature12745.
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Seattle Washington alternative derivation method to Naive state

Ware, C. et al. (2014). Derivation of naïve human embryonic stem cells. Proc Natl Acad Sci U S A. 2014 Mar 25; 111(12): 4484–4489. doi:10.1073/pnas.1319738111
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Whitehead MIT Talen mediated reporter system for naive derivation medium 5iL (R. Jaenisch)

Theunissen, T. et al. (2014). Systematic Identification of Culture Conditions for Induction and Maintenance of Naive Human Pluripotency. Cell Stem Cell doi: 10.1016/j.stem.2014.07.002
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A. Smith Cambridge team uses simple transient expression of two transcription factors to rewire back to Naive

Takashima, Y. et al (2014). Resetting Transcription Factor Control Circuitry toward Ground-State Pluripotency in Human. Cell, Vol.158, Issue 6, 2014 Sept 11. DOI: 10.1016/j.cell.2014.08.029
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Valencia early embryo gene analysis

Galan, Á. et al (2010). Functional Genomics of 5- to 8-Cell Stage Human Embryos by Blastomere Single-Cell cDNA Analysis. PLOS | One 2010, Oct 26. DOI: 10.1371/journal.pone.0013615
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Developmental biology focus on human tissue

Gerrelli, D. et al. (2015). Enabling research with human embryonic and fetal tissue resources. Development 2015, Sept 15. doi: 10.1242/dev.122820
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Harvard led w/ Daley/Jaenisch/Rossant - Comments by Hanna

De Los Angeles, A. et al (2015). Hallmarks of pluripotency. Nature 525, 469–478 (24 September 2015) doi:10.1038/nature15515

Creation, Ensoulment, Birth & The Ethical Use of a Donated Cell

School of Athens” by Rafael w/ Plato and Aristotle - referred to by
Pope Francis during EU Parliamentary address Nov 25, 2014
There is a bridge between the opinions that divide us on this subject. I have written a number of times on the Middle Way, a Compromise if you will, that will heal the scar and abate the fear.

There is an ethically sound scientific process to allow for a donated Pluripotent stem cell from Human pre-embryos to be used for medicine.

The cellular process of embryogenesis has been studied at great length. The fundamental origin of Human Life is indeed the Creation of a pre-embryo – that Sperm and Egg moment and the days thereafter of cell preparation for a Mother’s acceptance. This fertilization moment and the immediate cell divisions after are central to the beginnings of Healthy Physical Life. This understanding is universally acknowledged.

The success of that biological union in the combination of DNA from both parental sexes (male & female) provides the early catalytic events that set in motion the journey to deliver a full term baby. The process is clearly not perfect by anyone’s measure and doesn’t at all guarantee stepwise progress nor a healthy outcome. There are a number of important & vital moments along the way – most importantly to all is the Mother’s acceptance of the pre-embryo into her uterus via the Implantation process around Day 8 or 9 post fertilization.

The period before Implantation is referred to as the “pre-embryo” phase, as it is clear from the scientific evidence and analysis that the cellular process of developmental Life isn't sufficiently complete to begin the formation phase of Human Life unless these early individual cells develop to the Blastocyst stage, are accepted and successfully embedded in the uterus wall of the Mother. Unless that happens a woman will pass the pre-embryo cells out of her system, as she does with the uterus walls during her monthly period cycle. Some women never accept a pre-embryo into their uterus as a result of many possible problems, including the genetic instability or malformation of the combined DNA nucleuses. Some women can only conceive with IVF assistance and pre-embryo screening help.

IVF is not the topic here so I will leave that for others to continue to debate its validity as this blog article is in reference to the pre-embryo period and the possible non-destructive removal of a single cell during this post-fertilization phase prior to Implantation.

Fertilization and the pre-embryo period is a starting cycle without which Human Life couldn't develop, yet it is still merely a starting signal for the remaining many phases that will confirm and define what it is to Be Human.

The scientific distinction is as clear as an Egg and Sperm. A pre-embryo is the union of DNA strands ready to embark on the journey to create a Human. A ball of intelligent cells pre-programmed to develop if the formation is correct, the proper signals received and the internal script processed successfully. An embryo is the resultant accepted & developing Lifeform once embedded in the Mother’s uterus. A Fetus is an established growing person with a beating heart and developing brain within the Mother’s womb. These stages of Life are clearly delineated by the process itself. Science merely exposed what Nature has already defined. The success ratio of Nature is nowhere near perfect in this process, as naturally fertilized ovums are discarded regularly and assisted conception ratios low.

What is important to note here is the difference between a pre-embryo, an embryo and an Human Fetus.

Needless to say all stages are Life and should be duly respected.

Healthy Human Life can and does develop from a pre-embryo after one cell is extracted for analysis and medically screened while the remaining pre-embryo cells continue to divide and develop. The same biological process is required for all pre-embryos to be accepted into and nurtured by the Mother’s uterus – including the one that had a cell extracted for genetic screening. Healthy babies are born every day using various cell extraction screening techniques, free of genetic issues as a result.

The confusion here is that during these past years of discovery cells were used from leftover & donated pre-embryos that were not needed any longer by couples that had fertility treatment to conceive. These pre-embryos were donated and had their cells removed in a process which terminated the pre-embryo’s development. This method of obtaining cells via donated pre-embryos for science continues. This method of cell extraction isn't necessary as a cell can be extracted from an earlier stage pre-embryo using a technique called Preimplantation Genetic Diagnosis (PGD), which is used daily by fertility clinics world-wide. It can and should be used as the method of choice to extract a Pluripotent cell from a pre-embryo in order to screen for genetic issues while also enabling the process of scientific discovery & cellular science. A Pluripotent cell is not a pre-embryo nor is it capable of developing to become a pre-embryo or embryo. The use of this PGD process can & does maintain the integrity of the pre-embryo state and it’s potential, while allowing for genetic screening & vital treatments for those that suffer from disease. One does not negate the other.

While I can appreciate the moral dilemma with respect to those that feel a pre-embryo is a Human Life, I must differ in that the science has proven that Human Life isn’t yet defined in these cells. There is Biological Life of course present and the potential to develop further into a Human but it isn’t sure whether it may or may not have the integrity to be viable nor capacity to develop further. It isn't sure either that the Mother’s system will accept the pre-embryo into her uterus and begin the developmental process of formation to become what is defined by all as being Human. This process is dependent on a number of natural system checks and balances. It has been revealed that a successful pre-embryo must first properly create a DNA construct and divide correctly to the point of being presentable to the Mother’s uterus. Incorrectly formed pre-embryos don’t, in almost all cases, pass this initial test. To say that an incorrectly formed pre-embryo that is rejected by the Mother’s system is a Human is wrong. This would by extension apply also to a pre-embryo that seems to have the right cellular makeup but still doesn't get accepted by the Mother’s uterus for other natural selection reasons. There are chemical signals within the Mother’s body that function as a viability filter and She initiates acceptance & provides the signal environment for Human organ development post Implantation. So unless a pre-embryo embeds in the uterus we cannot begin to be classified as Human as we haven’t started to emerge from that pre-embryo ball of cells and take shape. Even then the issue of the many and correctly passaged development stages of the embryo into a Fetus lies ahead.

Our Churches, Temples & Shrines aren't the sole purveyors of ethics and moral standing in our community. They certainly can help us along the path but we must all accept our own responsibility to understand and draw conclusions on the reality of our progress as a society. If Religion is anything it is a bellwether for the community and when some within the community need its guidance it has a duty to inform and guide based on the best interests of the people themselves, by disseminating knowledge and wisdom in a practical and spiritual context.

I say this as it has long been debated whether pre-embryo cells from donated IVF fertility treatments are sound ethical starting blocks for medical science. Will this still be the case when the truth is known that pre-embryos need not be destroyed and their potential maintained?

It is my opinion that to negate the progress of medical science in assisting the creation of Life is tantamount to ignoring Man in their quest for Love & Happiness. Especially if it doesn't harm the potential of further Life becoming a reality. It is also important to acknowledge that while assisting Life science has opened a door for simultaneous treatment of the sick. Life and Treatments together in one, as God intended.

Will there be criticism when medical science proves that Mother Natures’ most important cells – the potential Life forming pre-embryo cells – are used for the living that suffer and provide needed relief? Or will the misunderstood concept of the need to destroy prevail while the true facts of early Life processes, the nature of an independent cell state & its developmental knowledge be withheld from God’s people?

Pre-embryo cells can be taken without harm to the potential of Life and donated to help the living. Tissue willingly provided, as is done regularly today with blood and organs. A child can be born only when a pre-embryo is accepted by a Mother’s uterus, develops and successfully grows to term.




A day 3-4 Morula stage cell extraction does not destroy the potential to create Life. 
Later stage cell extractions at the Blastocyst Stage terminates the pre-embryo.
 
Ensoulment is by a far the greatest gift to Human Life – for without it we would be unconscious. Consciousness defines our Personhood, our Self. It is the defining characteristic that allows the physical to exist and the non-physical to be reasoned. One could say that this component of Humanity is Divine. It certainly is one of the central tenets of Religion and for which a valued guide in our community is sought.

Throughout the History of Christianity there has been an overriding concept debated within the inner halls of the Institution itself – Ensoulment and when it occurs.

More clearly than ever today is the molecular insight into the developmental phases of the origins of Human Life. This in itself requires the ethical and moral concepts of the day to be reflected upon.

Terminating a pregnancy – once it is established in the Mother’s womb – has always been an immoral act in the eyes of the Christian Church. In certain circumstances the willful termination of a developing Life was considered unavoidable if the Life of the Mother was at risk. The implications of this Human Act in the eyes of the Catholic Church was Excommunication as the punishment, in most cases. However, this was not universally true throughout history as there was a clear separation between the ethics of the immoral act of terminating a Life willfully and the punishment itself, if it was performed early in the developmental cycle post fertilization.

It seems the “Ensoulment” moment was the dividing line. A uniformly accepted believe for most of recorded history as occurring after a period of weeks post fertilization. Therefore the doctrine of a Human Life’s relationship to God, beyond the potential of a developing Lifeform, was enshrined in the Church’s teachings in this fundamental Ensoulment moment. These philosophical discussions within the Catholic Church are a documented series of changing positions dating back to the beginnings of the Christian Church.

When the issue was debated it was framed by the obvious question of at what point in the development of a Life in the Mother´s womb is that Life considered Human with a Soul and therefore one with God.

That Ensoulment moment was long considered 40 days after fertilization at a minimum for a male Fetus and 90 days at the outside for a female Fetus. The documentation dates back thousands of years to the Ancient Greek scholars & Aristotle in 350 BC. However, even at that time there were contradictory opinions that held the Soul entered at the moment of conception. The teachings of Aristotle of a later Ensoulment moment became widespread by the time of Augustine in the fifth century as the concept of stage development of a Lifeform from vegetative to animal to Human became accepted. Prevailing Christian thought became documented in the 12th century by the preachings of Thomas Aquinas and the Council of Vienne to that of Aristotle. Yet subsequent Popes differed on the doctrine of excommunication on the basis of formed versus unformed Fetuses and the topic of Ensoulment as a consequence. Early Church theologians attempted to bridge this divide with a Casuistry compromise that allowed for non-ensouled Life to be regarded as different than that of an ensouled Human Life. Since the eighteenth century the Church has considered Human Life beginning at conception along with Ensoulment. Needless to say this debate has raged in the Church since it’s inception as an Institution.

What is apparent from a lay perspective is that the Church has adapted its own views to the popular reality of the day and considered scientific facts, as presented. The difference between then and now is fundamental in that today there is molecular science and it has revealed to all the embryonic process and the value of the cell in curing the living.

As the reality of the day becomes the norm, there is and will be assisted births, genetic treatments and cellular science derived from the earliest stage of Life (naturally conceived, programmed or reprogrammed). An altered series of biological interventions by science in the process of serving his fellow man.

This process can be done without destroying a naturally fertilized union between an Egg and Sperm. There are many ways to create that don’t destroy. There is a need to accept and understand what the difference is between the viability to create Life, the potential of cells and Human Life itself. Without bridging the divide on the issues a meaningful opportunity to engage and grow stronger together will be lost.

There is no question in my mind that there is a Duty in respecting existing and developing Human Life Implanted, Developing & Ensouled in the womb through all possible means.

Medical assistance by way of Non-Destructive cell science for the benefit of those in need is similarly a Duty and Humane.