To D(e)rive or Reverse: The Challenge and Choice of Pluripotent Stem Cells for Regenerative Medicine

Abstract

The immense potential of pluripotent human stem cells in transforming modern medicine is undeniable. Less than two decades since human embryonic stem cells (hESCs) were first derived, several clinical trials with hESC derivatives are underway. Though human-induced pluripotent stem cell (iPSC) lines are accepted by a wider community for use in research and therapy, issues of maintaining stem cell potency and achieving efficient differentiation are common to hESCs and iPSCs. While iPSCs are considered more accessible and acceptable, it is increasingly clear that iPSCs will be of limited use in autologous therapy. Hence haplobanks are being established for use in regenerative medicine. The additional cost of reprogramming to and characterizing iPSCs compared to deriving hESCs brings into question their suitability for regenerative applications in the Indian scenario, given the limited facilities and resources available. Here we discuss the importance of making an informed choice for the Indian context.