Human embryonic stem cells: technological challenges towards therapy.

1. Human embryonic stem cells (hESC) hold promise for overcoming many diseases because they provide a potential source for many of the slow-growing cell types needed for effective tissue repair, such as the dopaminergic neural cells for Parkinson's disease or the pancreatic islet cells needed to relieve diabetic patients of their daily insulin injections. 2. Human embryonic stem cells can be characterized by several surface antigen markers, transcription factors and enzymes, as well as their ability to differentiate into cells representative of the three germ layers, both in vivo and in vitro. 3. Significant progress has been made in defining the feeder-free and serum-free conditions needed for the culture of hESC. The fibroblast growth factor-2 and transforming growth factor-b signalling pathways appear to be important in maintaining self-renewal and preventing differentiation, respectively. 4. Several important quality controls, including karyotyping, immunogenicity and murine viral assays, will have to be established to monitor the production of hESC for therapeutic purposes. 5. Methods of expansion and differentiation of hESC are still in their infancy and the efficiency of these processes needs to be significantly enhanced.