The Published Record
              John Gearhart, Ph.D.
                C. Michael Armstrong Professor, Institute for Cell Engineering,
                Johns Hopkins University School of Medicine 
              There have been but two original research articles published 
                on human embryonic germ cell in the period covered by this 
                report.  It is appropriate that only peer-reviewed articles 
                be considered in this report, as the field of stem cell 
                research is rife with undocumented or unsubstantiated claims. 
                There have been several publications on EG cells derived 
                in mice and chick and comment will be made on these reports 
                as they may impact on the eventual use or study of the human 
                cells.
              There is a concern, given the imprinting-based developmental 
                abnormalities observed in humans, and those that have been 
                produced experimentally in animals, that dysregulated gene 
                expression in stem cell derived tissues could pose a serious 
                problem in the use of such tissues for cell-based therapies. 
                Genomic imprinting is defined as an epigenetic modification 
                of the DNA (other than sequence) in the germ line that leads 
                to the preferential expression of a specific allele (monoallelic 
                expression) of some genes in the somatic cells of the offspring 
                in a parental dependent manner.  Because a maternal gene 
                allele may be a paternal allele in the next generation, 
                the imprinting must be reprogrammed in the germ line, that 
                is, the epigenetic 'marks' must be erased (during germ cell 
                development) and established in the newly formed embryo.  
                The timing of the erasure in humans is not known. Imprinting 
                involves methylation at specific sites in the DNA and most 
                likely, other changes as well.
              There have been several reports from experiments with the 
                mouse that indicate that imprinting is abnormal in pluripotent 
                stem cells derived from mouse embryos.  These studies include 
                abnormal or variable imprints in mouse EG cells, abnormal 
                imprints in ES cells derived from interspecific crosses, 
                and abnormal gene expression in mice derived from ES cell 
                nuclear transfer.
              The results of the study by Onyango et al. utilizing 
                EG cell lines derived at John Hopkins, clearly demonstrate 
                that general dysregulation of imprinted genes will not be 
                a barrier to their use in transplantation therapies.  The 
                report has determined that the EG cells are not imprinted, 
                that is, imprinting has been erased in the primordial germ 
                cells that gave rise to the EG cells, that the erasure is 
                maintained in the EG cells, but in all informative cases, 
                they observed the transcription of only a single allele 
                in differentiated cells derived from the human EG cells.  
                These results, although on a limited number of lines and 
                only a few imprinted genes, would indicate that these human 
                EG cell lines will serve as reliable and safe sources for 
                the study of EG cell differentiation and, perhaps, cells 
                for cell-based interventions.
              Another area of interest in genetic regulation within EG 
                cells is that of X inactivation, the mammalian method for 
                equalization of the dosage of X-linked genes in males and 
                females.  This equalization is accomplished by the down 
                regulation of the transcriptional output of the X chromosomes 
                in females, so that only one X is active in diploid somatic 
                cells of both sexes.  Inactivation is initiated in female 
                blastocysts.  Both X chromosomes in female primordial germ 
                cells are active.  Migeon et al. (2001) have demonstrated 
                that in the very early stages of differentiation of cells 
                from human EGs, only one X chromosome is active, indicating 
                normal genetic regulation has occurred. In a report by Nesterova 
                et al. (2002) on the use of mouse female EG cells 
                in the study of X chromosome inactivation/reactivation during 
                primordial germ cell migration and EG cell formation.  Both 
                X chromosomes appear to be active in XX EG cells, and presumably, 
                one becomes inactive when cells differentiate from the EG 
                cells.  
              One of the goals of stem cell research is to provide sources 
                of cells for cell-based therapies.  As a step in this direction, 
                proof of concept or proof of principle studies involve the 
                use of human cells in animal models of human disease or 
                injury.  Although few, if any, animal models are true models 
                for the human diseases, they are the closest approximation 
                that can be made.  The first report on the use of cells 
                derived from stem cells of human embryonic sources was recently 
                published: Kerr et al. Human Embryonic Germ Cell 
                Derivatives Facilitate Motor Recovery of Rats with Diffuse 
                Motor Neuron Injury, J. Neuroscience 23, June 15, 2003. 
                This is the first demonstration that a human pluripotent 
                stem cell derived form embryonic or fetal tissue can ameliorate 
                a disease process in an animal model.
              Neural progenitor cells, derived from human EG cells, were 
                introduced into the cerebrospinal spinal fluid of rats that 
                had been paralyzed as a result of infection with a neuroadapted 
                Sindbis virus that specifically targets motor neurons in 
                the spinal cord.  All animals in which human cells were 
                found had some degree of hindlimb recovery.  It was clear 
                from the histology of the animals that the human cells had 
                differentiated into appropriate neural cell types within 
                the ventral horns, including motor neurons, the results 
                indicated that the major effect of the human cells was to 
                protect host neurons from death and to facilitate reafferentiation 
                of motor neuron cell bodies. Growth factors responsible 
                for this recovery, produced by the human cells, were identified 
                as brain-derived neurotrophic factor and transforming growth 
                factor.  
              The significance of this experiment appears to be that 
                for this disease model, the human cells supply factors that 
                facilitate motor neuron recovery following viral damage.  
                However, the cells did migrate to the site of injury in 
                the spinal cord, which differentiates them from other cellular 
                grafts, and then delivered the factors.  Also, there was 
                considerable differentiation of the human cells into various 
                neural cells types in the cord. 
              In a review article on deriving glucose-responsive insulin-producing 
                cells from stem cells (Kaczorowski et al. 2002), 
                mention is made on the isolation of such cells from mouse 
                and human ES cells and human EG cells, but no new data was 
                presented, only a reference to a paper published in 2001.
              EG cell studies in other species
              Several studies on EG cells from other species have been 
                published.  EG cells from the chick have been demonstrated 
                to yield germ line chimeras when transferred to early embryos 
                (Park et al. 2003).  EG cell lines of the mouse were 
                found to colonize not only the epiblast but also the primary 
                endoderm of the gastrulating embryo following aggregation 
                with 8-cell embryos (Durcova-Hills et al. 2003).  
                This observation was permitted as a result of using a transgenic 
                construct effect as a lineage marker for cells of the early 
                embryo.  Horii et al. (2002) report the serum-free 
                culture of mouse EG cells, a system which inhibits the 'spontaneous' 
                differentiation due to the presence of various growth factors 
                in the serum.  The cells are, however, are cultured on a 
                feeder layer.
              An area of great interest in EG cell derivation is the 
                basis of the underlying mechanism for the conversion, derivation 
                or transformation (terms reflecting our ignorance of the 
                process) of primordial germ cells to EG cells.  Kimura et 
                al. (2003) report that the loss of a tumor suppressor 
                gene in mice, PTEN (phosphatase and tensin homology deleted 
                form chromosome ten, aka MMAC1 and TEP1), leads to a high 
                incidence of testicular teratomas and enhances the production 
                of EG cells from PGCs of the mutant mice.  While it is highly 
                unlikely that the loss of this gene in the culture of normal 
                PGCs leads to the derivation of EG cells, it may implicate 
                downstream signaling pathways that are involved in cell 
                cycle progression, cell survival and cell migration as important 
                players in the process.
              
              _________________ 
              References
              Durcova-Hills, G., Wianny, F., Merriman, 
                J., Zernicka-Goetz, M., and McLaren, A. 2003.  Developmental 
                fate of embryonic stem cells (EGCs), in vivo and 
                in vitro.  Differentiation 71, 135-141.
              
Horii, T., Nagao, Y., Tokunaga, T., 
                and Imai, H. 20003. Serum-free culture of murine primordial 
                germ cells and embryonic germ cells. Theriogen. 59, 1257-1264.
              Kaczorowski, D.J., Patterson, E.S., 
                Jastromb, W.E., Shamblott, M.J. 2002. Review Article. Glucose-responsive 
                insulin-producing cells from stem cells. Diabetes Metab. 
                Res. Rev. 18, 442-450.
              Kerr, D.A., Lladó, J., Shamblott, M.J., 
                Maragakis, N.J., Irani, D.N., Crawford, T.O, Krishnan, C., 
                Dike, S., Gearhart, J.D., and Rothstein, J.D. 2003. Human 
                embryonic germ cell derivatives facilitate motor recovery 
                of rats with diffuse motor neuron injury. J. Neurosci. 23, 
                5131-5140.
              Kimura, T., Suzuki, A., Fujita, Y., 
                Yomogida, K., Lomeli, H., Asada, N., Ikeuchi, M., Nagy, 
                A., Mak, T.W., and Nakano, T. 2003.  Development and Disease. 
                Conditional loss of PTEN leads to testicular teratoma and 
                enhances embryonic germ cell production. Development 130, 
                1691-1700.
              Migeon, B.R., Chowdry, A.K., Dunston, 
                J.A., and McIntosh, I. 2001. Identification of TSIX, 
                encoding an RNA antisense to human XIST, reveals 
                differences from its murine counterpart: Implications for 
                X inactivation. Am. J. Human Genet. 69, 951-960.
              Onyango, P., Jiang, S., Uejima, H., 
                Shamblott, M.J., Gearhart, J.D., Cui, H., and Feinberg, 
                A.P. 2002. Monoallelic expression and methylation of imprinted 
                genes in human and mouse embryonic germ cell lineages. Proc. 
                Natl. Acad. Sci. USA 99, 10599-10604.
              Park, T.S., Hong, Y.H., Kwon, S.C., 
                Lim, J.M., and Han, J.Y. 2003. Birth of germline chimeras 
                by transfer of chicken embryonic germ (EG) cells into recipient 
                embryos.  Molec. Reprod, Develop. 65, 389-395.
              Sapienza, C. 2002. Commentary. Imprinted gene expression, 
              transplantation medicine, and the "other" human embryonic 
              stem cell. Proc. Natl. Acad. Sci. USA 99, 10243-10245.