[The pre-gastrulation embryonic human development: future models and societal concerns].

Abstract

Infertility, early miscarriages and congenital malformations are major public health issues that are frequent and poorly understood. Until now, what is known about early human development originates from two main sources: studies of human embryos and studies of model animals. Although some molecular mechanisms are conserved, there are specific human features. Thus, it is necessary to study model animals that are close to humans in the phylogenetic classification, which led to the use of pre-established primate cell lineages. Currently, the only human embryos available come from In Vitro Fertilization, which leads to important limitations: these embryos are relatively few and must be destroyed after 14 days. This has led researchers to develop new strategies. Several teams used Embryonic Stem Cells or Induced Pluripotent Stem Cells and their in vitro auto-organization properties to recreate "embryos" and thereby study their development. These new strategies allow a reduced use of human embryos but new questions arise about the legal status of these new research "models". In the future, it would be important to update the different legislations and recommendations of the International Society for Stem Cell Research as science progresses to avoid any failing drift. The respect of recommendations as well as the maintenance of discussions between specialists and the general public will allow a better understanding of early human development and the establishment of innovative strategies to target health challenges.