Tècniques de substitució mitocondrial : aspectes ètics

Abstract

Mitochondrial diseases are a group of clinical heterogenous mitochondrial disorders caused by DNA mitochondrial (DNAmt) mutations, which is maternally inherited. Nowadays, a new method called mitochondrial replacement techniques (MRT) has been developed. This method avoids the transmission of mitochondrial diseases from mother to her offspring by using an enucleated oocyte from a donor. MRT include two techniques: pronuclear transfer (PNT) and maternal spindle transfer (MST), which have thrown up great ethical controversy in society. This study is based on discussing different ethical parameters related with MRT using a bibliographic review of scientific papers. We have observed that MRT present more benefits than risks, despite the fact that a germline modification will take place if a female embryo is produced. It is also remarkable that there are ethical differences between PNT and MST, even though these doesn’t make one technique morally better than the other. In the majority of countries analysed MRT are not enough regulated, with the exception of China and the United States, where MRT are explicitly forbidden. Thus, the clinic use of MRT is only approved in the United Kingdom, where a licence is required for their use. It should be noted that the countries’ religion affects legal and social acceptance of MRT, for example, Christianism and Islam present ethic discussions about the inheritable modifications. In addition, one of the main concerns of the society is the DNAmt’s donor implication. In this case, we should consider that the donor has a minimum contribution to the offspring genetics. The potential application of the techniques in other areas such as infertility treatment of to help lesbian couples is currently being studied. The search of alternatives to MRT is also under study, despite the fact that, nowadays, they are the only technologies enough reliable that give the opportunity to obtain a genetically connected offspring and at the same time, avoiding the mitochondrial disease transmission. In conclusion, MRT are a group of innovative techniques with many benefits but more research is needed, in order to avoid potential harm and to develop new laws to regulate the clinic use of the method. It is also needed to generate a global acceptance in currently society