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New advances in human stem cell biology now permit the derivation of disease-specific induced pluripotent (iPS) stem cell lines, so-called “disease-in-a-dish” (DIAD) models. This is a promising approach for the study of disease phenotypes at the cellular and molecular level, both because such human cell lines may produce more faithful experimental models of disease than can be produced using non-human organisms, and because reprogrammed cell lines can provide a virtually infinite supply of cells without requiring additional tissue donation. However, expectations placed on this emerging technology privilege the laboratory over the clinic as the site for making sense of disease, thereby distracting from the socially embedded meanings of disease and reorienting how the goals of medicine are imagined. Here we identify and review the implications of this area of research for clinical approaches to disease. We argue that there is a central place for the larger medical community and patients in the very construction of experimental research programs and the expectations placed thereon. By attending to the constellation of social factors that inform understanding, treatments and experiences of disease, DIAD projects can be more effectively placed in the service of clinical goals, in both their research design and in the forms of innovation they claim to anticipate. Stem cells are increasingly considered to be at a forefront of medicine. Billions of Euros have been raised by both private and public institutions to battle disease and improve healthcare. Fundamentally immature, stem cells represent a plastic substrate for modern molecular bioengineering to generate therapeutics for diseased and injured patients [1, 2]. Research involving these plastic cells lies at the nexus of molecular research and clinical application. In this article, we discuss and anticipate emerging issues for clinical medicine that will likely unfold as this research progresses. |
