Foreskin-derived skin equivalent in exchange for animal testing*

* dibuat sebagai essay persyaratan mengikuti seleksi Novartis International Biocamp 2015

The European union completely ban the use of animal testing for cosmetics development in 2013. The ban was a critical milestones in the effort to phase out experimentation using animals. The medical research community were currently guided by principles that whenever possible, to replace animal with other reliable methods, reduce the number of animal and refine the techniques used to minimize potential pain and distress and promote animal welfare. These trends leads to the development of alternatives to animal testing. One such alternatives is the use of cell culture and tissue engineering.

                The Fraunhofer institute in 2010 launch the “skin from factory” project that essentially produced skin equivalents in a fully automated process. The institute recognized that skin equivalents as in vitro test system for chemicals, cosmetics and drugs are rare. Production of an in vitro test system by manual cell culture and tissue engineering is time consuming and required specifically trained personnel. Most interesting was that the skin source for such system were foreskins which was an abundant by product/medical waste of compulsory practice of khitan in Indonesia.

                Rumah Sunatan a leading company focused in khitan services claimed to reach more than 15.000 patient a year. This is an untapped resource unique of Indonesia home to millions of observant Muslims. This point of view is, for sure, not without challenges. Among others is the ethical and religious issues that centered on the commercial use of human tissues. However research on the potential cultivation of foreskins could result benefit for many field such as stem cells, regenerative medicine, cell therapy, cryopreservation.

                Recently, the discovery of the non-tumorigenic multilineage-stress enduring cells (MUSE) from dermal fibroblast potentially resolve the concern on the use of iPS cells for therapy. Dermal fibroblast contains a pluripotent subpopulation of mesenchymal stem cells that evidently does not form tumour. This findings extends further the importance of foreskin as skin sample source in regenerative medicine. Cryopreservation of cells isolated from so many samples a year will also stimulate research in the field of cryobiology and bio banking.

                In conclusion, the production of foreskin-derived skin equivalent as an in vitro skin testing system on a large scale will largely reduce the demand on animal testing.  Indonesia has a unique potential to solve other problems in medical research. Communication with appropriate religious body and government agency should be commenced to resolve issues that aroused on the collection, cultivation and storage of foreskins for medical research.