Regenerative Medicine: A Peek into the Future

Regenerative medicine is a growing field that offers the potential to repair and replace damaged cells, tissues, and organs by using those that are specially grown. Thus, instead of merely providing treatments to heal damaged body parts, as with transplants, doctors would be able to treat the underlying cause of the disease. Scientists and researchers have worked to fix skin burns, broken bones, diseased hearts, kidneys, and organs damaged by cancer, including bladders and livers, among other parts 1, 2.

Scientists in fields ranging from biology, genetics, physiology, nanotechnology, and pharmacology work collaboratively to contribute to three sub-fields of regenerative medicine: tissue engineering, cell therapies, and healing therapies. Tissue engineers focus on growing connective tissues and replacement organs for the body. They test their work on animals before implementing it into humans. Scientists in cell therapy try to stimulate reparation from the diseased tissue or organ itself. They identify and optimize the factors that lead to self-reparation of the organ. Healing therapists study strategies to restore the functions of an implanted tissue or organ 1.

Process

Scientists in the regenerative medicine field are making replacement parts out of their patients’ own cells, guaranteeing that the newly made organ will not be rejected by the body. Scientists first cut out a piece of the organ that is to be replaced, separate out the cells and place them in fluid that prompts them to multiply. Then, they treat an animal organ with mild detergent to remove all cells, leaving the basic support structure, called a scaffold. The patient’s cells are poured onto the scaffold, and the new organ is then placed in an incubator that simulates a human body; here the cells can grow and knit together. The organ is finally planted inside the patient’s body, and the scaffold slowly immaterializes, leaving only the regenerated organ 4.

Hurdles

Although regenerative medicine has shown rapid growth over the last decade, the field must overcome a few hurdles before it can be widely used by patients. The most pressing of these is the use of embryonic stem cells. At the moment, companies are using adult stem cells, which seem to work well; however, the jobs in this sector may run into some problems if they turn toward using more controversial embryonic stem cells 2.  President Obama legalized the use of human embryonic stem cells for “ethically responsible and worthy research”, but scientists still face opposition in their use 8. Many religious and ethical lobbies are against the use of embryonic stem cells, and until this opposition diminishes, scientists will have a hard time progressing with their research. The uncertainty hinders scientists’ progress, because researchers do not know whether to further develop methods that use embryonic stem cells, or to find alternate methods.

Another obstacle that companies in this sector face is the risk of zoonosis—the transmission to humans of disease previously limited to animals. Currently, scientists generate scaffolds from animals, most commonly pigs. Although the scaffold is decellularized, only 95% of the original DNA usually washes away 2. Because some DNA still remains, there is always a risk of transmitting a pathogen originally only evident in animals to humans.

Dr. Giuseppe Orlando, a research scientist at the Nuffield Department of Surgical Sciences at the University of Oxford, explains that the transmission of animal diseases may prevent the success of the current method of growing organs. “This may sound far from reality, but in fact is quite possible. A simple event could create a catastrophe and, therefore, this technology may not ultimately be one that will allow us to produce organs,” he stated in an interview 2.

Lastly, companies involved in regenerative medicine lack the government funding and public support needed to release their products to the market. The Regenerative Medicine Coordinating Council, established by the Regenerative Medicine Promotion Act of 2011, will help companies in this business gather monetary support from the government. The act will provide funds for research, studies, and trials, as well as support private companies with grants and partnerships. Although over four billion dollars have been invested into regenerative medicine research, only 10% has come from public sources 7. Companies involved in this field hope to accelerate their growth and spread their business in order to gain more support.

Future

As a potentially ground-breaking technology, regenerative medicine offers many benefits for the future of our society. Scientific advancements in regenerative medicine have greatly helped our current population. According to the 2011 U.S. National Academy of Sciences Report, the numbers of patients that can benefit from regenerative medicine include 58 million from cardiovascular disease, 30 million from autoimmune diseases, and 16 million from diabetes 3.

Unlike current methods of transplants and surgery, regenerative medicine focuses on finding ways to mend damaged tissues or organs, rather than fully replace them. This approach would be especially useful for patients who receive transplants; normally, patients who receive transplants often reject the newly implanted organ because their immune systems do not recognize the organ. To prevent their immune systems from fighting the implant, patients must consume immunosuppressive drugs after receiving implants. However, with regenerative medicine, patients face no risk of autoimmune rejection because the implanted organ will be made form their own cells 3, 4.

Economically, regenerative medicine can positively impact the U.S. in the long run. The California Institute of Regenerative Medicine (CIRM) predicts that its first 1.1 billion in grants will create nearly 25,000 jobs and $200 million in new tax revenue for California by the end of 2014. It will create jobs not only in research and laboratory fields but also construction and building. This is especially important for California, where the unemployment rate for construction workers is 30% 6.  Life Science Intelligent, a market data provider, predicts that the regenerative medicine market will exceed $118 billion dollars by 2013 5. BIO, a leading biotechnology organization, found that “every new job in this sector could have a multiplier effect of up to 5.7 additional jobs in other employment sectors throughout the community” 1.

Globally, several nations, including China, Japan, the U.K., and Australia, are also working to advance regenerative medicine 3. Although the United States accounted for 90% of results in regenerative medicine in 2008, these other nations are growing at a higher rate than the United States 5. To come up with more impactful results quicker than these growing powers, the U.S. must develop a national strategy promoting research and advancements in this field. In response, the Obama administration plans to develop incentives for the public to fund these works, increase federal funding for research, and reimburse companies for their products 3.

Success in regenerative medicine would allow the U.S. to maintain leadership in the health and biotechnology fields. All progress in this field will not only improve our scientific discoveries but also improve the lives of the general population and stimulate our economy with more manufacturing and jobs. If it can overcome complications with government funding, zoonosis, and public support, regenerative medicine certainly has a promising future.

References

  1. Atala A, Innovation, job creation, and economic growth issues, FDCHCongressional Testimony Mar. 2011.
  2. Orlando G, Transplantation as a subfield of regenerative medicine,Expert Review of Clinical Immunology Mar. 2011; 7(2):137.
  3. West E, Regerative medicine: The need for a national strategy.Pharmaceutical Technology 2011; 35(7):133, 134.
  4. Vogel G, Organs made to order: it won’t be long before surgeons routinely install replacement body parts created in the laboratory, Smithsonian 2010; 41(4):86.
  5. Life Science Intelligence. Worldwide Tissue Engineering and Regenerative Medicine Marker Forecast to Grow 16% Annually through 2013. [homepage on the Internet]. 2009 [cited 2011 Dec 16].
  6. California Institute for Regenerative Medicine. CIRM Generating 25,000 Jobs and $200 Million in Taxes for California with Grants Awarded so Far- With More to Come. [homepage on the Internet]. 2011 [cited 2011 Dec 16]. Available from: Government of California, California Institute for Regenerative Medicine.
  7. Alliance for Regenerative Medicine. Legislative Priorities: Alliance for Regenerative Medicine. [homepage on the Internet]. 2011 [cited 2011 Dec 16]. Available from:
  8. Executive Office of the President (US). Removing Barriers to Responsible Scientific Research Involving Human Stem Cells. Fed Regist. 2009 Mar 11; 74(46):10667.
  9. Image credit (public domain): Human stem cell. Wikimedia Commons. 2006 Dec 1.
  10. Image credit (Creative Commons): Dr. Anthony Atala talks on Regenerative Medicine. Flickr. 2011 Mar 3.

Trisha Jani is a high school student at The Harker School. Follow The Triple Helix Online on Twitter and join us on Facebook.

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  • Epiminondas

    It would be nice if they could quickly come up with a method to restore the human heart. Hurry up, guys! I’m not getting any younger!

  • Ira S. Pastor

    Interesting article.

    But there is one problem to keep in mind behind some of the hype.

    In nature (whether it be the starfish, or salamander, or flatworm,
    etc.), regeneration (and generation for that matter) is a bottom-up
    process, where you start with a small group of cells that grows,
    differentiates, interacts, and organizes based on a defined set of steps
    in the genetic blueprints AND continual changes to those blueprints
    following every sequential step (each step dictates the next in the
    process).

    Organ bio-printing, or growing stem cells on scaffolds, is trying to
    approach the problem from top-down perspective, which misses many of the
    intricacies of organogenesis (like size control, polarity, positional
    specification, etc. not to mention issues related to vascularization)

    You couldn’t “build a baby” by mixing together a few trillion cells in a bowl…

    And while top down may work alright for simple tissues in sheets or
    tubes, it gets much more complex when dealing with the requirements for
    tissue stability and survival of critical organ systems that need to
    operate in 3 and technically 4 dimensional space.

    Ira S. Pastor

    CEO

    Bioquark Inc.

  • cristiano

    very very very interesting