The End of the End of Life as we Know It: Regenerative Medicine Breakthroughs
Regenerative medicine is the process of replacing or regenerating human cells, tissues
or organs to restore or establish normal function. This field holds the promise of
regenerating damaged tissues and organs in the body by replacing damaged tissue
and/or by stimulating the body's own repair mechanisms to heal previously
irreparable tissues or organs.
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Regenerative medicine also
empowers scientists to grow tissues and organs in the laboratory and safely
implant them when the body cannot heal itself. Importantly, regenerative
medicine has the potential to solve the problem of the shortage of organs
available for donation compared to the number of patients that require
life-saving organ transplantation. Depending on the source of cells, it can
potentially solve the problem of organ transplant rejection if the organ's cells are
derived from the patient's own tissue or cells.
Widely
attributed to having first been coined by William Haseltine (founder of Human Genome Sciences), the term "Regenerative Medicine" was
first found in a 1992 article on hospital administration by Leland Kaiser.
Kaiser’s paper closes with a series of short paragraphs on future technologies
that will impact hospitals. One such paragraph had ‘‘Regenerative Medicine’’ as a bold print title and went on to
state, ‘‘A new branch of medicine will develop that attempts to change the
course of chronic disease and in many instances will regenerate tired and
failing organ systems.’’
Regenerative Medicine
refers to a group of biomedical approaches to clinical therapies that may
involve the use of stem cells.
Examples include the injection of stem cells or progenitor cells (cell therapies);
the induction of regeneration by biologically active molecules
administered alone or as a secretion by infused cells (immunomodulation
therapy); and transplantation of in
vitro grown organs and
tissues (Tissue engineering).
A form of regenerative medicine that recently
made it into clinical practice, is the use of heparan sulfate analogues on (chronic) wound healing. Heparan
sulfate analogues replace degraded heparan sulfate at the wound site. They
assist the damaged tissue to heal itself by repositioning growth factors and
cytokines back into the damaged extracellular matrix. For example, in abdominal wall
reconstruction (like inguinal hernia repair), biologic meshes are being used with some success.
Type 1 Diabetes
A clinical trial
under way at the University of Florida is examining how an infusion of
autologous cord blood stem cells into children with Type 1 diabetes will impact
metabolic control over time, as compared to standard insulin treatments.
Preliminary results demonstrate that an infusion of cord blood stem cell is
safe and may provide some slowing of the loss of insulin production in children
with type 1 diabetes.
Cardiovascular
The stem cells found
in a newborn’s umbilical cord blood are holding great promise in cardiovascular
repair. Researchers are noting several positive observations in pre-clinical
animal studies. Thus far, in animal models of myocardial infarction, cord blood
stem cells have shown the ability to selectively migrate to injured cardiac
tissue, improve vascular function and blood flow at the site of injury, and
improve overall heart function.
Central Nervous System
Research has
demonstrated convincing evidence in animal models that cord blood stem cells
injected intravenously have the ability to migrate to the area of brain injury,
alleviating mobility related symptoms. Also, administration of human cord blood
stem cells into animals with stroke was shown to significantly improve behavior
by stimulating the creation of new blood vessels and neurons in the brain. This
research also lends support for the pioneering clinical work at Duke
University, focused on evaluating the impact of autologous cord blood infusions
in children diagnosed with cerebral palsy and other forms of brain injury. This
study is examining if an infusion of the child’s own cord blood stem cells
facilitates repair of damaged brain tissue, including many with cerebral palsy.
To date, more than 100 children have participated in the experimental treatment
– many whose parents are reporting good progress. Another report published
encouraging results in 2 toddlers with cerebral palsy where autologous cord
blood infusion was combined with G-CSF.
As these clinical and
pre-clinical studies demonstrate, cord blood stem cells will likely be an
important resource as medicine advances toward harnessing the body’s own cells
for treatment. The field of regenerative medicine can be expected to benefit
greatly as additional cord blood stem cell applications are researched and more
people have access to their own preserved cord blood. "Steenblock Research Institute, umbilical cord
stem cell therapy".On May 17, 2012, Osiris Therapeutics announced that Canadian health regulators approved Prochymal, a drug for acute graft-versus-host disease in children who have failed to respond to steroid treatment. Prochymal is the first stem cell drug to be approved anywhere in the world for a systemic disease. Graft-versus-host disease, a potentially fatal complication from bone marrow transplant, involves the newly implanted cells attacking the patient’s body.
