From Wikipedia, the free encyclopedia Regenerative medicine
Regenerative medicine
munomodulation therapy); and transplantation of in vitro
grown organs and tissues (Tissue engineering).[9][10]
A form of regenerative medicine that recently made
it into clinical practice, is the use of heparan sulfate ana-
logues on (chronic) wound healing. Heparan sulfate ana-
logues replace degraded heparan sulfate at the wound
site. They assist the damaged tissue to heal itself by repo-
sitioning growth factors and cytokines back into the
damaged extracellular matrix. [11] [12] [13]
Pioneers
At the Wake Forest Institute for Regenerative Medicine,
in North Carolina, Dr. Anthony Atala and his colleagues
Human stem cells have successfully extracted muscle and bladder cells
from several patients’ bodies, cultivated these cells in
Regenerative medicine is the "process of replacing or petri dishes, and then layered the cells in three-dimen-
regenerating human cells, tissues or organs to restore sional molds that resembled the shapes of the bladders.
or establish normal function"[1]. This field holds the Within weeks, the cells in the molds began functioning
promise of regenerating damaged tissues and organs in as regular bladders which were then implanted back into
the body by replacing damaged tissue and/or by stimu- the patients’ bodies.[14] The team is currently working on
lating the body’s own repair mechanisms to heal previ- re-growing over 22 other different organs including the
ously irreparable tissues or organs. Regenerative medi- Liver, Heart, Kidneys and Testicles.[15]
cine also empowers scientists to grow tissues and organs Dr. Stephen Badylak, a Research Professor in the
in the laboratory and safely implant them when the body Department of Surgery and director of Tissue Engineer-
cannot heal itself. Importantly, regenerative medicine ing at the McGowan Institute for Regenerative Medicine
has the potential to solve the problem of the shortage of at the University of Pittsburgh, has developed a process
organs available for donation compared to the number which involves scraping cells from the lining of a pig’s
of patients that require life-saving organ transplantation, bladder, decellularizing (removing cells to leave a clean
as well as solve the problem of organ transplant rejec- extracellular structure) the tissue and then drying it to
tion, since the organ’s cells will match that of the pa- become a sheet or a powder. This cellular matrix powder
tient.[2] [3] [4] was used to regrow the finger of Lee Spievak, who had
Widely attributed (incorrectly as it turns out) to hav- severed half an inch of his finger after getting it caught
ing first been coined by William Haseltine (founder of in a propeller of a model plane.[16][17][18] However, Ben
Human Genome Sciences).[5] From the work of Michael Goldacre has described this as "the missing finger that
Lysaght (Brown University), his team "first found the term never was", claiming that fingertips regrow and quoted
in a 1992 article on hospital administration by Leland Kaiser. Simon Kay, professor of hand surgery at the University
Kaiser’s paper closes with a series of short paragraphs on future of Leeds, who from the picture provided by Goldacre de-
technologies that will impact hospitals. One such paragraph scribed the case as seemingly "an ordinary fingertip in-
had ‘‘Regenerative Medicine’’ as a bold print title and went on jury with quite unremarkable healing" and as "junk sci-
to state, ‘‘A new branch of medicine will develop that attempts ence".[19]
to change the course of chronic disease and in many instances In June 2008, at the Hospital Clínic de Barcelona, Pro-
will regenerate tired and failing organ systems.’’[6][7] fessor Paolo Macchiarini and his team, of the University
Regenerative Medicine refers to a group of biomed- of Barcelona, performed the first tissue engineered tra-
ical approaches to clinical therapies that may involve the chea (wind pipe) transplantation. Adult stem cells were
use of stem cells.[8] Examples include the injection of extracted from the patient’s bone marrow, grown into
stem cells or progenitor cells (cell therapies); the induc- a large population, and matured into cartilage cells, or
tion of regeneration by biologically active molecules ad- chondrocytes, using an adaptive method originally de-
ministered alone or as a secretion by infused cells (im- vised for treating osteoarthritis. The team then seeded
the newly grown chondrocytes, as well as epithileal cells,
1
From Wikipedia, the free encyclopedia Regenerative medicine
into a decellularised (free of donor cells) tracheal seg- Central Nervous System
ment that was donated from a 51 year old transplant
Research has demonstrated convincing evidence in an-
donor who had died of cerebral hemorrhage. After four
imal models that cord blood stem cells injected intra-
days of seeding, the graft was used to replace the pa-
venously have the ability to migrate to the area of brain
tient’s left main bronchus. After one month, a biopsy
injury, alleviating mobility related symptoms.[29][30] Al-
elicited local bleeding, indicating that the blood vessels
so, administration of human cord blood stem cells into
had already grown back successfully.[20][21]
animals with stroke was shown to significantly improve
behavior by stimulating the creation of new blood vessels
Cord blood and Regenerative and neurons in the brain.[31]
This research also lends support for the pioneering
Medicine clinical work at Duke University, focused on evaluating
Because a person’s own (autologous) cord blood stem the impact of autologous cord blood infusions in children
cells can be safely infused back into that individual with- diagnosed with cerebral palsy and other forms of brain
out being rejected by the body’s immune system — and injury. This study is examining if an infusion of the
because they have unique characteristics compared to child’s own cord blood stem cells facilitates repair of
other sources of stem cells — they are an increasing focus damaged brain tissue, including many with cerebral pal-
of regenerative medicine research. sy. To date, more than 100 children have participated in
The use of cord blood stem cells in treating condi- the experimental treatment – many whose parents are
tions such as brain injury [22] and Type 1 Diabetes [23] reporting good progress.[32]
is already being studied in humans, and earlier stage re- Another report published encouraging results in 2
search is being conducted for treatments of stroke,[24][25] toddlers with cerebral palsy where autologous cord
and hearing loss.[26] blood infusion was combined with G-CSF.[33]
Current estimates indicate that approximately 1 in 3 As these clinical and pre-clinical studies demonstrate,
Americans could benefit from regenerative medicine,[27] cord blood stem cells will likely be an important resource
and children whose cord blood stem cells are available as medicine advances toward harnessing the body’s own
for their own potential use could be among the first to cells for treatment. The field of regenerative medicine
benefit from new therapies as they become available. can be expected to benefit greatly as additional cord
With autologous (the person’s own) cells, there is no risk blood stem cell applications are researched and more
of the immune system rejecting the cells, so physicians people have access to their own preserved cord blood.[ci-
and researchers are only performing these potential cord tation needed] [34]"Steenblock Research Institute, umbilical
blood therapies on children who have their own stem cord stem cell therapy".
cells available. http://www.stemcelltherapies.org/.
Researchers are exploring the use of cord blood stem
cells in the following regenerative medicine applications:
Heparan Sulfate Analogues
Type 1 Diabetes Heparan sulfates glycosylaminoglycans bind to the he-
paran sulfate binding domain of matrix proteins such
A clinical trial under way at the University of Florida
as collagens and fibronectin on the extracellular matrix.
is examining how an infusion of autologous cord blood
Heparan sulfate consist of a chain of subunits of 85kD
stem cells into children with Type 1 diabetes will impact
which is negatively charged and can therefore interact
metabolic control over time, as compared to standard in-
with the slightly positively charged basic amino acids
sulin treatments. Preliminary results demonstrate that
of growth factors and cytokines, protecting and holding
an infusion of cord blood stem cell is safe and may pro-
them in the process. In any wound area heparan sulfates
vide some slowing of the loss of insulin production in
are degraded by glycanases and heparanases. This dis-
children with type 1 diabetes.[28]
rupts the normal tissue homeostasis because the differ-
ent growth factors and cytokines cannot be held and pro-
Cardiovascular
tected by the heparan sulfate. [11] [12] [13] Heparan sulfate
The stem cells found in a newborn’s umbilical cord blood analogue is a synthetic heparan sulfate mimetic. Due to
are holding great promise in cardiovascular repair. Re- a different coupling of subunits it is resistant to enzy-
searchers are noting several positive observations in pre- matic degradation: the β2-4 carbon-carbon binding of the
clinical animal studies. Thus far, in animal models of my- subunits of heperan sulfate is prone to enzymatic cleav-
ocardial infarction, cord blood stem cells have shown the age whereas the α1-6 carbon-carbon binding of the sub-
ability to selectively migrate to injured cardiac tissue, im- units of heparan sulfate analogues are resistant to cleav-
prove vascular function and blood flow at the site of inju- age by all known glycanases and heparanases .[11] [12] [13]
ry, and improve overall heart function.[27] Heparan sulfate analogues have shown significant im-
2
From Wikipedia, the free encyclopedia Regenerative medicine
provement on different kind of wounds in pre-clinical re- [11] ^ Tong et al, Stimulated neovascularization,
search. Animal research has shown that heparan sulfate inflammation resolution and collagen maturation
analogues help the wounds heal but retain the normal in healing rat cutaneous wounds by a heparan
tissue structure and prevent scarring. [11] [12] [13] [35] [36] sulfate glycosaminoglycan mimetic, OTR4120.
Wound Repair Regen. 2009 Nov-Dec;17(6):840-52.
See also [12] ^ Barritault et al, Regenerating agents (RGTAs): a
new therapeutic approach. Ann Pharm Fr. 2006
• Artificial organ Mar;64(2):135-44.
• Axolotl [13] ^ Van Neck et al, Heparan sulfate proteoglycan
• Biomedicine mimetics thrive tissue regeneration: an overview.
• Regeneration (biology) In Intech book under the working title "Tissue
• Rejuvenation (aging) Regeneration", ISBN 978-953-307-876-2 is
• Stem Cell Treatments scheduled for on line publication on Nov 26, 2011”
• TERMIS [14] "Stephanie Smith, April 5, 2006". Edition.cnn.com.
• Heparan sulfate analogue http://edition.cnn.com/2006/HEALTH/conditions/
04/03/engineered.organs/index.html. Retrieved
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j.exphem.2008.01.009. PMC 2444031. feasibility of autologous umbilical cord blood
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External links
blood stem cells for use in regenerative medicine.". Less technical further reading
Expert Opin. Biol. Ther. 7 (9): 1311–1322. doi:10.1517/ • Regenerative Medicine, 2006 report, US National
14712598.7.9.1311. PMID 17727322. Institutes of Health
[28] Haller MJ, et al. (2008). "Autologous umbilical cord • Cogle CR, Guthrie SM, Sanders RC, Allen WL, Scott
blood infusion for type 1 diabetes. EW, Petersen BE (August 2003). "An overview of stem
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(6): 710–715. doi:10.1016/j.exphem.2008.01.009. Proceedings 78 (8): 993–1003. doi:10.4065/78.8.993.
PMC 2444031. PMID 18358588. PMID 12911047.
http://www.pubmedcentral.nih.gov/ http://www.mayoclinicproceedings.com/content/
articlerender.fcgi?tool=pmcentrez&artid=2444031. 78/8/993.full.pdf.
[29] Lu D, et al. (2002). "Intravenous administration of • Center for Regenerative Medicine, More on history,
human umbilical cord blood reduces neurological healing potential and research activities on
deficit in the rat after traumatic brain injury.". Cell autologus stem cells technologies in regenerative
Transplant. 11 (3): 275–281. PMID 12075993. medicine.
[30] Meier C, etal.; Middelanis, Johannes; Wasielewski, More technical further reading
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Gantert, Markus; Dinse, Hubert R.; Dermietzel, Rolf (June 2008). "Engineering tissue from human
et al. (2006). "Spastic paresis after perinatal brain embryonic stem cells". Journal of Cellular and Molecular
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privately and publicly banked umbilical cord blood Scientific Journals
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infusion in children with acquired neurologic • Regenerative Medicine Glossary
disorders.". Transfusion. 50 (9): 1980–1987. • Regenerative Dental Medicine Journal
doi:10.1111/j.1537-2995.2010.02720.x.. • Tissue Engineering
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From Wikipedia, the free encyclopedia Regenerative medicine
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