Advances and Challenges of Regenerative Medicine
Regenerative medicine, including tissue engineering and cell therapy, is a promising and growing field. It has enormous potential to revolutionise medical treatment options for a very wide range of patients, such as those suffering from traumatic injuries, congenital defects, and simple aging and loss of function of organs and tissues.
Various tissue engineering approaches must be thoroughly tested and evaluated. Already extensive and successful research has been done on biological scaffolds, using donor organs that have been decellularized (using DNase, deoxycholate, SDS) and then reseeeded with the patient's own cells. Similarly research is ongoing into using synthetic scaffolds (fabricated using molding techniques, electrospinning, 3-D-printing) seeded with different cell types (MSCs, MNCs, epithelial cells, chondrocytes). Cell therapy has also been examined in experimental disease models and initial clinical transfer realized in patients suffering from acute lung disease. In addition to these approaches, there are a number of exciting new possibilities currently at the early stages of research, such as investigating the regenerative potential of exosomes and proteosomes, the uses for 2D and 3D chip technology, the formation of new organs through organogenesis and 3D bioprinting.
Small and large animals models have been used to generate both biological and synthetic tissue engineered grafts for the trachea, lungs, esophagus, heart, heat valves and the diaphragm. Initial clinical transfer of both has been performed for the trachea and oesophagus. Tissue engineered scaffolds for the trachea, the oesophagus and the diaphragm have been demonstrated their functionality in animal models. Early clinical data (5-year follow-up) provides initial evidence for successful tracheal and oesophageal replacement using biological scaffolds. Cell-based therapy has resulted in significant improvement in acute and chronic lung diseases both in experimental studies and clinical setting.
Regenerative medicine may represent a promising therapeutic alternative in the future. However, further efforts are necessary to detect underlying mechanisms and investigate the real impact of these new approaches for the treatment of thoracic diseases. These studies require careful consideration of the ethical issues to ensure that both in vivo and clinical research is carried out to give the maximum benefit to current and future patients with the minimum risk to human welfare and sacrifice of animal life.