Tuesday 3 December 2019

Are stem cells and regenerative medicine living up to their promises?


Stem cell therapy's concept is deceptively simple: take cells from a donor and put them into a patient to treat a disease or injury. However, the reality falls far short of the dream.
Regenerative medicine makes use of cells, biomaterials, and molecules to fix structures in the body that do not function properly due to disease or injury.
What sets regenerative medicine apart from many traditional drugs is that the latter mostly treat symptoms, whereas the former aims to treat the root cause of a patient's condition by replacing lost cells or organs, or by fixing a faulty gene.
The allure of regenerative medicine promises to redefine medical treatment, putting stem cells and biocompatible materials center stage in this revolution. Many breakthroughs have been reported and hailed in scientific journals and the media over the years.
However, the number of regenerative medicine treatments in medical use today is disappointingly low, and a panel of commissioners criticizes this lack of progress in a reportTrusted Source published last week in The Lancet.
In fact, according to Prof. Giulio Cossu - from the Division of Cell and Matrix Biology & Regenerative Medicine at the University of Manchester in the United Kingdom - and his fellow commissioners, only a handful of breakthroughs have made it to patients, and private clinics are cashing in on patients' desperate search for treatments by offering unproven therapies.
Why have so many promises of new therapies fallen short? And what will it take for society to benefit from the immense potential that regenerative medicine holds?
What is regenerative medicine?
The commissioners say in their report that regenerative medicine "aims to replace or repair human cells, or regenerate tissue or organs to restore normal function." The emphasis on "normal function" sets this approach to medical treatments apart from many commonly used drugs, which tend to treat symptoms but do not address the underlying causes.
"Cell therapies and regenerative medicine, with their potential to improve the health of patients, represent a structural shift in healthcare by focusing on the underlying causes of disease by repairing, replacing, or regenerating damaged cells in the body," the authors explain.
For example, an individual with type 1 diabetes cannot produce insulin. Instead, daily insulin injections are required to keep blood sugar levels in check.
Regenerative medicine seeks to solve this by regenerating the islets of Langerhans, which allow the individual to make insulin. This would mean no more insulin injections and a return to normal sugar metabolism.
While the treatment of type 1 diabetes in this way is not yet a reality, there are some areas of regenerative medicine that are well established in medical practice.
Early successes
The earliest form of cell therapy was the transfusion of blood, which is commonplace in most clinical settings nowadays.
Next on the list was the transplantation of bone marrow, giving patients with radiation damage or blood cancers a chance to make new, healthy blood cells using the donor's bone marrow stem cells.
Cell therapy using a patient's own cells is also used in cases of severe burn and scald injuries, when a patient does not have a sufficient amount of undamaged skin for skin graft treatment.
Here, skin cells are isolated from a small biopsy and expanded in a specialized laboratory. Millions of cells can be grown in a relatively short time and transplanted onto the burn wound to speed up healing.
But despite these successes and the fact that scientists around the world are furiously working on new therapies, regenerative medicine treatments have not entered mainstream medical practice in most areas of medicine.
According to the report in The Lancet, "the potential exists to substantially reduce the burden of disease for some common conditions (e.g., strokeheart disease, progressive neurological conditions, autoimmune diseases, and trauma)."
And, "As well as increasing life expectancy, regenerative medicine therapies could greatly improve the health-related quality of life of many patients with chronic diseases."
So, what is holding back these developments?
From research to medical practice
An army of scientists from around the world is working on new regenerative medicine solutions to common diseases and injuries.
In the past year alone, Medical News Today reported on a chip technology that can change one cell type into another and heal entire organs, a new method of spray painting biomaterials onto damaged hearts using minimally invasive surgery, and a growth factor that might reverse osteoporosis.Top of Form

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