Regenerative Medicine: Are We Ready?

All Cells

The human body has the remarkable, natural ability to heal itself from injuries and illnesses. From a cut to the skin to mending broken bones. From that to a liver regenerating within weeks. What if we could apply that same ability and use it towards a wider range of conditions?

Think of conditions that the human body can’t fix on its own. Organ failure, diseases, asthma, and neurological disorders are all examples of lasting disorders that are managed through medication. Using regenerative medicine we can harness the body’s self-healing act as intervention treatments for lifelong degenerative conditions.

What is Regenerative Medicine?

Regenerative medicine is a rapidly growing field in biomedical studies. It is centered on restoring, replacing, and engineering human cells, tissues, or organs that have been damaged or lost due to aging, disease, injury, or genetic defects. As of now, several techniques are currently being tested.

Stem cells

One major technique is the use of stem cells. They have the unique ability to differentiate into various types of cells in the body. Using differentiation, the stem cell undergoes specialization to become a specific type of cell and functions accordingly.

In cases of severe damage such as myocardial infarction (heart attack), where a significant portion of heart muscle cells (cardiomyocytes) are lost due to the lack of blood supply, the damaged cells are typically replaced by scar tissue. Scar tissues do not contract like healthy heart muscle tissues and can impair the heart’s ability to pump effectively, leading to heart failure.

Stem cells have the capacity to differentiate to different cells, including cardiomyocytes—the cells responsible for heart muscle contraction. By implanting stem cells into that damaged heart tissue, these cells can potentially integrate into the myocardium and replace the lost or damaged cardiomyocytes, restoring contractile function and improving heart function.

CRISPR

Another way used to treat illnesses is the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) or also called the “genetic scissors.” It is a component of bacterial immune systems that can cut DNA, and has been repurposed as a gene editing tool. It acts as a precise pair of molecular scissors that can cut a target DNA sequence, directed by a customizable guide. It allows scientists to rewrite the genetic code in almost any organism.

Another example of a condition being treated is sickle cell anemia. Sickle cell anemia, also known as sickle cell disease, is a chronic, inherited blood disorder that affects the shape of red blood cells to become misshapen or broken down. 2019 marked a major event when Victoria Gray became the first person to be treated for sickle cell using CRISPR somewhat successfully. Using CRISPR, an edit (or “cut”) is made in a particular gene to reactivate the production of fetal hemoglobin, which dilutes the faulty red blood cells caused by sickle cell disease, hence, curing it.

Tissue Engineering

The last most major way is tissue engineering. The goal of tissue engineering is to assemble functional constructs that restore, maintain, or improve damaged tissues or whole organs. As of now, artificial skin and cartilage has been approved by the FDA; yet, currently have limited use in human patients.

A ghost organ is an example of the use of tissue engineering as it can serve as a scaffold or template for seeding with a patient's own cells or stem cells. By repopulating the scaffold with cells, it is possible to regenerate functional tissue that mimics an original organ. This approach offers potential solutions for organ transplantation, as it could help overcome the shortage of donor organs and reduce the risk of rejection.

While these regenerative methods offer great potential for certain operations, we still need to be mindful about the possible consequences or limitations that need to be carefully considered. There are many safety concerns that need to be evaluated before this becomes widespread.

Now, on a bigger level, we need to make sure while trying to heal others, we maintain ethical integrity.

The Ethical Side of Regenerative Medicine

Should these methods of regenerative medicine even be available?

Many debates about this topic have been focused on stem cells. The primary source of embryonic stem cells, is the surplus embryos that remain after in vitro fertilization (IVF) procedures. These are embryos that are not implanted into the uterus and are instead donated for research or therapeutic purposes. However, the research involves the destruction of human embryos, which can be controversial in the United States, where the beginning of human life is a highly debated topic.

Additionally, there is a safety concern. Not everything is 100% accurate however most of these methods are still in the testing phase so we should still be cautious about when to use this. As most are still very inefficient, therefore needs to be evaluated. There are still many questions that need to be asked before clinics around the world start adapting to these new technologies. Will the outcomes outweigh the risks? When should we use this? Once diagnosed? Last case scenario? Is it safe? What are the guidelines and standards? We need these questions answered to truly know if this is really the next step in healthcare. Hopefully by then, with more conversations about this topic, we can move towards a more healthy, safe, and equitable use of regenerative medicine.

Written By: Jaslynn Lee

References

Hippensteele, A. (2023, March 10). CRISPR Technology Has Cured Patients of Certain Genetic Diseases, But Not All Patients Can Receive It Due to Cost, Accessibility. Pharmacy Times. https://www.pharmacytimes.com/view/crispr-technology-has-cured-patients-of-certain-genetic-diseases-but-not-all-patients-can-receive-it-due-to-cost-accessibility

Mayo Clinic. (n.d.). About Regenerative Medicine. CENTER FOR REGENERATIVE BIOTHERAPEUTICS. https://www.mayo.edu/research/centers-programs/center-regenerative-biotherapeutics/about/about-regenerative-medicine

NIH. (n.d.). Tissue Engineering and Regenerative Medicine. U.S. Department of Health & Human Services. https://www.nibib.nih.gov/science-education/science-topics/tissue-engineering-and-regenerative-medicine#:~:text=The%20goal%20of%20tissue%20engineering,limited%20use%20in%20human%20patients.

Synthego. (n.d.). What Is CRISPR. Synthego. https://www.synthego.com/learn/crispr#:~:text=CRISPR%20stands%20for%20Clustered%20Regularly,directed%20by%20a%20customizable%20guide.

Ventura-Juncá Patricio. (n.d.). Science and Ethics: Bridge to the Future for Regenerative Medicine. PubMed Central. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840959/