Tissue regeneration: Hope for injured vets?
By William H. McMichael - Staff writer
Posted : Thursday Apr 17, 2008 18:06:02 EDT
In future years, troops who have lost body parts, often from the
blast injuries so common in Iraq and Afghanistan, may actually be
able to grow them anew — using their own stem cells.
More than 1,000 troops have endured amputations due to war injuries,
and many others have been badly burned, or suffered spinal cord
injuries or vision loss.
The new Armed Forces Institute of Regenerative Medicine will seek
ways to regenerate replacement body parts and "make our soldiers
whole again," as Lt. Gen. Eric Schoomaker, the Army surgeon general,
put it at a Thursday news conference at the Pentagon.
The $250 million effort will be led by two multi-institutional
consortia of university researchers who will work with the U.S. Army
Institute of Surgical Research to develop and conduct clinical trials
over the next five years. The teams will be led by Wake Forest
University and the University of Pittsburgh and, separately, Rutgers
University and the Cleveland Clinic.
Schoomaker called it a "dream team of some of the greatest minds in
tissue engineering.
"We will use the soldiers' own stem cells to repair nerve damage ...
muscles and tendons, to repair burn wounds, and to help them heal
without scarring," he said. "In addition, the team will work with
techniques to salvage and reconstruct damaged limbs, hands, fingers,
as well as facial repair, like ears and noses — and help with cranial
reconstruction.
Schoomaker said he became aware of the possibilities a couple of
years ago when he and other Army medical researchers heard a
presentation by Anthony Atala of Wake Forest, a pediatric urologist
and regenerative medicine researcher.
Atala told the group he had been able to replace a patient's damaged
bladder using the patient's own cells, grown in a biodegradable
bladder implant. Atala also had replicated blood vessels and ureters.
"Prior to his talk, I have to say, frankly, that I and many of us
thought that tissue engineering and regenerative medicine were
decades away from being able to deliver, really, any meaningful
replacement organs or sophisticated structure, [like] re-growing
limbs," said Schoomaker. "At that moment, I was not alone in seeing
this had tremendous potential to solve some of our big reconstructive
medical problems facing our surgeons, and the potential benefit for
injured soldiers."
For instance, researchers have already seeded a nose-shaped
polymer "scaffold" with human stem cells and created a replacement
that could be grafted onto a victim who has lost all or part of his
nose. Over the following months, the scaffold would dissolve, but the
cells would continue to grow, creating a natural-looking replacement.
The procedure has already been done on animals; Schoomaker showed a
startling photo of a mouse with a human ear grafted onto its back.
Clinical trials on humans could start in two years.
The most immediate promise, he said, will be the ability to provide
greater structure and function for amputees with partially functional
limbs who have lost muscle mass or large areas of skin.
Just the mention of stem cells evokes the debate in recent years over
the ethics of using embryonic stem cells harvested from embryos in
development. It's true, researchers say, that these are the most
useful stem cells because they can be turned into literally any cell
in the body and might be used to treat degenerative diseases. But
their use for research is strictly limited by presidential policy.
But that angry debate clouded advances made with less potent, yet
still useful, adult stem cells.
"We've had bone marrow transplant since the 1950s," said George
Muschler, a professor of orthopedic surgery at the Cleveland
Clinic. "That's stem cell therapy. We've already been using it. We've
been doing skin transplants, in terms of skin grafting, since even
before the Second World War. And so we've been systematically doing
that better."
All parts of an adult human's body, Atala said, have a natural
repository of such cells.
"There's no doubt that the best resource is the cells that come from
your own body," said Atala, who has been performing such work with
humans for the past decade. "If you want to make a windpipe, your
trachea — you take a cell from your trachea, that cell already knows
what to do. It's already a trachea cell. And you can just grow those
cells, put them back into the patient. So, no rejection issues, no
chance of the cell going awry.
"And these are cells we can use today."
Funding and management for the AFIRM is being provided by the Army's
Medical Research and Materiel Command, with additional funding from
the Office of Naval Research, the National Institutes of Health, the
Air Force Office of the Surgeon General and the Department of
Veterans Affairs.
http://www.armytime
42808w/
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StemCells subscribers may also be interested in these sites:
Children's Neurobiological Solutions
http://www.CNSfoundation.org/
Cord Blood Registry
http://www.CordBlood.com/at.cgi?a=150123
The CNS Healing Group
http://groups.yahoo.com/group/CNS_Healing
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