The field of regenerative medicine and tissue engineering is making great progress in the advancement of medicine. This multidisciplinary field involves biology, medicine, and engineering and could be the next revolution in medicine, says Timothy Wick, PhD., co-director of the BioMatrix Engineering and Regenerative Medicine (BERM) Center at UAB, along with co-director Joanne Murphy-Ullrich, PhD.
“Tissue engineering may revolutionize the ways we improve health and quality of life for millions of people by restoring, maintaining or enhancing tissue and organ function. It could be used to cure diseases and replace worn out body parts with living tissue equivalents instead of metals, plastics and ceramics,” Wick says.
Since its emergence in the 1980s, regenerative medicine has grown to a $1.5 billion industry in 2009, and it could grow to $500 billion by 2030, Wick says. The BERM Center plays a large role in the advancement of regenerative medicine at UAB by promoting excellence in research and education in tissue regeneration and repair by developing scientific expertise to translate bench top discoveries to patients and industry. At UAB, a team of 70 researchers, including stem cell biologists, matrix biologists, biomaterials scientists, biomedical engineers, and clinicians, work together on advancements in the field.
“The BERM Center provides a way to focus expertise at UAB to solve problems in regenerative medicine and tissue engineering,” Murphy-Ullrich says. “It supports the intellectual infrastructure to get the researchers to talk to each other and provides resources to promote interdisciplinary interactions across UAB.”
The goal of researchers is to replace diseased and damaged body parts with functioning equivalents, says Wick. “Engineered skin and cartilage are already on the market. The tissue takes about six to eight weeks to grow and in the case of cartilage, the patients’ own cells are used to make the tissue to fit their needs. For instance, instead of doing a whole knee replacement, we want to replace worn knee cartilage with living cartilage that responds as needed for the rest of the patient’s life,” he says.
“Our ultimate goal is to do what we call off-the-shelf availability where a company makes hundreds or thousands of pieces of cartilage or blood vessels or other tissue. The tissue can be frozen and then shipped to surgical centers. When you need it, your doctor will pull it off the shelf for you.”
For the past eight to 10 years, doctors have been using engineered skin for burn patients who don’t have enough of their own skin available for grafting. Cardiologists also are using engineered patches to repair certain regions of the heart. “These patches are created by making scaffolds from layers of connective tissue or extracellular matrix which signal the body’s own cells to take over and regenerate heart tissue,” Murphy-Ullrich says.
Other tissues are currently being tested in humans, and bone, tendons and blood vessels should be available soon, Wick says. Researchers also are focusing on teeth, gums and retinas. “Down the road, the goal is to create entire organs for transplant. A diabetes patient could get a new pancreas and have no more problems with insulin, or a defective liver could be replaced,” he says.
When these technologies are created, the BERM Center can help the companies deliver their products to patients. “In this case, UAB is unique,” Wick says. “These companies successfully create products but don’t know how to get the product to patients. We do it backwards. We want to make the tissue in a lab under conditions that make it appropriate for use by humans right away.”
Also, because the BERM Center can help facilitate 3-D tissue engineering using human cells, the functional tissues are available for studying drugs without using animal testing. “This provides a platform for the pharmaceutical companies. They will use fewer animals, and the drugs will get to human testing much faster,” Wick says.
Another success of tissue engineering at UAB is the partnership that has formed between biomedical engineers and clinical cardiologists. They have created a bioengineering material that can coat vascular stents to reduce clinical complications. The material mimics natural endothelium and can help prevent post-operative tissue scarring and thrombosis among the reported 10 million people who receive stent implants annually.
While some of the goals for regenerative medicine may be decades away, others are closer to being realized, including the possibility of regrowing worn-out hip cartilage in aging patients instead of installing artificial joints and inserting new blood vessels instead of opening clogged ones with mechanical stents. In all of those cases, the new tissues would be made of only natural human cells, Wick says, which means they won’t wear out and would act like a normal part of the patient’s body.
“At some point, there will be a ‘eureka’ moment when scientists realize that a breakthrough can be applied to a number of tissues and organs that need to be engineered,” Murphy-Ullrich says. “The next step is to keep engineering the tissues which will lead to further advancement.”