Regenerative Medicine

hESCs
Pluripotent Stem Cells (HESCs)
Image: Nissim Benvenisty,
PLoS Biol 3(7): e234. doi:10.1371/journal.pbio.0030234

In biology, regeneration is the process of renewal or restoration of damaged parts or tissue of an organism with the goal to restore its original state. This regeneration capacity is found in all species and most tissue types up to a certain level.

The most important actor in this self-healing powers are the so called stem cells. In human they are found in great quantities within organs that are highly stressed. For example in our skin, liver, intestinal mucosa and bone marrow stem cells divide themself and differentiate in specialized cells to repair or replace tissue for our whole life.  In many other organs like the heart or the central nervous system this regeneration processes are less developed or almost absent.

Furthermore in large tissue defects this capability of regeneration is limited. The body builds scar tissue instead of restoring the damaged tissue completely.

 

The basic idea of the regenerative medicine is to initiate, support and use this self-healing powers of the organism in a targeted manner. The intent is to heal and not only to repair or treat symptomatically. The most important tool of the regenerative medicine are the body's own cells. They provoke the activation of regeneration processes and also deliver the material to replace tissue. In the last 40 years many scientist and physician are exploring different interesting approaches to find usable methodes for the regenerative medicine. In laboratories all over the world researchers are working on the in vitro cultivation of stem cells and specialised cells through to methodes for tissue engineering of whole organs. Besides this promising fundamental research the regenerative technology already entered the clinical practice with the use of autologous body cells and medical implants that are developed to use and support the bodies regeneration processes.

 

Throbozyten
Thrombocytes in front of red blood cells
Based on Image from: Louisa Howard (PD)

One well-established method is the use of autologous Platelet Rich Plasma (PRP). The range of applications vary from the treatment of non-healing wounds over uses in aesthetic and plastic surgery to orthopedic applications like the treatment of arthrosis or injuries of tendons and ligaments. The PRP therapy makes use of the thrombocytes high capability to release growth factors and other peptides that are fundamental for healing processes and that attract mesenchymal stem cells to the site of injury. Autologous Platelet Rich Plasma can be easily produced and applied by physicians and surgeons. Practitioners can now perform PRP treatments for their patients using Renamedical's new cost-effectiv PRP Kit. In combination with the AdiLight-2 photoactivation unit it forms a highly effective and time-saving method for PRP preparation that perfectly integrates in everyday clinical practice.

 

A newer approach with very promising result is the treatment with adult mesenchymal stem cells. These stem cells are found in high quantities in the bone marrow, muscles, skin as well as adipose tissue and have a high potential to repair damaged body tissue. For this treatment the adult mesenchymal stem cells are  harvested from the patient`s own tissue. After extraction, concentration, cleaning and activation the cells are reinjected in the target region of the patient's body. Due to the higher concentration of active stem cells in the target region the natural regeneration process is induced and reinforced. In the last years mesenchymal stem cells were harvested in most cases by bone marrow puncture. Because of the small quantity of stem cells acquired by this method the stem cells are normally cultured i an specialised laboratory for some days before they can be reimplanted to the patients body. 

 

hESCs
Adipose Stem Cells (ASCs)
Image: Wikimedia Commons and Mulberriful

Because of these limitations of bone marrow derived stem cells scientifc and clinical research focused in the last year on the fat tissue as a source mesenchymal stem cells. Adipose tissue is avaliable in large quantities in the human body and contains a large quantity of stem cells. The adipose tissue can be harvested in a minimal-invasive liposuktion (50-100 ml) procedure and can be easily cleaned and processed. The mesenchymal stem cells are used in the clinical application as a part of the Stromal Vascular Fraction (SVF). Because of the high quantity of adipose-derived stem cells (ASCs) in this fraction there is no need for cultivation in an laboratory before reimplant. The whole procedure from harvesting to implantation of the stromal vascular fraction can be performed during one surgical session without the need of a special laboratory infrastructure.