Biomedical Engineering Reference
In-Depth Information
Chapter 4
Regenerative Medicine and Cell Therapy:
Past, Present, and Future
Hooman Sadri-Ardekani
1-3
and Anthony Atala
1,3
1
Wake Forest Institute of Regenerative Medicine (WFIRM), Wake Forest University School
of Medicine, Winston-Salem, NC, USA
2
Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
3
Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Introduction
Organ transplantation has extended the lives of many patients suffering from chronic
diseases and severely injured organs. Using one part of the body for another or the exchange
of body parts from one individual to another was mentioned in ancient medical literature.
Interestingly, the famous American aviator, Charles Lindbergh and French Nobel Prize
recipient, Alexis Carrel collaborated in the 1930s to develop a system to support long-term
ex vivo
organ survival [1]. Three decades later, the kidney was the first whole organ to be
replaced in a human [2]. This transplant was performed between identical twins, and thus,
did not address the immune response to transplanted organs. In the early 1960s, Murray
performed the first kidney transplantation in a patient from a nongenetically identical
donor. This innovation, to overcome the immunologic barrier, started a new field in medical
treatment and paved the way for use of transplantation as a means of therapy for different
organ systems.
Due to the lack of effective immune-suppression, the difficulty to monitor and con-
trol organ rejection, and the limited number of suitable donors, physicians and researchers
sought other options. The introduction of synthetic materials, such as tetrafluoroethyl-
ene (Teflon) and silicone, provided clinicians with a wide range of devices to replace or
rebuild dysfunctional tissues or organs in the human body; however, the functional
component of the original tissue has not yet been achieved. Novel techniques for cell
isolation and
in vitro
propagation were developed. As researchers understood the inter-
action between extracellular matrix, cells, and growth factors, they could regulate cell
and tissue growth and differentiation. The first human bone-marrow cell transplant in
the 1970s introduced a new field of medicine known as “Tissue Engineering,” which
focused on the combination of devices and materials with cell biology techniques.
Efforts to regenerate living tissues and organs further united scientists from a variety of
disciplines, including cell transplantation, tissue engineering, and stem-cell biology, all
