In a world where innovation reigns supreme, one breakthrough has captivated hearts and minds like never before. In the realm of 2023, artificial intelligence took centre stage, revolutionising industries far and wide. Yet, amidst this technological renaissance, one marvel stands out in the healthcare sector: TERM, Tissue Engineering and Regenerative Medicine, the beacon of hope.
It is the next revolution in healthcare. What can it do? Anything….I mean literally anything, just like Chat-GPT. A human is made of trillions of cells. And every single human starts their life as a single cell inside the mother’s womb. It’s the story of all living organisms on earth. From gigantesque banyan trees to tiny hummingbirds. It shows us the boundless energy of Mother Nature. Humans studied this magical power of nature, and after years of studies and research, promising results are in our hands.
Approximately 20 people die every day waiting for organ transplants in India (1). Lakhs of people are waiting for an organ donor. For people who have organ transplants as their only resort, regenerative medicine is surely a blessing. The ability to regenerate a new kidney from a patient’s own cells would provide major relief for the hundreds of thousands of patients suffering from kidney disease. Experimenting on rats, pigs, and human kidney cells has shown positive results (3). The ultimate goal of TERM is to translate the findings of basic research into clinical practice. Creating organs from stem cells is a well known example of TERM. Another such example is the use of mineralized collagen, which mimics natural bone. It will aid in decreasing the problems of donor organ shortages and the morbidity associated with immunosuppression in organ transplants (3). With the ageing of the world population trend intensifying, there is an increasing demand for organ replacements. TERM holds the potential to meet the future needs of patients (4).
Let’s delve into the treasure of TERM. Are you aware of stem cells? Why do we call them stem cells? The stem cells are the master cells of our body. They have immense potential. Can grow and differentiate into any type of cell. Stem cells give rise to all the different tissues in our body. Stem cells, all the way from their pluripotent state to their mature cell state, could be transplanted into a patient. And harnessing this power is the basic principle of TERM.
The amniotic membrane, a thin sac covering the baby, is a rich source of stem cells. Which is used to harvest organs. Athletes encounter various physical injuries during their careers, with broken tendons and ligaments being the most common ones. With TERM, we can repair those with good outcomes. Even in the case of a heart attack, when the heart muscles are damaged beyond repair, an implant named PeriCord is showing promising results. 5 Using state-of-the-art tissue engineering techniques and a 3D printer, researchers at Weill Cornell Medicine and Cornell Engineering have assembled a replica of an adult human ear that looks and feels natural (2).
Tissues need a good “plumbing system” or blood supply —a way to bring nutrients to the cells and carry away the waste. To create this system, blood is added, which easily dissolves the lattice made of a sugar solution. This leaves the pre-formed channels to act as blood vessels (3). Cartilage has been very difficult to repair due to a lack of blood supply to promote regeneration. A biological gel that can be injected into a cartilage defect creates an environment that facilitates regeneration (3).
Woah! This seems very fascinating. Let’s put on a scientific lens for a bit. What is TERM? TERM is a branch of regenerative medicine, itself a branch of biomedical engineering. Tissue engineering and regenerative medicine are concerned with the replacement or regeneration of cells, tissues, or organs to restore normal biological function.
The process of creating de novo tissue begins with building a scaffold from a wide set of possible sources, from proteins to plastics. Once scaffolds are created, cells with or without a “cocktail” of growth factors can be introduced. If the environment is right, a tissue develops. In some cases, the cells, scaffolds, and growth factors are all mixed together at once, allowing the tissue to “self-assemble” (3).
Apart from amniotic membrane multipotent cells, embryonic stem cells, bone marrow stem cells, tissue-specific progenitor stem cells, umbilical cord stem cells, and iPS cells, all have proven to be effective. Polymer, ceramic, and metal for TERM have different applications (4). 3D bioprinting and microfluidics technology excel due to their precision and controllability in preparing personalised materials and complex tissues/organs. In particular, the cell sheet is a novel technique (4) Non-therapeutic applications include using tissues as biosensors to detect biological or chemical threat agents and using tissue chips to test the toxicity of an experimental medication
The ultimate goal of TERM is to translate the findings of basic research into the clinic. Fully repairing or regenerating damaged tissues or organs and restoring their functions has been a dream of human beings, and it can be accomplished with TERM. It will improve the healthcare of the ageing and diseased population.
This is a slowly evolving branch of medicine, but it is the future of medicine. I hope to see this branch bring smiles to millions of people.
References:
- https://www.organdonor.gov/learn/organ-donation-statistics
- https://www.news-medical.net/news/20240329/Researchers-develop-realistic-replica-of-adult-human-ear-using-3D-printing.aspx
- https://www.nibib.nih.gov/science-education/science-topics/tissue-engineering-and-regenerative-medicine#:~:text=Regenerative%20medicine%20is%20a%20broad,and%20rebuild%20tissues%20and%20organs.
- https://www.frontiersin.org/articles/10.3389/fbioe.2020.00083/full
- https://www.news-medical.net/news/20240405/PeriCord-bioimplants-show-promise-in-heart-regeneration-studies.aspx
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Writer
Apoorva Koli
Editor
Gauri Panzade
Illustrator
Dhaval Shejwal