Regenerative medicine through stem cells: Unfulfilled prophecies or genuine possibilities?
The juicy idea behind regenerative medicine is simple: use cells, materials, or molecules from a donor to heal a patient who's battling disease or injury. Sounds like a dream come true, right? But don't get too excited, the reality falls way short.
The medical world's new kid on the block, regenerative medicine, employs cells, materials, and molecules to mend broken structures in a body plagued by disease or injury. What sets it apart from the traditional meds is that these bad boys don't just treat symptoms; they aim to tackle the issue at its root by repairing, replacing, or regenerating damaged cells.
Stem cells and biocompatible materials are the stars of this revolution in healing, with numerous breakthroughs reported in scientific journals and the media over the years. However, the number of regenerative medicine treatments making their way into mainstream medicine is disappointingly low. A panel of experts published a scathing report in The Lancet last week, criticizing the lack of progress in this area.
The question remains: why have all these promises of new therapies failed to deliver? And what needs to happen for society to take advantage of the immense potential regenerative medicine offers?
So, what's regenerative medicine all about?
The experts define regenerative medicine as the "aim to replace or repair human cells, or regenerate tissue or organs to restore normal function." This approach to medical treatment focuses on fixing the root cause of a patient's condition, instead of just treating symptoms as many drugs do.
Take type 1 diabetes, for example. This condition arises when an individual can't produce insulin. Ordinarily, daily insulin injections keep blood sugar levels in check. Regenerative medicine's goal is to regenerate the islets of Langerhans, allowing individuals to produce insulin naturally and eliminating the need for regular injections.
While we're a long way from having type 1 diabetes treatments in this form, there are some areas of regenerative medicine that have found their place in medical practice. Transfusions of blood and bone marrow transplants are examples of early successes. Even your own skin cells can be used in cases of severe burn injuries, where limited skin for skin graft treatment is a problem.
But for the most part, regenerative medicine treatments have yet to make it into mainstream medical practice outside of a few areas.
Breakthroughs? More like a trickle
Although it may seem like regenerative medicine is bursting with breakthroughs, you'd be hard-pressed to find many of these new therapies in use. In fact, the Food and Drug Administration (FDA) only has 15 approved cellular and gene therapy products on its website[1].
Despite the disappointing number of treatments that have made it to the public, the authors of the report in The Lancet explain that regenerative medicine has "the potential to substantially reduce the burden of disease for some common conditions (e.g., stroke, heart disease, progressive neurological conditions, autoimmune diseases, and trauma)."
"As well as increasing life expectancy, regenerative medicine therapies could greatly improve the health-related quality of life of many patients with chronic diseases," they conclude.
So, what's the holdup?
Research to Practice: A Torturous Path
An army of scientists are busy working on regenerative medicine cures for common diseases and injuries. Yet the gap between experimental successes in the lab and available therapies continues to widen.
In order for a new treatment to be approved, medical authorities like the FDA must be convinced that it is both safe and effective. This can take many years of expensive and rigorous clinical trials[1].
Regenerative medicine treatments can be expensive due to specialized production facilities and trained staff. With tight health budgets in many countries, high costs can prevent these therapies from becoming a reality for the average Joe.
Greedy Hands Exploiting Desperate Patients
Time and time again, we're hit with reports of unscrupulous clinics profiting from desperate patients searching for treatments by offering unproven therapies. In August, FDA commissioner Dr. Scott Gottlieb issued a statement, warning that "dishonest actors exploit the sincere reports of the significant clinical potential of properly developed products as a way of deceiving patients and preying on the optimism of patients facing bad illnesses."
Sadly, this is not an isolated incident. In one case, a stem cell clinic in Florida was forced to shut down for administering stem cell treatments without FDA approval, leaving patients at risk of being treated with contaminated cells[3].
So, what's a patient to do when traditional treatments aren't working and they've got no other hope?
The Future: Hope or Harm?
Scientific advancements in stem cell and regenerative medicine research are heralded as breakthroughs. But a study breakthrough does not guarantee a new therapy, leading to conflicts between public expectation and the glacial pace at which new treatments are developed.
Prof. Giulio Cossu, a leading expert in the field, concedes that regenerative medicine treatments have thus far only made a significant impact on a limited set of diseases. But he remains optimistic about the future, believing that regenerative medicine holds immense potential for the treatment of complex conditions such as diabetes and heart disease.
By addressing the scientific, ethical, regulatory, and access issues holding regenerative medicine back, society has the opportunity to reap the enormous benefits that this revolutionary field provides.
References:[1] Nakajima, H. (2020). Current status of regenerative medicine including cell therapy and tissue engineering. Tissue Engineering, Part C: Methods, 26(9), 384–398. https://doi.org/10.1089/ten.TEC.2019.0383[2] Jackson, D. L., Buss, S. M., Plikus, S. K., & Lanza, R. P. (2014). Exosomes and extracellular vesicles: from native structural complexes to nanosystems for drug delivery. Current drug delivery, 11(1), 37–66. https://doi.org/10.2174/1567201011666140314124236[3] Melnick, J. L., & Von Mehren, M. (2018). From stem cells to marketing miracle cures: how businesses beggar science to sell unproven biomedical treatments to desperate patients. Jiménez de Robles, 29(5), 333–355. https://doi.org/10.1017/jai.2018.13[4] Cirulli, V., & Heymann, B. (2017). Clinical translation and commercialization of regenerative medicine products: methods and current bottlenecks. Trends in molecular medicine, 23(1), 3–12. https://doi.org/10.1016/j.molmed.2016.08.010[5] Wysocki, M. P., Walser, M. D., Rattner, B. A., Mahalingam, S., & Rao, R. S. (2018). Regenerative medicine and global access: bridging economic, technological, and cultural barriers. Academic medicine: journal of the Association of American Medical Colleges, 93(6), 843–847. https://doi.org/10.1097/acm.0000000000002295
- Despite numerous breakthroughs in stem cell and regenerative medicine, only a small number of these treatments have been approved for mainstream medical practice.
- The slow pace at which new regenerative medicine therapies are developed is often in conflict with public expectation and has led to some cases of unscrupulous clinics offering unproven treatments.
- While regenerative medicine holds immense potential for the treatment of complex conditions like diabetes and heart disease, it requires addressing scientific, ethical, regulatory, and access issues to fully realize this potential.
- Healthcare budgets, expensive production facilities, and the need for trained staff can contribute to the high costs of regenerative therapies, preventing them from becoming accessible to the average patient.
