Connecting the Lab and the Clinic in Regenerative Medicine
An interview with the director of the Translational Tissue Engineering Center at Johns Hopkins University School of Medicine can be found at the Methuselah Foundation blog:
We named it the Translational Tissue Engineering Center because we're focused not just on the development of new technologies in regenerative medicine, but on addressing clinical challenges and developing new therapeutic outcomes for patients. In my lab, we're looking at a number of different applications in orthopedic surgery, rheumatology, and musculoskeletal repair. We're working on the regeneration of cartilage tissue, which lines the surfaces of joints. We're also looking at bone repair, which is important for joints and in craniofacial reconstruction, and exploring what can be done with muscle disease to repair tissues and treat the underlying disease. Then there are the plastic surgery applications - reconstruction of tissues and wound healing in the craniofacial region and soft tissue throughout the body. We're also in an ophthalmology building, so we're surrounded by a lot of clinicians focused on the eye, and we've begun projects looking at both corneal repair and retinal repair.What's interesting right now is that there seems to be a renewed excitement for cell therapies and gene therapies, both among students and in the commercial sector. These types of industrial investment and commercial excitement tend to go through ups and downs, and I think there's a lot of excitement right now that we definitely want to get more and more connected with. One of the biggest gaps in my mind is what happens at the university versus what's feasible in commercial settings, and there are a number of these so-called valleys of death between the two. There's a valley of death in the laboratory of moving to proof of concept and actual efficacy in the most relevant pre-clinical models that the FDA will approve. Then there's another valley of death when you come out of the laboratory regarding how to manufacture and deliver whatever technology you're working with, and how to make it commercially viable.
Right now, I'm most encouraged by the interface between regenerative medicine and transplantation. There have been some exciting advances in transplantation and microsurgery, for example, with very complex grafts on the face, hands, and arms. And in order to take it beyond that, and make it less of a rare, boutique occurrence into something more widespread and accessible to a larger number of people, I think it could be very interesting to combine the latest work in cell therapy with the latest in both materials and immunomodulation. Also, I think some of the recent advancements in cancer immunology, which is really a type of regenerative medicine engineering - in other words, engineering the immune system to treat a disease - involve principles that are very promising and can be applied to many other things.
It is an interesting perspective to think of recent cancer immunotherapies as regenerative medicine. I've always thought of them as fighting disease/the evolved abilities of cancer to turn off the immune system. But from another angle the ability of cancer to turn off the immune system is really just evolved damage which is being repaired by antagonistic antibodies to the immunomodulatory T-Cell receptors CTLA4 and PD1.