When was the last time you got really excited to hear about a medical breakthrough? Was it when a team led by Ian Wilmut cloned a sheep called Dolly in 1996? Or, was it when a group of scientists released a rough draft of the human genome to the public in 2000? The paucity of blockbuster breakthroughs might make one wonder whatever happened to the golden age of medicine. But the reality is that researchers across the world are pushing the boundaries of science and quietly advancing the cause of healing humankind, one small step at a time.
Of late, no branch of medical science has seen as much progress as regenerative medicine, which is a brave new way of treating disease and injury by helping the body to rebuild itself. Advancement in the field has been coming fast and furious in recent months. For example, scientists are using tissue-engineering techniques to restore liver function in mice, regrow human muscle and even implant bioengineered blood vessels into ailing patients. Recently, scientists at the University of Pittsburgh managed to grow human heart tissue that can beat autonomously in a petri dish, an exciting step towards devising transplantable replacement organs.
It is at the same campus that Dr Alan Russell, as the founding director of the McGowan Institute for Regenerative Medicine, has pioneered new ways to tackle disease. There, he leads an ambitious biomedicine programme that explores tissue engineering, stem cell research, biosurgery and biohybrid organs. By straddling the branches of both surgery and chemical engineering, Dr Russell is expanding the horizons on how doctors treat disease, injury and congenital defects. “We can treat symptoms or we can replace our damaged parts with bioengineered tissue,” says Dr Russell. “If salamanders can regenerate a lost limb, why can’t we?”
Tissue injuries are common on the battlefield. An explosion goes off. Soldiers bleed. The body knows how to respond to injuries. It forms a clot. And it tries to stop the bleeding fast. The next thing that happens is inflammation. Soon, all sorts of cells rush to that site of damage and begin to sort things out. They replace the damaged tissue with scar tissue. We have evolved to be able to replace damaged tissue with scars. It happens when we are diseased, when we are injured. The body begins to reconstruct the whole scar. We have the tissue repaired but never restored to where it was.
Ponder this: if we could intervene in this sequence of events and instead of sending cells that create inflammation to a site of damage, send cells that restore tissue like the salamander does, we could actually change the paradigm through which patients are treated.
“We know that there’s a lot of medicine that has been developed over the years to stop the loss of blood,” says Dr Russell. “There are tonnes of anti-inflammatory medications that we can take every day and, of course, there are lots of surgical interventions possible that can repair us after some kind of injury. Imagine if we could tell the body to send regenerative cells instead of inflammatory cells.”
According to Dr Russell, one of the most exciting areas that has been looked at, in recent years, is the idea of using cells to treat heart disease. Nearly 25,000 people around the world have had cells injected directly into their heart to try to reverse the damage caused by heart disease. If we can find the right cell, it can change the course of the history of the disease by simply intervening and starting to do what was once thought to be impossible.
Thousands of people are enjoying the benefits of regenerative medicine: wounded war veterans, cancer patients, people with heart disease, including former US vice-president Dick Cheney. The idea of using machines to rest an organ outside the body while the doctors fix it with cells and materials will become fundamental in the future, says Dr Russell.
He admits that regenerative medicine is available only to a select few right now. “We need to take it to places where it’s not affordable,” he says. For the sake of millions of patients in India and abroad, let’s hope he keeps that promise.