The promises of regenerative medicine cause both hope and fear. Professor Kevin Shakesheff explains some of the controversy.
What is regenerative medicine?
Regenerative medicine creates treatments that restore tissue and organs to their original functional state. It uses cells to reconstruct three-dimensional tissues. It should transform the treatment of millions of patients within the next 50 years.
What are its (potential) applications?
Virtually every tissue of the body is being studied to develop medical applications. Reversing damage to the heart after a heart attack, curing type 1 diabetes, and repairing brain tissue after a stroke are three out of many applications progressing to clinical trials.
Why are people worried?
There are at least two things that people worry about. The first is the source of the cells that will repair the tissue. For many tissues, we need something called pluripotent stem cells. These exist in early embryos when tissues are forming. We don’t use new embryos to make medical treatments, but we sometimes use embryonic stem cells that were once derived from embryos that were produced in in vitro fertilisation (IVF) processes but never required for pregnancies. Some people have a fundamental problem with the use of these cells. Recently, new sources of pluriportent stem cells have been found that don’t require the use of any embryo tissue. That might solve the ethical issue for those people who object.
A second issue is the fact that the human body becomes repairable, rather like a classic car that has all its engine components changed to keep it running. At present, and for the foreseeable future, the impact of regenerative medicine will be to allow people to recover from illness or injury, but not to radically increase average life expectancy. However, you could foresee regenerative medicine eventually contributing to major increases in life expectancy for those who can afford replacement tissues.
What are the different legal structures that may affect or prevent research? What role do international collaborations play in this?
The most well-known legal effect on regenerative medicine has been the banning of research on new embryonic stem cell lines for a period of time, in some countries. Press coverage of this issue has led to protracted legal cases in the US and much debate in Europe, where countries have divergent views. The best contribution of international collaborators is to bring good researchers together to share knowledge and accelerate progress. International collaborations help to reduce duplication, and help companies understand the differences in markets for regenerative medicine products around the world.
'Unlocking the secrets behind regenerative medicine' is part of BIRAX, our UK-Israel initiative to support international research into some of the world's diseases.
Professor Kevin Shakesheff is Director, Wolfson Centre for Stem Cells, Tissue Engineering and Modelling (STEM), University of Nottingham, UK; Director of UK Regenerative Medicine Platform Hub in Acellular Technologies and Co-Director of the EPSRC Centre for Innovative Manufacturing in Regenerative Medicine. He is also a BIRAX grant recipient.