TUESDAY Q & A: Regenerative Medicine Ready to Revolutionize Disease Management
DEAR MAYO CLINIC: I’ve been hearing a lot about regenerative medicine lately. What is it exactly, and what can it be used for?
Regenerative medicine is an emerging discipline in medicine and surgery focused on finding ways to boost the body’s ability to heal itself. It examines new therapies and advances new ways to manage diseases that go beyond current medical treatment. Regenerative medicine is really poised to revolutionize disease management, offering potential solutions throughout a person’s life for a spectrum of diseases.
Today, treatment for many diseases focuses on managing symptoms. For example, insulin therapy keeps diabetes under control. Dialysis does the work of a failing kidney. Medications ease the strain on a damaged heart. In contrast, the aim of regenerative medicine is to reverse the course of the disease by targeting its root cause and repairing diseased, injured, or defective tissues and organs to restore their function and structure.
One disease being addressed by regenerative medicine is diabetes. People with diabetes have a problem with their beta cells — a type of cell in the pancreas that makes insulin. Right now, no method exists for making new beta cells that work properly. That means people need to take medication to help their bodies do what their defective beta cells are unable to do. In the laboratory, researchers are discovering ways to generate beta cells using a person’s own skin cells as a renewable source for treating diabetes.
Another area in which regenerative medicine holds particular promise is orthopedics. A variety of new technologies are under investigation. These technologies are geared toward repairing and replacing diseased bone, as well as cartilage, tendons and muscle.
An additional example can be found in cardiology and cardiac surgery. Many people now survive a heart attack. But afterward, their heart may become weak and develop heart failure. Medications or a transplant can be used to support or ultimately replace that weak heart. But regenerative medicine seeks to provide more advanced solutions. Clinical trials now under way are examining alternative ways to strengthen a failing heart based on regenerative medicine innovations. These approaches may be applicable not only in the adult, but also in children with congenital heart disease.
At its core, regenerative medicine leverages the natural concept that our bodies can self-heal. When we cut our skin, it usually heals quite well on its own. We can give part of our liver to someone in need of a transplant, and our own liver will regrow.
What researchers and physicians involved in regenerative medicine are coming to understand more clearly is that some organs believed to remain the same throughout our lives really do regenerate. Organs such as the heart, for example, may be able to refresh or rejuvenate themselves. But they do so slowly, at a rate that is not fast enough to repair a failing heart after a heart attack, for example. That’s where regenerative medicine comes in. The goal is to apply therapies that will boost the heart’s innate ability to heal and repair itself.
The same concept of healing from within applies to other organs, too. Researchers and clinicians working together are currently trying to understand and increase the speed and the efficiency with which each of our organs can self-repair. They will use the information to help find the best regenerative solutions to enhance that existing natural ability.
Increasingly, as this field advances, we will be well-equipped to go after the root cause of many medical problems. So in many ways, regenerative medicine provides a remarkable opportunity to move forward, beyond the scope of current medicine, ultimately offering curative solutions and transforming the health care landscape. The first steps in this exciting domain are very promising. The progress to date gives us confidence that as the field grows, we’ll be able to help more and more people in need. — Andre Terzic, M.D. Ph.D., Center for Regenerative Medicine, Mayo Clinic, Rochester, Minn.