Different Pathways of Regenerative Medicine
Objective
The development of regenerative medicine is guided by several problems. One of those is the using of the term ‘regenerative medicine’. Plenty of biologist, physicians, genetics and other theoretical and clinical researchers attempt to build up an innovative field of medicine though it is unclear what is meant by this term. There is neither a technical definition nor a common use in practice. The aim of this study is to draw the line at the limits of regeneration and medicine in order to figure out a proper understanding of regenerative medicine and, furthermore, to uncover the potential for future development.
Methods and materials
A systematic literature research should help to get insights and make clear how medicine can be regenerative. For this purpose we searched Pubmed and included studies that met following criteria: clinical trials, case reports, publication date from 1/1/2009 to 31/3/2015. All found entries should be filtered in relevance to regenerative medicine and analysed in respect of date, country, technology, therapeutic use, study design. Here present our preliminary results.
Results
As we found only 218 entries in the first turn the rarely use of ‘regenerative medicine’ in clinical practice proves true. Because we assumed this could not be an appropriate representation of what is part of the entire research complex we needed to specify our search items. Although it is a multi-based approach and regeneration could only be achieved by unifying different technologies we segmented this big complex in its fields of technology: tissue engineering, scaffold, stem cell. In a second step we modified the search items and combined different therapeutic areas (liver, bone and cartilage, heart and vessels) each with ("tissue engineering" OR "regenerative medicine" OR "stem cell" OR scaffold) in separate queries.
Roughly 30% of 415 entries we found were related to liver regeneration. Of the 25 studies that have been analysed to date, targeted 19 to a regeneration of the liver function. Only 6 of them aimed at tissue regeneration. In the most cases (84%) the therapies are based on an application of stem cells, mostly hematopoietic or mesenchymal. We found 230 entries for bone and cartilage regeneration of which approximately 50% are relevant. The analysis of 23 clinical trials reveals a clear tendency to bone regeneration (83%) by using tissue engineering (74%), mostly for repairing craniofacial and mandible defects (48%). Of the 785 studies we found for heart and vascular diseases are 257 related to regenerative medicine. The analysis has not started yet.
Conclusion
As a preliminary result, we assert that regenerative medicine could neither be defined by its technological nor therapeutic approaches. It is a complex field of medicine with blurred boundaries. There is little chance to define it by its core, but before we need a debate about what should be regenerated, function or tissue. Sometimes both will take effect and sometimes not.
In order to see what would be possible in the near future and to estimate the translational potential no clear cut definition is necessary. This study reveals the edges of regenerative medicine and an analysis of current trials, as it was initiated here, helps to figure out which technological approach could be used in different therapeutic fields. To continue this in an open-ended database seems to be beneficial for translational knowledge and success.
The development of regenerative medicine is guided by several problems. One of those is the using of the term ‘regenerative medicine’. Plenty of biologist, physicians, genetics and other theoretical and clinical researchers attempt to build up an innovative field of medicine though it is unclear what is meant by this term. There is neither a technical definition nor a common use in practice. The aim of this study is to draw the line at the limits of regeneration and medicine in order to figure out a proper understanding of regenerative medicine and, furthermore, to uncover the potential for future development.
Methods and materials
A systematic literature research should help to get insights and make clear how medicine can be regenerative. For this purpose we searched Pubmed and included studies that met following criteria: clinical trials, case reports, publication date from 1/1/2009 to 31/3/2015. All found entries should be filtered in relevance to regenerative medicine and analysed in respect of date, country, technology, therapeutic use, study design. Here present our preliminary results.
Results
As we found only 218 entries in the first turn the rarely use of ‘regenerative medicine’ in clinical practice proves true. Because we assumed this could not be an appropriate representation of what is part of the entire research complex we needed to specify our search items. Although it is a multi-based approach and regeneration could only be achieved by unifying different technologies we segmented this big complex in its fields of technology: tissue engineering, scaffold, stem cell. In a second step we modified the search items and combined different therapeutic areas (liver, bone and cartilage, heart and vessels) each with ("tissue engineering" OR "regenerative medicine" OR "stem cell" OR scaffold) in separate queries.
Roughly 30% of 415 entries we found were related to liver regeneration. Of the 25 studies that have been analysed to date, targeted 19 to a regeneration of the liver function. Only 6 of them aimed at tissue regeneration. In the most cases (84%) the therapies are based on an application of stem cells, mostly hematopoietic or mesenchymal. We found 230 entries for bone and cartilage regeneration of which approximately 50% are relevant. The analysis of 23 clinical trials reveals a clear tendency to bone regeneration (83%) by using tissue engineering (74%), mostly for repairing craniofacial and mandible defects (48%). Of the 785 studies we found for heart and vascular diseases are 257 related to regenerative medicine. The analysis has not started yet.
Conclusion
As a preliminary result, we assert that regenerative medicine could neither be defined by its technological nor therapeutic approaches. It is a complex field of medicine with blurred boundaries. There is little chance to define it by its core, but before we need a debate about what should be regenerated, function or tissue. Sometimes both will take effect and sometimes not.
In order to see what would be possible in the near future and to estimate the translational potential no clear cut definition is necessary. This study reveals the edges of regenerative medicine and an analysis of current trials, as it was initiated here, helps to figure out which technological approach could be used in different therapeutic fields. To continue this in an open-ended database seems to be beneficial for translational knowledge and success.
