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2.
BMJ ; 369: m718, 2020 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-32349978

RESUMO

Head and neck structures govern the vital functions of breathing and swallowing. Additionally, these structures facilitate our sense of self through vocal communication, hearing, facial animation, and physical appearance. Loss of these functions can lead to loss of life or greatly affect quality of life. Regenerative medicine is a rapidly developing field that aims to repair or replace damaged cells, tissues, and organs. Although the field is largely in its nascence, regenerative medicine holds promise for improving on conventional treatments for head and neck disorders or providing therapies where no current standard exists. This review presents milestones in the research of regenerative medicine in head and neck surgery.


Assuntos
Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Otolaringologia/tendências , Procedimentos Cirúrgicos Reconstrutivos/tendências , Medicina Regenerativa/tendências , Tecidos Suporte , Bioengenharia , Transplante de Células/métodos , Transplante de Células/tendências , Cóclea , Cartilagem da Orelha , Ossos Faciais , Humanos , Laringe , Cartilagens Nasais , Procedimentos Cirúrgicos Reconstrutivos/métodos , Glândulas Salivares , Crânio , Engenharia Tecidual/métodos , Engenharia Tecidual/tendências , Traqueia , Membrana Timpânica
4.
Arch Phys Med Rehabil ; 101(5): 917-923, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32035141

RESUMO

The growing field of regenerative rehabilitation has great potential to improve clinical outcomes for individuals with disabilities. However, the science to elucidate the specific biological underpinnings of regenerative rehabilitation-based approaches is still in its infancy and critical questions regarding clinical translation and implementation still exist. In a recent roundtable discussion from International Consortium for Regenerative Rehabilitation stakeholders, key challenges to progress in the field were identified. The goal of this article is to summarize those discussions and to initiate a broader discussion among clinicians and scientists across the fields of regenerative medicine and rehabilitation science to ultimately progress regenerative rehabilitation from an emerging field to an established interdisciplinary one. Strategies and case studies from consortium institutions-including interdisciplinary research centers, formalized courses, degree programs, international symposia, and collaborative grants-are presented. We propose that these strategic directions have the potential to engage and train clinical practitioners and basic scientists, transform clinical practice, and, ultimately, optimize patient outcomes.


Assuntos
Medicina Regenerativa/tendências , Reabilitação/tendências , Certificação , Congressos como Assunto , Currículo , Bolsas de Estudo , Humanos , Medicina Regenerativa/educação , Reabilitação/educação
5.
Cell Mol Life Sci ; 77(14): 2771-2794, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31965214

RESUMO

Mesenchymal stem cells (MSCs) have been extensively investigated for the treatment of various diseases. The therapeutic potential of MSCs is attributed to complex cellular and molecular mechanisms of action including differentiation into multiple cell lineages and regulation of immune responses via immunomodulation. The plasticity of MSCs in immunomodulation allow these cells to exert different immune effects depending on different diseases. Understanding the biology of MSCs and their role in treatment is critical to determine their potential for various therapeutic applications and for the development of MSC-based regenerative medicine. This review summarizes the recent progress of particular mechanisms underlying the tissue regenerative properties and immunomodulatory effects of MSCs. We focused on discussing the functional roles of paracrine activities, direct cell-cell contact, mitochondrial transfer, and extracellular vesicles related to MSC-mediated effects on immune cell responses, cell survival, and regeneration. This will provide an overview of the current research on the rapid development of MSC-based therapies.


Assuntos
Transplante de Células-Tronco Mesenquimais/tendências , Células-Tronco Mesenquimais , Medicina Regenerativa/tendências , Diferenciação Celular/genética , Sobrevivência Celular/genética , Humanos , Imunomodulação/genética , Regeneração/genética
6.
Adv Exp Med Biol ; 1237: 75-95, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31302869

RESUMO

Cellular-based therapies have drawn a great deal of attention thanks to their regenerative medicine approaches to treat incurable diseases and specific injuries. In this regard, injectable cell delivery systems could actualize the therapeutically beneficial outcomes of cell-based therapeutic products. These systems have found considerable clinical uses. Hence, the recent studies have focused on developing injectable bio-constructs to protect transplanted cells during delivery and stimulating endogenous regeneration through interactions of these cells and host tissue. This paper introduces a framework, as a general concept, to improve cell delivery systems for cell-based therapeutic products. Studies on stable injectable carriers can enhance cell homing, proliferation, viability, dressing of irregular shape of target sites, and subsequently support transplanted cell functionality. However, more studies should be conducted on new technologies for the injectable cell-based product for cell delivery and the clinical applications.


Assuntos
Terapia Baseada em Transplante de Células e Tecidos/tendências , Medicina Regenerativa/tendências , Qualidade de Produtos para o Consumidor , Humanos
7.
Acta Biochim Pol ; 66(4): 483-489, 2019 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-31834688

RESUMO

Nowadays, mesenchymal stem cells (MSCs) are essential players in cellular therapy and regenerative medicine. MSCs are used to treat cardiac disorders by intramyocardial injection or injection into the bloodstream. Therefore, a premise of successful MSC-based therapy is that the cells reach the site of injury and home the damaged tissue. In response to inflammatory conditions, MSCs can potentially move into the place of injury and colonize damaged tissues, where they participate in their regeneration. This review presents the current knowledge of the mechanisms of MSCs migration and target tissue homing in the field of cardiovascular therapies.


Assuntos
Cardiopatias/terapia , Coração/crescimento & desenvolvimento , Transplante de Células-Tronco Mesenquimais , Medicina Regenerativa/tendências , Diferenciação Celular/genética , Movimento Celular/genética , Coração/fisiopatologia , Cardiopatias/genética , Humanos , Células-Tronco Mesenquimais/citologia
8.
Med Sci (Paris) ; 35 Hors série n° 2: 7-10, 2019 Nov.
Artigo em Francês | MEDLINE | ID: mdl-31859623

RESUMO

Cell therapy approaches dedicated to the treatment of dystrophinopathies and involving essentially myoblasts and mesoangioblasts have produced mitigated clinical results. If several types of alternative progenitors have been developed, no standardized comparison has been carried out yet to investigate their regenerative efficacy in vivo, at least at a local level. A comparative study has therefore been designed recently aiming at giving a new impetus to this therapeutic field.


Assuntos
Terapia Baseada em Transplante de Células e Tecidos/tendências , Doenças Musculares/terapia , Fisiologia Comparada , Células-Tronco/classificação , Células-Tronco/fisiologia , Animais , Diferenciação Celular , Terapia Baseada em Transplante de Células e Tecidos/métodos , Células Cultivadas , Humanos , Músculo Esquelético/citologia , Músculo Esquelético/fisiologia , Mioblastos/fisiologia , Fisiologia Comparada/métodos , Fisiologia Comparada/normas , Fisiologia Comparada/tendências , Padrões de Referência , Medicina Regenerativa/normas , Medicina Regenerativa/tendências , Células-Tronco/citologia
9.
Rev Med Chil ; 147(6): 787-789, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31859832

RESUMO

Heart failure is one of the first diseases in which stem cells were used for regenerative medicine. Since 2001, many publications have shown that stem cell therapy has the potential to mitigate heart diseases, but there is no solid scientific evidence to fully support its clinical application at present. The future of regenerative medicine requires validated clinical trials with standardized platforms and transdisciplinary efforts to enable the development of safe and effective regenerative therapies to protect patients and to promote the ethical application of this new and highly promising therapy. Doctors and scientists have a responsibility to discuss with patients the current reality of regenerative therapies. They also have a responsibility to discourage the indiscriminate and commercial use of these therapies, which are sometimes based on false hopes, since their inappropriate use can harm vulnerable patients as well as research efforts. Although regenerative medicine may be the medicine of the future and might bring the hope of cure for chronic diseases, it is not yet ready for its wide clinical application.


Assuntos
Insuficiência Cardíaca/terapia , Transplante de Células-Tronco/ética , Humanos , Medicina Regenerativa/ética , Medicina Regenerativa/tendências , Transplante de Células-Tronco/tendências
10.
Int J Mol Sci ; 20(21)2019 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-31684035

RESUMO

Mesenchymal stem cells (MSCs) are capable of differentiating into multilineage cells, thus making them a significant prospect as a cell source for regenerative therapy; however, the differentiation capacity of MSCs into osteoblasts seems to not be the main mechanism responsible for the benefits associated with human mesenchymal stem cells hMSCs when used in cell therapy approaches. The process of bone fracture restoration starts with an instant inflammatory reaction, as the innate immune system responds with cytokines that enhance and activate many cell types, including MSCs, at the site of the injury. In this review, we address the influence of MSCs on the immune system in fracture repair and osteogenesis. This paradigm offers a means of distinguishing target bone diseases to be treated with MSC therapy to enhance bone repair by targeting the crosstalk between MSCs and the immune system.


Assuntos
Diferenciação Celular/imunologia , Fraturas Ósseas/imunologia , Imunomodulação/imunologia , Células-Tronco Mesenquimais/imunologia , Osteoblastos/imunologia , Animais , Citocinas/imunologia , Citocinas/metabolismo , Citocinas/farmacologia , Fraturas Ósseas/fisiopatologia , Fraturas Ósseas/terapia , Humanos , Imunomodulação/efeitos dos fármacos , Células-Tronco Mesenquimais/citologia , Osteogênese/efeitos dos fármacos , Osteogênese/imunologia , Medicina Regenerativa/métodos , Medicina Regenerativa/tendências
11.
Zhonghua Shao Shang Za Zhi ; 35(11): 828-832, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775475

RESUMO

The repair strategy after organs injuries has always been a hot topic in the field of regenerative medicine. Traditional injury repair measures mainly promote tissue repair through mesenchymal stem cells and various growth factors, but these strategies have been constrained in the aspects of security and economy. Hence, there is an urgent need to find new ways to promote tissue repair and regeneration. There have been a lot of evidences showing that the immune system plays an important role in tissue regeneration and repair. In recent years, more and more studies have been done on adaptive immunity in tissue repair, especially the regulatory T cells. Some evidences indicate that regulatory T cells participate in damage tissue repair and regeneration of multiple organs and tissue. This review briefly introduces the new advances in the repair effects and regulatory mechanism of regulatory T cells in different organ injuries, in order to provide new ideas for designing advanced repair materials with good immunoregulatory functions.


Assuntos
Regeneração , Linfócitos T Reguladores/imunologia , Cicatrização/imunologia , Humanos , Medicina Regenerativa/tendências
12.
Curr Cardiol Rep ; 21(9): 105, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31367922

RESUMO

PURPOSE OF REVIEW: Tissue engineering has expanded into a highly versatile manufacturing landscape that holds great promise for advancing cardiovascular regenerative medicine. In this review, we provide a summary of the current state-of-the-art bioengineering technologies used to create functional cardiac tissues for a variety of applications in vitro and in vivo. RECENT FINDINGS: Studies over the past few years have made a strong case that tissue engineering is one of the major driving forces behind the accelerating fields of patient-specific regenerative medicine, precision medicine, compound screening, and disease modeling. To date, a variety of approaches have been used to bioengineer functional cardiac constructs, including biomaterial-based, cell-based, and hybrid (using cells and biomaterials) approaches. While some major progress has been made using cellular approaches, with multiple ongoing clinical trials, cell-free cardiac tissue engineering approaches have also accomplished multiple breakthroughs, although drawbacks remain. This review summarizes the most promising methods that have been employed to generate cardiovascular tissue constructs for basic science or clinical applications. Further, we outline the strengths and challenges that are inherent to this field as a whole and for each highlighted technology.


Assuntos
Coração/fisiologia , Miocárdio/citologia , Engenharia Tecidual/métodos , Materiais Biocompatíveis/administração & dosagem , Bioimpressão , Terapia Baseada em Transplante de Células e Tecidos/métodos , Humanos , Miócitos Cardíacos/fisiologia , Impressão Tridimensional , Medicina Regenerativa/métodos , Medicina Regenerativa/tendências , Engenharia Tecidual/tendências , Tecidos Suporte , Pesquisa Médica Translacional
13.
Plast Reconstr Surg ; 144(5): 1079-1088, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31454336

RESUMO

BACKGROUND: Recent technology developed by Tulip Medical Products allows clinicians to mechanically disaggregate fat tissue into small fat particles known as nanofat. The present study aimed to evaluate the cell yield obtained from nanofat generation in comparison to traditional methods involving enzymatic dissociation (stromal vascular fraction). METHODS: Nanofat preparations were characterized by cell content and viability, based on DNA quantification and image cytometry, respectively. DNA analysis was also used to determine the cell content in unprocessed dry lipoaspirate and native adipose tissue (excised adipose tissue). To evaluate cell yield, the authors compared the number of cells recovered from 1 g of lipoaspirate between stromal vascular fraction and nanofat preparations, and subsequently determined the final cell inoculum obtained following their respective protocols. RESULTS: The data showed that nanofat samples presented a cell burden of 7.3 million cells/g, close to 80 percent of unprocessed dry lipoaspirate, and 70 percent of native excised adipose tissue. Moreover, cell viability was not altered by mechanical disaggregation in nanofat samples compared to unprocessed dry lipoaspirate. Nanofat samples exhibited a cell yield of 6.63 million cells/g lipoaspirate, whereas stromal vascular fraction preparations resulted in only 0.68 million cells/g lipoaspirate. The final cell inoculum obtained from stromal vascular fraction isolation was 120 million cells and it required 200 to 250 cc of raw lipoaspirate as starting material, whereas nanofat preparation resulted in 125 million cells with only 20 cc of raw lipoaspirate. CONCLUSION: Mechanical disaggregation offers a better cell inoculum than conventional enzymatic dissociation methods by using 10 times less fat tissue as starting material and delivering a higher cell yield.


Assuntos
Adipócitos/transplante , Tecido Adiposo/citologia , Lipectomia/métodos , Medicina de Precisão/métodos , Células Estromais/transplante , Tecido Adiposo/transplante , Sobrevivência Celular , Células Cultivadas , Previsões , Humanos , Medicina de Precisão/tendências , Medicina Regenerativa/métodos , Medicina Regenerativa/tendências , Coleta de Tecidos e Órgãos
14.
Int J Mol Sci ; 20(17)2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438477

RESUMO

Collagen is the most widespread extracellular matrix (ECM) protein in the body and is important in maintaining the functionality of organs and tissues. Studies have explored interventions using collagen-targeting tissue engineered techniques, using collagen hybridizing or collagen binding peptides, to target or treat dysregulated or injured collagen in developmental defects, injuries, and diseases. Researchers have used collagen-targeting peptides to deliver growth factors, drugs, and genetic materials, to develop bioactive surfaces, and to detect the distribution and status of collagen. All of these approaches have been used for various regenerative medicine applications, including neovascularization, wound healing, and tissue regeneration. In this review, we describe in depth the collagen-targeting approaches for regenerative therapeutics and compare the benefits of using the different molecules for various present and future applications.


Assuntos
Colágeno/metabolismo , Matriz Extracelular/metabolismo , Peptídeos/metabolismo , Medicina Regenerativa/tendências , Animais , Humanos , Engenharia Tecidual
15.
Int J Mol Sci ; 20(15)2019 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-31382625

RESUMO

Several expedited regulatory review projects for innovative drugs and regenerative medical products have been developed in the US, the EU, and Japan. Each regulatory agency has elaborated an original regulatory framework and adopted regulatory projects developed by the other regulatory agencies. For example, the Food and Drug Administration (FDA) first developed the breakthrough therapy designation, and then the Pharmaceuticals and Medical Devices Agency (PMDA) and European Medicines Agency (EMA) introduced the Sakigake designation and the priority medicines (PRIME) designation, respectively. In addition, the necessity of the product being first development in Japan is the original feature of the Sakigake designation, while actively supporting the development of advanced-therapy medicinal products (AMTPs) by academia or small/medium-sized sponsors is the original feature of the PRIME; these particular features are different from the breakthrough therapy designation in the US. In this review article, flexible and expedited review processes for new drugs, and cell and gene therapies in the US, the EU, and Japan are described. Moreover, all the drugs and regenerative medical products that were granted conditional approval or Sakigake designation in Japan are listed and analyzed herein.


Assuntos
Terapia Genética/tendências , Medicina Regenerativa/tendências , Terapias em Estudo/tendências , Europa (Continente)/epidemiologia , Órgãos Governamentais/tendências , Humanos , Japão/epidemiologia , Estados Unidos/epidemiologia , United States Food and Drug Administration
16.
Rheum Dis Clin North Am ; 45(3): 417-438, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31277753

RESUMO

Osteoarthritis is the most common form of arthritis and unfortunately lacks disease-modifying treatments. This has led to a growing demand for more effective nonoperative treatment options. Platelet-rich plasma and mesenchymal stem cell therapy offer the potential to modify the natural course of knee osteoarthritis using cell-based technology. Because of the lack of high-quality evidence and the large degree of heterogeneity, in terms of study designs and measured outcomes, the use of platelet-rich plasma or mesenchymal stem cell therapy to treat knee osteoarthritis cannot be recommended at this time.


Assuntos
Transplante de Células-Tronco Mesenquimais/métodos , Osteoartrite/terapia , Plasma Rico em Plaquetas , Progressão da Doença , Humanos , Osteoartrite/fisiopatologia , Medicina Regenerativa/métodos , Medicina Regenerativa/tendências
17.
Harefuah ; 158(6): 383-387, 2019 Jun.
Artigo em Hebraico | MEDLINE | ID: mdl-31215191

RESUMO

INTRODUCTION: Neural stem cells are characterized by their capacity for self-renewal and for differentiation into neural and glial lineages. In addition, multiple studies have identified their therapeutic properties, by which stem cells inhibit local injurious inflammatory processes, protect their microenvironment from injury, and promote repair processes. These unique properties provide the main rationale for current clinical translation of cell therapy in neurodegenerative and neuro-inflammatory diseases. Candidate cell platforms (such as Mesenchymal stem cells, neural and glial stem cells, placental cells) differ in their tissue of origin and differentiation potential, in their use as an autologous or allogeneic graft, in their capacity for expansion and in ethical issues concerning their production. Future use of human embryonic stem cell and induced pluripotent stem cell based technologies may achieve direct graft-induced regeneration. Alternatively, drugs that induce the proliferation, migration and differentiation of resident stem and progenitor cells might facilitate the failing natural tissue repair processes.


Assuntos
Encefalopatias , Células-Tronco Mesenquimais , Medicina Regenerativa , Encefalopatias/terapia , Diferenciação Celular , Feminino , Humanos , Placenta/citologia , Gravidez , Medicina Regenerativa/tendências , Células-Tronco
19.
Intern Emerg Med ; 14(6): 911-921, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31203564

RESUMO

Regenerative medicine represents the forefront of health sciences and holds promises for the treatment and, possibly, the cure of a number of challenging conditions. It relies on the use of stem cells, tissue engineering, and gene therapy alone or in different combinations. The goal is to deliver cells, tissues, or organs to repair, regenerate, or replace the damaged ones. Among stem-cell populations, both haematopoietic and mesenchymal stem cells have been employed in the treatment of refractory chronic inflammatory diseases with promising results. However, only mesenchymal stem cells seem advantageous as both systemic and local injections may be performed without the need for immune ablation. Recently, also induced pluripotent stem cells have been exploited for therapeutic purposes given their tremendous potential to be an unlimited source of any tissue-specific cells. Moreover, through the development of technologies that make organ fabrication possible using cells and supporting scaffolding materials, regenerative medicine promises to enable organ-on-demand, whereby patients will receive organs in a timely fashion without the risk of rejection. Finally, gene therapy is emerging as a successful strategy not only in monogenic diseases, but also in multifactorial conditions. Several of these approaches have recently received approval for commercialization, thus opening a new therapeutic era. This is why both General Practitioners and Internists should be aware of these great advancements.


Assuntos
Medicina Regenerativa/métodos , Humanos , Medicina Regenerativa/tendências , Células-Tronco , Engenharia Tecidual/métodos , Engenharia Tecidual/tendências
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