Immune Editing: Overcoming Immune Barriers in Stem Cell Transplantation.

Purpose of Review: Human pluripotent stem cells have the potential to revolutionize the treatment of inborn and degenerative diseases, including aging and autoimmunity. A major barrier to their wider adoption in cell therapies is immune rejection. Genome editing allows for tinkering of the human genome in stem and progenitor cells and raises the prospect for overcoming the immune barriers to transplantation. Recent Findings: Initial attempts have focused primarily on the major histocompatibility barrier that is formed by the human leukocyte antigens (HLA). More recently, immune checkpoint inhibitors, such as PD-L1, CD47, or HLA-G, are being explored both, in the presence or absence of HLA, to mitigate immune rejection by the various cellular components of the immune system. Summary: In this review, we discuss progress in surmounting immune barriers to cell transplantation, with a particular focus on genetic engineering of human pluripotent stem and progenitor cells and the therapeutic cell types derived from them.

Fusing spheroids to aligned µ-tissues in a heart-on-chip featuring oxygen sensing and electrical pacing capabilities.

Over the last decade, Organ-on-Chip (OoC) emerged as a promising technology for advanced in vitro models, recapitulating key physiological cues. OoC approaches tailored for cardiac tissue engineering resulted in a variety of platforms, some of which integrate stimulation or probing capabilities. Due to manual handling processes, however, a large-scale standardized and robust tissue generation, applicable in an industrial setting, is still out of reach. Here, we present a novel cell injection and tissue generation concept relying on spheroids, which can be produced in large quantities and uniform size from induced pluripotent stem cell-derived human cardiomyocytes. Hydrostatic flow transports and accumulates spheroids in dogbone-shaped tissue chambers, which subsequently fuse and form aligned, contracting cardiac muscle fibers. Furthermore, we demonstrate electrical stimulation capabilities by utilizing fluidic media connectors as electrodes and provide the blueprint of a low-cost, open-source, scriptable pulse generator. We report on a novel integration strategy of optical O2 sensor spots into resin-based microfluidic systems, enabling in situ determination of O2 partial pressures. Finally, a proof-of-concept demonstrating electrical stimulation combined with in situ monitoring of metabolic activity in cardiac tissues is provided. The developed system thus opens the door for advanced OoCs integrating biophysical stimulation as well as probing capabilities and serves as a blueprint for the facile and robust generation of high density microtissues in microfluidic modules amenable to scaling-up and automation.

Worldwide assessment of healthcare personnel dealing with lymphoedema.

BACKGROUND: Lymphoedema is a pandemic with about 250 million people suffering from this condition worldwide. Lymphatic diseases have considerable public health significance, but yet few professionals are specialised in their management causing a substantial burden on health resources. AIMS AND OBJECTIVES: This study aims to give an overview of the approximate number of medical professionals, professional societies, institutions and companies dealing with lymphoedema in various countries. Concepts of improvement for current human resources are considered. METHODS: An online database analysis (Google search engine and PubMed) was carried out for each country of the world. Additionally, relevant congress participant lists as well as member lists of significant medical societies and reports of the World Health Organisation were analysed. RESULTS: Overall distribution of tertiary level professionals specialised in this field is heterogenous. A decrescent gradient of professionals can be seen between developed and developing countries and between urban and rural areas. Countries in general do not seem to have yet met the current demand for specialists at tertiary level in this field. CONCLUSIONS: This study intends to draw attention to the current medical coverage gaps due to a low number of lymphoedema specialists at tertiary level. It wishes to start a discussion about structured reimbursement and certification of knowledge and skills that are essential incentives for experts to act as multiplicators and change the lack of care in the mid-term. Current fail prescriptions and evitable disability and sick certificates represent a high financial burden that could be reinvested in a correct management. Policy makers must focus in the two above mentioned essential measures. Medical training and the consequent development of the industry will then naturally take place, as it was the case for other professional groups in the past.

On center field or at the sidelines? - A plea for a multimodal approach between medical schools and medical student communities while integrating international medical students.

An increasing number of medical schools offer support services for international students. Their frequent focus on linguistic and academic support often reflects a rather deficit-oriented perception of international medical students. Therefore, this comment advocates a stronger focus on the integration into the local medical student communities. This happens both against the background of the expected academic benefits and the added value of intercultural learning at medical schools.

Symposium "International Medical Students - Support Programs in Practical Application": Networking, best-practice examples and local representation.

The new project "International Medical Students" within the German Medical Students' Association (bvmd) aims at connecting local support programs for international medical students as well as the representation of their interests within the bvmd. Within the frame of this project, the first symposium "International Medical Students - Support Programs in Practical Application" took place from the 12th to the 14th of May 2017 at the Hannover Medical School (MHH). Through partaking in different workshops, 31 participants discussed the framework conditions of local work (i.e. curricula, tutorials, social offers, cooperation between faculty members and student body, legal aspects), common problems (i.e. addressing the target group, funding of support programs) and possible solutions (i.e. targeted advertisement, application for public funds). This report constitutes a summary of the results of these discussions. The feedback from the participants on the need for such a regular exchange and the format of the symposium was positive. However, there were requests for further thematic specification. Based on this feedback the next symposium is planned for 2018.