Some experts pointed out that regenerative medicine refers to the use of biological and engineering theories and methods to create missing or functionally impaired tissues and organs, so that they have the institutions and functions of normal tissues and organs. Academician Lu Shibi also introduced the progress of cartilage tissue engineering.
Some experts believe that the concept of regenerative medicine should be divided into broad sense and narrow sense. Broadly speaking, regenerative medicine can be regarded as a new discipline to study how to promote the physiological repair of trauma and tissue and organ defects and how to regenerate and rebuild tissues and organs. It can be understood that by studying the characteristics and functions of normal tissues, the mechanism of wound repair and regeneration, and the mechanism of stem cell differentiation, we can find effective biotherapy methods to promote self-repair and regeneration of the body, or build new tissues and organs to maintain, repair, regenerate or improve the functions of damaged tissues and organs. In a narrow sense, it refers to the definition of replacement, repair, improvement or regeneration of various tissues and organs of human body and the research and development of information technology by using the principles and methods of life science, material science, computer science and engineering. Its technology and products can be used for regenerative treatment of tissue and organ defects or dysfunction caused by diseases, trauma, aging or genetic factors.
The relationship between regenerative medicine and tissue engineering Tissue engineering was originally used to describe the theory and technology of constructing tissues or organs in vitro. Now its connotation is constantly expanding, and various methods and technologies that can guide tissue regeneration have been brought into the category of tissue engineering. The scientific significance of tissue engineering lies not only in the new treatment methods, but also in the new concept of replicating tissues and organs, which makes regenerative medicine face great opportunities and challenges.
In a special report entitled "Regenerative Medicine", Academician Huang Zhiqiang of PLA General Hospital commented on the method of constructing tissue-engineered liver by applying tissue engineering and corresponding comprehensive technologies. The liver itself is an organ with strong regenerative ability. From a new point of view, the culture, expansion and transplantation of stem cells and the in vitro construction of the whole liver have become the focus of regenerative medicine, but due to the complexity of liver structure and function, it is still the first difficulty.
The special report of Tissue Engineering and Regenerative Medicine introduces the work of a large number of scaffold materials (bioactive materials for cell therapy, bioactive factors and composite scaffold materials for cells).
The special report "Research Progress of Heart Regeneration and Myocardial Tissue Engineering" points out that the breakthrough progress in tissue engineering, biomaterials and stem cell research in recent ten years has brought new opportunities for the development of "regenerative medicine", and heart tissue regeneration is the biggest challenge facing mankind.
The special report "The New Frontier of Regenerative Medicine-Liver Regeneration and Artificial Manufacturing" introduces the research status and domestic progress of liver tissue engineering abroad.
The special report on the relationship between regenerative medicine and stem cells, Plasticity Research and Tissue Regeneration of Adult Stem Cells, introduces the plasticity of adult stem cells, the relationship between induced differentiation of stem cells and tissue function repair. Adult stem cells may have several breakthroughs in the treatment of diseases, including the regeneration of skin attachment files and the treatment of cardiovascular diseases. At present, it has been preliminarily observed that bone marrow stem cells may become sweat glands, sebaceous glands and hair follicles under certain conditions.
Adult stem cells are very valuable research objects, and their advantages over embryonic stem cells lie in their more practical performance in clinical application. Recently, the theory of pluripotent stem cells was put forward. This kind of cells just break away from the characteristics of embryonic stem cells, but they are not adult stem cells. Experiments show that human pluripotent stem cells can be induced to differentiate into various tissue cells, which can be transplanted into recipients to participate in tissue regeneration and repair, thus expanding a new therapeutic approach for malignant hematological diseases, cardiovascular diseases, diabetes, liver failure and other serious diseases. Stem cells can be used to treat many diseases or injuries.
The special report "Application of Several New Technologies in Bone Regeneration" introduces the application of nanotechnology, which enables us to observe, intervene and simulate tissue regeneration at the molecular level. The application of computer-aided technology and gene modification technology (including local gene delivery vector technology and local gene delivery cell technology) has promoted the development of regenerative medicine. Professor Yang Li of Chongqing University believes that biomechanics plays a very important role in tissue engineering, which is a problem that everyone will encounter. In stem cell research, after differentiation induction and mechanical stimulation, new growth factors may appear. If there is no mechanical environment, they may only be morphological and have no function. The evaluation of biomaterials needs the help of biomechanics, so regenerative medicine provides a new platform for biomechanics.
Regenerative Medicine Regenerative Medicine Research Open Regenerative Medicine Journal (OJRM) is an international peer-reviewed open aess magazine, which publishes original research, reviews and case reports on various aspects of regenerative medicine in English. Symposium or seminar papers may be published as supplements.
The open source journal Regenerative Medicine (OJRM) is a professional journal with international peer review. This journal is an original English study published by American Scientific Research Press, commenting on all aspects of regenerative medicine case reports. Papers from regular symposiums or seminars are published as supplements. Include the following research areas:
Research on Regenerative Medicine of Biodegradable Nanomaterials
Bioreactor and tissue engineering
Bone engineering
Cardiovascular implant
Cell therapy for muscle regeneration
Interaction between cells and biomaterials in tissue repair
Cell therapy at your fingertips
Prospects and limitations of embryonic stem cells
Ligament and tendon engineering
Myocardial engineering and other artificial neural network systems
Hollow engineering
Improving the distribution of blood vessels in engineering structures
Nerve innervation in engineering ans
Development of Medical Devices and Artificial Neural Networks
Microenvironment and regeneration
Nanotechnology and Regenerative Medicine
Natural biomaterials
Neural tissue engineering
Organ replacement is within reach
peripheral nerve
Pluripotency of stem cell and emerging technology
Support liver and kidney function
Development of synthetic biomaterials
Therapy using engineering tissue
Development of tissue engineering and artificial neural network
Regenerative Medicine: Opportunities and Challenges Regenerative Medicine (RM) originally refers to the theory, technology and surgery of tissue regeneration in vivo; Now, its connotation is constantly expanding, including tissue engineering, cell and cytokine therapy, gene therapy, microecological therapy and so on. The International Foundation for Regenerative Medicine (IFRM) has clearly defined tissue engineering as a branch of regenerative medicine. It is reported that Professor Feng Yuanzhen, a Chinese American scientist, was the first to put forward the term "tissue engineering". The basic principle of tissue engineering is to obtain a small amount of functional cells of living tissue from the body, mix them with degradable or absorbable three-dimensional scaffold materials in a certain proportion, and implant them into the diseased part of the human body, and finally form the required tissue mixed organs, so as to achieve the purpose of repairing the wound and reconstructing the function. Wang Zhengguo believes that the scientific significance of tissue engineering lies not only in proposing a new treatment method, but also in proposing a new concept of replicating tissues and organs, which makes regenerative medicine face great opportunities and challenges. Wang Zhengguo said that generally speaking, there is no strict difference between tissue engineering and regenerative medicine. Nowadays, academic circles believe that various methods and technologies that can guide tissue regeneration have been brought into the category of tissue engineering, such as stem cell therapy, cytokines, gene therapy and so on. From the perspective of the development of surgery, after three "R" stages of resection, repair and replacement, the appearance of tissue engineering means that surgery has entered a new stage of regenerative medicine, that is, the fourth "R". "Regenerative medicine" breaks through "robbing Peter to pay Paul" It is reported that the repair and reconstruction of damaged tissues and organs in the process of body injury and disease rehabilitation is still a major problem facing biology and clinical medicine. With the development of modern science and technology, it has become the focus of biology, basic medicine and clinical medicine to completely regenerate damaged tissues and organs or replicate needed tissues or organs in vitro for replacement therapy. It is reported that millions of people all over the world suffer from various forms of trauma every year, millions of people lose their functions due to fibrosis of important organs in the process of disease rehabilitation, and hundreds of thousands of people are eager for various organ transplants. But unfortunately, on the one hand, the current tissue and organ repair, whether it is body surface or internal organs, still stays at the anatomical repair level of scar healing, far from achieving the "regeneration of a complete damaged organ" that people hope; On the other hand, organ transplantation, as an alternative treatment method, although it has great therapeutic effect, is still a damaging and expensive treatment method of "robbing Peter to pay Paul", and it is difficult to meet the needs of clinical treatment due to ethical limitations and immune rejection. Wang Zhengguo said that since 1990s, with the rapid development of basic disciplines such as cell biology, molecular biology, immunology and genetics, and the application of stem cells and tissue engineering technology in modern medicine, modern regenerative medicine has shown a good development prospect in the treatment of nervous system diseases such as hematological diseases, muscular atrophy and brain atrophy. It is reported that the importance of regenerative medicine has attracted great attention of relevant decision-making departments and scientific and technological personnel in China. At the 264th Xiangshan Science Conference held in Beijing in mid-June, 1, academic leaders of major tissue engineering and stem cell research centers in China, as well as 4/kloc-0 scientists, including clinicians, biologists, biomedical engineering experts and social science ethics experts, took "regenerative medicine" as the theme, and specifically discussed the key points, development directions, major subject problems to be solved and Wang Zhengguo said that tissue engineering has developed rapidly in China since the establishment of the discipline, and a variety of regenerative tissues have been successfully constructed in a variety of large animals, some of which (such as cartilage and artificial skin) have been marketed, and it is expected that more tissue engineering products will come out soon. However, it is very difficult to construct different organs with normal physiological functions, especially important living organs, and it is still unclear whether they even have the ability to form complex organs. The arrival of the so-called "human era of biological science" is still too early. 165438+1October1~14 The first Asian Traumatic Orthopedics Summit Forum was held in Guangzhou with the aim of "promoting the development of China's traumatic orthopedics, enhancing mutual understanding and expanding academic exchanges and technical cooperation with Asian countries". According to reports, the Asian Traumatology Summit Forum will be held in Guangzhou in the form of an annual meeting on the second weekend of June 165438+ 10 every year. At the forum, Professor Wang Zhengguo, academician of China Academy of Engineering and chairman of the Trauma Branch of Chinese Medical Association, introduced the development status and prospect of regenerative medicine to the participants.
Experts suggested that it is too early to unify the understanding of the concept of regenerative medicine, and it is important to form several important scientific problems. Experts put forward the following suggestions for the future development of regenerative medicine:
What scientific problems should regenerative medicine solve? 1. What scientific problems does regenerative medicine need to solve? Only by clarifying the scientific problems that need to be solved in regenerative medicine can we make a breakthrough in basic theory and lay the foundation for future development. Experts believe that the scientific problem of regenerative medicine is actually a problem faced by developmental biology, and its core is the induced differentiation and regulation of cells. Only by connecting the three stages of basic research, industrialization and enterprise production can the current individualized treatment enter the clinical treatment with unified standards. At present, the domestic basic theory research level is limited, which hinders the clinical development to some extent. Although the clinical prospect is very good, once the possibility of cancer is considered, I dare not do it. This is not a clinical problem, which shows that many theories need to be studied.
Combining basic theoretical innovation with solving clinical practical problems II. The development of regenerative medicine must adhere to the combination of basic theoretical innovation and solving clinical practical problems and multidisciplinary integration, and embark on a scientific research road based on innovation and aiming at serving patients. Generally speaking, the problems in regenerative medicine are more applied research, and more clinical needs should be considered. The research results serve the clinic. At present, some fields of regenerative medicine, such as tissue engineering and stem cell therapy, are closely combined with clinic, and some treatment methods and products have been applied in clinic and some signs of success have been initially observed, which is a good start. However, under the condition that the basic theory of regenerative medicine has not been completely broken through, it is worth considering whether it is necessary to carry out relevant clinical treatment. In view of the current development at home and abroad, we can choose some indications with clear therapeutic purpose, easy observation and simple treatment methods to carry out research.
Pay special attention to long-term effects and possible adverse reactions. 3. In clinical observation, special attention should be paid to the long-term effect and possible adverse reactions, mainly the safety and directional differentiation of stem cells. Many experts stressed that compared with the history of traditional medicine for thousands of years and chemical pharmacy for hundreds of years, the development history of some treatments in regenerative medicine, such as stem cell therapy, biological products therapy, gene technology and tissue engineering technology, is still very short, only a few decades or more, so it is necessary to take a more cautious attitude to evaluate a treatment in such a short time, on the one hand, to make this treatment more scientific, on the other hand, to effectively protect the life safety of patients.
Pay attention to ethical issues. Pay attention to ethical issues. At the seminar, people are more concerned about the ethical issues that may be involved in regenerative medicine research. Attention should be paid to legislation and ethics should be in line with international standards. On this issue, we are backward in consciousness and have not done enough. Some people want to donate their bodies, but they can't find a place to accept them. Moreover, organ transplantation is not standardized and wasteful, and only one organ is taken at a time. Here, we call on the management department to issue corresponding ethical policies and regulations, and call for legislation on body donation. Also pay attention to safety and risk. These ethical problems need to be solved step by step in our progress.
The expansion of related fields. At present, the domestic team span is relatively large, and a lot of basic research work needs to be done. Although the construction is developing rapidly and advanced in some areas, the weak areas need to be strengthened and innovation is needed. At the same time, it is necessary to have a scientific understanding process and a reasonable prediction of development. Therefore, how to form an advantageous team of regenerative medicine, how to integrate and cooperate with experts in various fields, concentrate on scientific research and organize major scientific and technological projects.
Applied research and product concept. Applied research and product concept. There is no clear understanding of the concept of products in China. If enterprises can get involved in basic research as early as possible, it will have a good effect, and researchers in China should also strengthen their understanding of enterprises and products, so that scientific research results can be transformed into productive forces.
China has invested heavily in regenerative medicine. According to China's data, the country now trains 400,000 scientific and medical graduates every year and recruits many high-level scientists from overseas.
China's R&D expenditure has increased from $5.9 billion in 1996 to $44 billion now. Stem cell research, tissue engineering and gene therapy are the key areas to receive priority funding, which are mainly concentrated in major central cities of China, especially universities, hospitals and research institutions in Beijing and Shanghai.
About 78% of R&D funding for regenerative medicine in China is used for product research and development, and about 16.8% is used for applied research. China has developed a large number of primate groups for preclinical testing, and a series of therapies have started clinical testing.
According to MRC, China's urgent need for clinical application-which enables it to generate new scientific knowledge quickly-comes at the expense of some basic research aimed at overcoming technical challenges, such as controlling stem cell behavior and differentiation.
Only 5.2% of China's R&D budget is allocated to basic research, while that of Japan, South Korea and the United States ranges from 13% to 19%. Even those basic research grants allocated to support "strategic basic research" are intended to encourage applications.
The rules of free research guide the principles of China's research, but they are similar to those of other countries.
The laws and regulations in China prohibit reproductive cloning, the use of human embryos fertilized for more than 14 days, the fusion of human gametes with non-human gametes (cells combined during fertilization) or the implantation of research embryos into human or animal uterus.
Scientists need to obtain the informed consent of the subjects, and research institutions must have an ethics review committee to approve research involving human embryonic stem cells.
The fertility clinic in China has become the source of discarded embryonic stem cells used in some studies, and the umbilical cord blood bank may become the source of stem cells for clinical application.
Therapeutic cloning is allowed, as are the use of surplus embryos or fetal cells discarded after abortion and artificially assisted embryos.