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Current Situation of Regenerative Medicine

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Regenerative Medicine in Otolaryngology

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Abstract

Regenerative medicine has made remarkable progress. This has been supported by the development of tissue engineering, which was a combination of medicine and engineering. Tissue engineering applies the principles and methods of engineering, material science, and cell and molecular biology toward the development of viable substitutes that restore, maintain, or improve the function of human tissues.

According to the theories of tissue engineering, tissues and organs can be regenerated by manipulating three elements: cells, scaffolds, and regulation factors. In this field, cells mean stem cells that possess both capabilities of self-renewal and differentiation into various tissue-specific cells. Stem cells are divided into three groups: embryonic stem cells (ES cells), somatic stem cells, and induced pluripotent stem (iPS) cells. Although ES cells are the best cell-source having the omnipotency to generate all tissues, ethical problems and rejections by the immune system remain to be resolved. On the other hand, somatic stem cells are promising cell-sources because they are free of the above problems. Actually, almost all clinical applications of regenerative medicine have been performed using somatic stem cells or progenitor cells.

Mesenchymal stem cells (MSCs) belonging to somatic stem cells are defined as pluripotent progenitor cells with the ability to generate bone, cartilage, muscle, tendon, ligament, and fat. Moreover, in some kind of conditions, MSCs can be differentiated into another lineage: nerve, epithelium, and so on. These properties have generated great interest in the potential use of MSCs to replace damaged tissues. Mesenchymal stem cells could be cultured to expand their numbers or after or seeded in/on shaped biomimetic scaffold to generate appropriate tissue constructs, then transplanted to the injured site.

The iPS cells have been considered to be comparable to ES cells and are promising cell-sources as substitutes for ES cells. Generation of iPS cells has dramatically changed the landscape of stem cell research and its future clinical application. Especially, it is possible that novel drug discovery using iPS cell-based disease models/toxicity screening can be useful in filling the gap between animal models and clinical trials.

A scaffold that sustains cells is necessary to regenerate injured tissues and organs. Owing to the development of biotechnology and polymer chemistry, we can create more desirable biomaterial scaffolds with appropriate mechanical properties that can be modified to incorporate biological activity, such as growth factors and structural adhesive proteins. It is no exaggeration to say that successful regeneration of tissues and organs depends on how to establish an appropriate scaffold in the injured site.

Regulation factors also play an important role in tissue regeneration. They can induce angiogenesis, which promotes a sufficient supply of oxygen and nutrients to effectively maintain the biological functions of cells transplanted for organ substitution. Therefore, if we do not understand and manipulate the complex relationships among cells, scaffolds, and regulation factors, we cannot repair and/or regenerate tissues and organs.

This chapter discusses the basic principles of tissue engineering and introduces current situations of regenerative medicines.

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Authors and Affiliations

  1. Department of Otolaryngology – Head and Neck Surgery, Medical Research Institute, Kitano Hospital, 2-4-20 Ohgimachi, Kitaku, Osaka, 530-8480, Japan

    Shin-ichi Kanemaru MD, PhD

  2. Department of Otolaryngology, Foundation for Biomedical Research and Innovation Hospital, 2-2 Minami-machi, Minatojima, Chuo-ku, Kobe, Hyogo, 650-0047, Japan

    Shin-ichi Kanemaru MD, PhD

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  1. Department of Otolaryngology, Head and Neck Surgery, Kyoto University, Kyoto, Japan

    Juichi Ito

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Kanemaru, Si. (2015). Current Situation of Regenerative Medicine. In: Ito, J. (eds) Regenerative Medicine in Otolaryngology. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54856-0_1

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