37 Future Perspectives
Clinical Impact
As Dr. Alan Russell mentioned in his TED Talk, the potential clinical impact of regenerative medicine is enormous. Regenerative medicine unlocks the potential to treat a disease before it becomes a life-altering issue for patients and removes the need for many medical devices or implantable that often treat the symptoms, but don’t effectively fix the problem. An example provided by Dr. Russell was using regenerative medicine to cure diabetes. In this scenario, a patient’s Pancreas would be injected with cells that naturally enable regrowth of the disfunctional area. The patient no longer has to prick their finger, wear a continuous glucose monitor, or need insulin injections to regulate their blood sugar. Their overall cost of treatment drops significantly and their quality of life improves dramatically. Other examples given included treating foot ulcers, heart disease, and the loss of a limb.
The long-term benefit of highly successful regenerative medicine is a dramatic shift in how care is provided and overall patient outcomes. More funding will likely have to be provided through insurers to have more pre-symptomatic diagnostic testing, which rarely exists today in our healthcare system. Diseases like cancer have insurance-funded pre-symptomatic checks for colon, breast, prostate cancer, and a few other age-correlated types of cancer, but many others aren’t currently covered for pre-symptomatic testing.
While developing this technology will be time-consuming and costly, implementing this technology and actually using it on patients will be yet another challenge. It’s one thing to grow cells and test them in a lab or on an animal, but it’s another to give these treatments to a human. The regulator path for this type of technology will start in a lab where it will have to be proven to an extent that animal studies make sense. Animal studies will follow and finally human testing. There will likely be many animal studies before human studies are even considered. Human studies will have to start small, likely in a third-world country where regulations are at a lower standard due to the lower standard of care available. Patients without a life-threatening disease such as heart disease may opt-in to have this procedure done to them, fully aware there is a possibility of both full recovery or death. From there, this data can be submitted to the FDA for permission to run a full-sized clinical trial. In addition to getting approval, the FDA will likely have to deliberate over what are acceptable standards for the technology before even allowing testing to begin. All-in-all, this technology provides a major clinical impact, but it will take a significant amount of time, money, and research before it is available to the masses.
Scientific Impact
This technology will be approached from the three main viewpoints of cellular therapies, tissue engineering, and medical devices/artificial organs. Cellular therapies will involve injecting an organ or tissue with cells, likely stem cells, that naturally regrow tissues and unlock our regenerative abilities that the body quickly loses with age. In the womb, the body can regrow a limb; before the age of five the body can regrow digits; later in life we even lose the ability to regrow our hair and skin. Cellular therapies have the potential to change this and give our bodies back those regenerative abilities. Tissue engineering focuses on the same outcomes, but is an approach that involves inventing, designing, or extracting materials to enable regeneration. Lastly, smart devices may unlock this potential by “off-loading the work of the body and allowing it to heal” says Dr. Russell.
Interdisciplinary collaboration between scientists, engineers, and physicians will be necessary for the success of these technologies as they’re highly cross-linked between each discipline. This type of work is difficult to fund; however, the growing need for these types of technologies will surely drive change in the amount and types of funding available to bring these technologies to life.
