Chapter 4 Tissue Engineering and Regenerative Therapies

Tissue engineering and regenerative medicine are relatively new but rapidly expanding multidisciplinary fields relevant to surgery that have the potential to transform the treatment of a wide range of human diseases. This chapter explores the development of the tissue engineering paradigm and the constituent processes that have been used to enhance tissue healing by considering cells, materials and molecules and the interplay between them, alongside key exemplars. The potential impact of tissue engineering and regenerative therapies is so far-reaching that practising surgeons should be aware of the resulting opportunities to improve patient management. Advances in tissue engineering and more broadly regenerative medicine are underpinned by developments in both the physical and biological sciences, building on the classical tissue engineering paradigm. Stem cells are undifferentiated or non-specialised cells that are able, through cell division, to renew themselves indefinitely.

Multiple Choice Questions
Weblinks

Journal articles

https://onlinelibrary.wiley.com/doi/epdf/10.1002/jor.1100090504/ (free)

Seminal paper by Arnold Caplan that defines the mesenchymal stem cells and discusses their utility in the regeneration of cartilage.

https://www.isct-cytotherapy.org/article/S1465-3249(06)70881-7/fulltext/ (paid)

A definition paper describing the cell surface markers that should be present to define a mesenchymal stem cell. This is a recognised position paper that was endorsed by the International Society for Cell & Gene Therapy.

https://academic.oup.com/stcltm/article/6/6/1445/6448531/ (free)

Paper by Arnold Caplan, in which he proposes the redefinition of mesenchymal stem cells as medicinal signalling cells, on the basis that they seem to exhibit the capacity to migrate to the site of injured tissue.

https://www.nature.com/articles/d41586-018-06756-9/ (free)

A paper that outlines the current confusion around what constitutes a mesenchymal stem cell. A tighter definition was suggested in order to ensure that what is used medically is quality assured.

https://www.isct-cytotherapy.org/article/S1465-3249(19)30841-2/fulltext/ (paid)

Clarification of the definition of what constitutes a mesenchymal stem cell, with the suggestion that, in addition to surface markers, they are characterised using functional assays and considering tissue of origin.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292498/ (free)

Definition of standardised assays that should be used for the characterisation of stem cell products that are to be used clinically.

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