health.mil

Laura Curtin  |  FHP&R Staff Writer

November 19, 2010

New technologies are needed to advance the clinical rehabilitation of severely injured Service members. And, advanced ways to heal the injured appear to be on the horizon thanks to research grants allocated by the Defense Medical Research and Development Program (DMRDP) – and by many other institutions, like the Armed Forces Institute of Regenerative Medicine (AFIRM).

Research efforts under investigation could reduce a need for some surgeries, and could even produce better results than any surgery currently offers. Efforts in regenerative medicine namely provide hope for restoring the structure and use of damaged tissues and organs, and for possibly curing previously untreatable injuries and diseases.

Researchers have worked for over 25 years to find the right natural substance and application to create an environment for the body to heal itself in a whole new way. Instead of multiple surgeries, doctors manipulate cells with regenerative medicine techniques that stimulate the body’s cells to repair and restore use on its own.

The most basic concept of regenerative medicine is to replace or regenerate human cells, tissues, or organs that restore or establish normal function. Each part of the body has specific stem cells with their own set of instructions to meet the functions of its job in the human body. Changing the cells’ instructions from an inflammation and scar tissue response to an alternative default similar to fetal growth allows the body to rebuild tissue.

One of many regenerative medicine studies is using a material approved by the FDA that is based on extracellular matrix (ECM), a natural scaffold for cells. The material based on ECM is being investigated to regenerate large amounts of thigh, calf or upper arm muscle in patients who have lost tissue at these sites due to trauma.

Dr. Stephen F. Badylak is the deputy director at the McGowan Institute for Regenerative Medicine and the inventor of a technology that could decrease functional loss of limb, amputation, or prosthetic limb requirements.

Experimentation in the lab back in 1987 presented Dr. Badylak with surprising findings when investigating how to make one body part do another body part’s function. The experiment involved applying human cells to pig tissue to create an environment that could change biology’s default mechanisms. Instead of signaling molecules to act like another body part, applying cells to pig tissue led to a response where tissue actually transformed.

“There is little a surgeon can do when there is a 25 to 40 percent degree of muscle loss. Poor solutions exist, making correction difficult or impossible,” Dr. Badylak said of why regenerating muscle is necessary.

ECM is surgically applied and is a natural material. In the release of biochemical signals, ECM recruits stem cells and other precursor cells to injury sites. This sets the stage for restoration of normal tissue instead of scar formation that can lead to loss of a functioning limb.

Badylak considers applying ECM for muscular growth as a “constructive remodeling,” where applying cells to natural scaffolds changes the body’s default mechanisms. Preclinical trials demonstrate that ECM appears to improve strength and increase muscle mass.

Dr. Steven Wolf, director of the burn center at Brooke Army Medical Center, is one of several contributing researchers on the use of ECM. Dr. Wolf works with wounded Service members on both muscle loss and burns. He is enthusiastic about the prospects of regenerative medicine research.

“I’ve been astounded with results so far. ECM actually seems to work. If it is the solution, we don’t know yet. But, we haven’t been stopped yet – we’re going to keep testing and optimizing the technique to see if we can restore Service members back to normal functioning,” Dr. Wolf said.

Dr. Badylak summarized the sentiment of many regenerative medicine researchers: “I’m looking forward to aiding Service members and seeing how effective the procedure proves to be. The DoD has recognized the way warfare has changed and that many people are returning with serious injuries. This clinical trial is a great example of DoD’s commitment to do everything possible for our wounded warriors.”

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