While challenges remain, regenerative medicine therapies are moving full steam ahead, according to a review article in June issue of Plastic and Reconstructive Surgery.
During the past 10 years, researchers have developed several promising gene therapy techniques to grow skin, bone, and other tissues for reconstructive surgery, but challenges remain in developing gene-based approaches that can make the leap from the lab to the operating room, report researchers led by Giorgio Giatsidis, MD, and colleagues of Padua University Hospital in Italy.
Giatsidis and colleagues reviewed research on gene therapy techniques for treatment of local disorders and injuries—the first such review in more than a decade. They found studies using gene therapy to promote the growth of “almost every different tissue” for use in regenerative surgery. “Gene therapy may represent a leading strategy to develop more efficient regenerative surgical treatments for numerous clinical needs,” they write.
Gene therapy has the potential to provide reconstructive surgeons with a new approach to solving one of their most difficult problems: the lack of adequate tissues to correct deformities of a specific area or structure. But for patients with burns involving larger areas, the lack of suitable tissues for coverage may severely limit the reconstructive options, they note. Using gene techniques to promote growth of specific types of tissues would be a major step forward in the ability to perform truly regenerative surgery.
Several research groups are pursuing gene therapy approaches to regenerate skin such as using genes to control expression of growth factors involved in skin healing. Researchers are also targeting growth factors involved in new bone formation, with promising results in techniques using transplantation of genetically modified donor bone.
Progress aside, translating experimental gene therapy methods into regenerative surgery techniques for use in the operating is a challenge. “After 2 decades, regenerative surgery is an adolescent looking forward to growing up,” Giatsidis and coauthors write. “Despite extensive preclinical approaches, translation of gene therapy strategies into clinical trials is still a difficult and expensive process.”
Yet “cutting-edge gene therapy-based strategies in reconstructive procedures [are close] to setting valuable milestones for development of efficient treatments in a growing number of local diseases and injuries,” they write.