TE Flashcards
(162 cards)
Definition of Regenerative medicine?
Umbrella term incompassing tissue engineering and research into self-healing, where the body uses its own systems, sometimes with help [biomaterials] to recreate cells and rebuild tissues and organs.
Definition of Tissue engineering?
Multidisciplinary field aiming to develop biological substitutes to restore, maintain or improve tissue functions.
e.g. specific cornea or trachea replacements, or lab grown food or heart etc.
Definition of cell therapy?
Where cellular material is injected, grafted or implanted into a patients e.g. in tact living cells e.g. T cells capable of fighting cancer cells or stem cells to a wound.
May need support by biomaterials (scaffold)
Mechanical device examples used in the body? (3)
- Pacemaker
- Dialysis machine
- Hip replacements
What is an artificial pacemaker?
generates electrical impulses delivered by electrodes to contract the heart muscles and regulate the electrical conduction system of the heart. Replaces the SAN for patients with arrhythmias.
Diadvantages to mechanical devices use in the body?
Cant replace tissues- dont perform all the functions e.g. Hip replacements- may offer support as a bone alternative, but bone has other roles for example calcium homeostasis or bone marrow. Also doesn’t grow with patient if child.
Transplantation disadvantages?
- Immunosupression tablets to avoid rejection.
- Transplantation crisis- ageing pop always demand over supply waiting lists v long.
- Due to demand may have to use less suitable alternatives e.g. from elderly, or less vigorous checks- in 2013 kidney given carried encephalitus and 2 donors infected and killed.
HENCE THE GROWTH OF TE SINCE 1990’s.
Why growth of TE field?
- Transplantation demand etc,
- 1998 IPSCs derived which excited scientists and prompted a lot of study.
3 components of TE?
Cells+ EXCM/ Biomaterial Scaffold + Bio-active molecules. (direct cellular behaviour)
Stats on the Transplantation crisis?
3 people in the UK die everyday waiting for an organ for transplantation(2010) with 55,000 on the waiting list for kidneys alone, and only 17,000 kidney transplantations happening a year-
Mouse ear study aim?
- Wanted to create an off the shelf preformed flexible yet structural slicone scaffold as an alternative to using autogenous costal cartilage- where the shape was less similar and involves host site mobidity and long operating times.
Evaluated feesibility of this, monitoring rejection, cell take over etc.
Mouse ear study method?
1997.
Chondrocytes (calf cartilage cells) were seeded onto the polymer scaffold mold (3 year old ear). This was implanted subcutaneously onto a mouse and fixed with or without an external stent.
Mouse ear study results?
1997
No implants were extruded or infected significantly. Without the stent the tissues lost their shape, but if kept for 4weeks maintained shape for the trail duration. Neocartilage grew over the structure. BruD labelling- proliferation of chondrocytes- still alive and AB to collagen 11- specific to cartilage.
(+) Scaffolds were populated by cells
(-) Skin Coverage was missing, Bovine Chondrocytes are poor model for human cells, Scaffold not v stable needed stent or collapsed. Growth rate was slower.
Current treatments for organ failure?
surgical reconstruction
mechanical devices
transplantation
From bench to bedside timescale?
Research: 1-5 years
Development: 3-5 years- preclinical and clinical testing safety.
Regulation: 3-5 years- regulatory review of testing results in small and large scale patient populations.
Commercialisation: Registration and post marketing survelliance.
4 types of tissue are?
Epithelial (carry out functions) Connective tissue (support and nourishment) Muscle (support and movement) Nervous (instructions)
3 phases of tissue repair in body?
- Inflammatory phase- stop bleeding, clear up dead cells and microbe protection.
- Proliferative stage- Day 4 to weeks - make new tissue but disorganised.
- Remodelling phase- week 4 to 2-3 years. Reorganse the new tissue.
Inflammatory stage of tissue repair?
Leukocytes migrate through vessel wall into tissue (WBCs recruited by inflammatory mediators and chemoattractants e.g. cytokines). Leukocyes engulf cellular debris to prevent infection.
GF release by CT and attract fibroblasts and angiogenesis.
Proliferative stage of tissue repair?
Resolution stage clears up the inflammation e.g. IL-1B macrophages engulf apoptosed neutrophils which have engulfed cellular debris.
Blastema is made of proliferating fibroblasts. New tissue is built to fill the wound space. Fibroblasts secrete collagen and GFs- promotes EC proliferation and angiogenesis. Epithelialization- proliferation, differentiation and migration at wound edge. Granulation tissue (EC+fibroblasts)
Remodelling stage of tissue repair?
Granulation tissue is the foundation tissue for scar tissue. This is formed by synthesis and lysis of collagen simultaneously. Scar tissue is avascular and is 70-80% tensile strength by 3 months.
How is the wound gap blocked?
- Cut blood vessels bleed into the wound.
- Blood clots to fill the gap and leukocytes in the blood clean up wound.
- Granulation tissue is layed down (collagen) by fibroblsts.
- Epithelium regeneration causes scar tissue formation
When is no scar tissue formed?
If its a mild superficial injury that only damages the epithelium. If only proliferation stage needed, no remodelling. REGENERATION.
WHen does scar tissue form?
If its a more severe injury with damage ti the tissue framework. Connective tissue deposition is needed due to a disrupted matrix. REPAIR.
Or Peristant tissue damage= FIBROSIS
Regeneration vs repair?
Regeneration- only proliferation- no scar tissue.
Repair- need to lay down new structures, proliferationa differentiation and reorganisation- scar tissue.
E.g. repair a bike- change parts etc may be blue bike with red handles. Whereas to regenerate it- it will magically extend itself to make red handles.