The Mass Production of Living Tissue 157
An anonymous reader sends in this moderately disturbing quote from Gizmodo:
"I'm touching a wet slab of protein, what feels like a paper-thin slice of bologna. It's supple, slimy, but unlike meat, if you were to slice it down the center today, tomorrow the wound would heal. It's factory-grown living tissue. The company behind the living, petri-dish-grown substance known as Apligraf hates my new name for it: meat band-aid. 'It's living,' Dr. Damien Bates, Chief Medical Officer at Organogenesis, corrects me. 'Meat isn't living.' But no one argues with me that this substance is really just a band-aid. A living, $1500 band-aid, I should say. Apligraf is a matrix of cow collagen, human fibroblasts and keratinocyte stem cells (from discarded circumcisions), that, when applied to chronic wounds (particularly nasty problems like diabetic sores), can seed healing and regeneration. But Organogenesis is not interested in creating boutique organs for proof of concept scientific advancement. They're a business in the business of mass tissue manufacturing — and the first of its kind."
Literature much? (Score:2, Informative)
Re:Science Fiction Reality (Score:5, Informative)
Many a SciFi story I've read has used this kind of thing for wounds. I wonder how soon until they have it to the point where these slices are vacuum packed and you can open it and stuff it into a wound in the field?
A little while.
There are two main approaches to using non-autologous grafting approaches. One is the matrix approach, where the material grafted is not tissue per se, but rather an organic matrix that is suitable for colonization by the autologous tissues and provides an environment conducive to growth. Such matrices are already being used in fields of orthopedic surgery and surgical dentistry to cause bone growth.
The second approach, which appears to be this company's goal, is to create graftable tissues in-vitro. Please note that this isn't really a new idea, since ex-vivo grown "skin" has been available for at least a couple of years now. While the method described in TFA is potentially both more effective and has a wider range of use, it seems to me that it would likely require careful surgical grafting in order to supply the graft with blood vessels, so it's unlikely that we'd be able to just stuff it into the wound right away.
However, given how quickly our knowledge of the mechanisms of angiogenesis (blood vessel growth and proliferation) has expanded in the last decade due to the research into tumor progression, I can envision that in the relatively near future we would be able to embed sufficient angiogenesis-mediating factors into the ex-vivo grown tissues that under.
Re:Science Fiction Reality (Score:5, Informative)
Correction: last sentence should read:
" ...I can envision that in the relatively near future we would be able to embed sufficient angiogenesis-mediating factors into the ex-vivo grown tissues that under the right conditions they would generate a sufficient blood supply of their own in-situ. "
Re:UNlike mean?? WTF? (Score:4, Informative)
but unlike meat, if you were to slice it down the center today, tomorrow the wound would heal.
Yeah, because there never even was a animal who cut itself, and where then the wound healed...
FAIL
That would be called a fleshwound. A wound to its flesh or tissues. Meat is the same tissue, but terminally locked into 'deadness'.
There is a difference.
The story behind Apligraf (Score:5, Informative)
I am not sure why this item was introduced as "moderately disturbing". If you will permit me, I will explain what it is, since I use it regularly. (I have no stock nor other biased affiliation with the company or product.) The product first came on the market in 1998, over 10 years ago. It has a well-established place in the treatment of chronic wounds. It is not the only product in the category of "living cell therapies" for chronic wounds. The other product is Dermagraft, similar, and likewise around for nearly 10 years. When Apligraf first came out, it was promoted as skin-graft-in-a-box. It is not. It is allogeneic material (recipients will reject it), and thus it does not "take" to the body like an autogenous skin graft. In its earliest years, when the company was promoting it as a skin graft, it got some high profile press because it was put to good use as readily available biological coverage for burn victims of the 9-11-2001 twin towers catastrophe. The company that makes it, Organogenesis, partnered with pharma giant Novartis for marketing and product management, and under them, they listened to customers who told them it was not skin grafts in a box, and they redefined its marketing for chronic wounds. The product management has been back in the hands of Organogenesis for about 3 or 4 years now.
The material is essentially a poly-pharmaceutical packaged in a living material. The raw materials come from donated foreskins. Extensive safety testing is done. Pure extracted fibroblasts are put into cell culture, where they do their business and re-form a collagen matrix equivalent to normal dermis. After that, pure keratinocytes are cultured on top of the dermis, and an epidermis forms. The product is shipped in its petri dish, as a circle of 44 sq cm area. The Gizmodo article shows a picture of it. As a living material, its procurement and handling are a bit different than most medical devices, but it is easy to get and apply.
The juvenile cells in the material make a broad spectrum of growth factors and other biochemicals which have a positive pro-proliferative effect on wounds. The role for this material is for chronic and pathological wounds. The company got its market approval and indications from the FDA for studies done on diabetic and venous ulcers, but the material is useful for chronic and pathological ("cap") wounds of any cause. Like anything else, it does not work for all wounds or patients, but it is fairly predictable, and its results can be rather dramatic. When a cap wound of whatever cause has been treated to the point that disease is quiet, inflammation is gone, and the wound should be healing but it is not, then that is when wound stimulatory therapies are applied. There are several available, and Apligraf has been one of the flagship products in this category for 10 years now. Many wounds which simply will not budge no matter what will take off and heal once this is applied.
Organogenesis has its first new product coming out soon, for oral mucosa and gingiva, so perhaps that is why they are trying to stir up some attention with articles like the one quoted. However, it is not Brave New World nor Coma nor any other meat factory. It is just on the leading edge of biological therapeutics in the 21st century. And if Slashdotters want to make lots of jokes as they often do, like "put Viagra in the petri dish to grow more", well, we've already heard them all.
(All very timely, since I just gave a presentation on this last week (and have been for 8 years). If you want to learn more, I posted a copy of the presentation on the website I use for posting talks and presentations and whatnot. This particular talk has a mix of my slides and company slides. It is NOT yet annotated with full text on each slide, so some will just be pictures and you will have to infer what you can, but text should be coming one of these days:
http://www.arimedica.com/content/arimedica_apligraf_(partially%20annotated)_2005-1006.pdf [arimedica.com]
Again, I have no investment nor bias here, I just use this stuff in practice because it works and it's an important product.)
Re:Modern Science at its best... (Score:1, Informative)
We're still trying to make it safe for idiots to pilot.
Most people can't handle navigating on a 2 dimensional plane, how do you think joe sixpack would deal with 3?