Successful Stem Cell Replacement of Windpipe 116
thepacketmaster writes "In what is being hailed as a medical milestone, CNN reports a woman suffering from long-term tuberculosis had her lower trachea and bronchial tube replaced by tissue grown from her own stem cells. A team from the universities of Barcelona, Spain; Bristol, England; and Padua and Milan, Italy, decided to go ahead with the surgery instead of having to remove her left lung. The operation, reported Wednesday in the British medical journal The Lancet, has been hailed as a major leap for medicine that could offer new hope for patients suffering from serious illness."
!embryonic (Score:5, Informative)
Seems like Adult stem cells are the way to go. (Score:4, Informative)
No rejection and lots of progress. This is really great news.
Re:!embryonic (Score:2, Informative)
Re:!embryonic (Score:1, Informative)
Only it's not a hypocritical statement at all. LWATCDR and fish_in_the_c aren't claiming that it's amoral (that would be hypocritical); they're claiming that it's morally questionable.
"Morally questionable" isn't a judgment call. It doesn't mean "sort of moral". It means people are questioning its morality, and you can find people who question the morality of embryonic stem cells in droves.
Re:Seems like Adult stem cells are the way to go. (Score:3, Informative)
I'd point out that ES cells are being widely used for primary research and are giving us new insights into basic cell biology and cellular differentiation. That will inevitably help with adult stem cells.
Also, companies are not the major source of funding in biomedical research, although they do often contribute. Government funding, from taxes, supports far more biomedical research than private enterprises do.
Third, IPS cells, basically cells turned into ES-like cells, are the most promising of all three, although they are the youngest and therefore least developed. IPS cells have the benefits of ES cells without the tissue rejection. So far we've only been able to make them using viruses, but they've only been around for a few years.
Re:!embryonic (Score:4, Informative)
That is part of why I doubt it, especially since we are talking about mammals & not amphibians, so they don't have "equivelant" stages
Way off. Embryology is very heavily conserved, such that while there are clear differences, there are also clear similarities. An egg gets fertilized to make a one cell stage, cell division makes a hollow space called the blastula stage, the part that becomes the embryo is one cell layer thick. A pocket forms that becomes the gut, that's the gastrula stage. The part of the embryo that becomes the central nervous system makes a tube, that's the neurula stage.
After that point, things start to diverge more, but up until that point the two do have the same stages.
Here are some pictures of blastulas.
http://www.bootstrike.com/Genetics/StemCells/images/human_blastocyst.jpg [bootstrike.com]
http://porpax.bio.miami.edu/~cmallery/150/devel/human_blastula_removed.gif [miami.edu]
http://www.fotosearch.com/comp/PDS/PDS139/microscopic-image-frog_~AA003891.jpg [fotosearch.com]
http://abacus.bates.edu/~ganderso/biology/electron/frog_blastula_composite_image_x350.gif [bates.edu]
As you can see, quite similar. There are certainly equivalent stages.
Here's a wiki page on "embryo" (http://en.wikipedia.org/wiki/Embryo) Notice it says just "animals," many places and doesn't specify which species? It's not laziness.
Maybe you should take his class?
New and interesting, but over hyped (Score:5, Informative)
I have been listening to this story being hyped in the news all day, but it doesn't deserve quite that much attention. While this is a "great case" that most surgeons would appreciate, and a great outcome for the patient, the CNN report (and NPR and others) does what lay media generally do with medical reports - over-dramatize yesterday's news. This is an evolutionary case based on established surgical technologies which have been validated over the past 12 years, not a revolutionary implementation of new science. And regardless if you have any thoughts or opinions about embryonic stem cell research, this is not an embryonic case, it is just the use of autogenous cells to repopulate a regenerative biomatrix.
This is the "new surgery" of the 21st century, a move toward live engineering of living tissues rather than using alloplastic implants. Much of this new surgery is done strictly in situ, inserting an implant, and letting pluripotential cells circulating through the host find the implant and then reorganize themselves into a mature tissue. This works well with connective tissue matrices that will support the ingrowth of "connective tissue cells" derived from the embryonic mesoderm. The items available to surgeons are manufactured matrices such as Integra (Integra Life Sciences, New Jersey), and cadaveric matrices, usually dermis (of human, bovine, porcine, and equine origin, eg from LifeCell, Ethicon, TEI Biosciences, et al). Simply put, we implant these materials to reconstruct dermis, fascias, ligaments, and various skeletal and mesenchymal structures, and human host cells find them and make new living dermis-fascia-ligaments-etc. This works extremely well for reconstruction of skin and musculoskeletal structures. Not much progress has been made yet on the generation of glands and organs (which require function specific epithelial or ecto-entodermal cells).
These technologies and procedures have been a part of regular surgical practice since about 1996. Make no mistake about it - the tracheo-bronchial reconstruction you read about is a great case, but it is just a progressive implementation of existing concepts and methods to a wider range of diseases and indications. There will be more and more and more of this is the coming decades. In fact, existing regenerative materials could have easily made a new trachea-like conduit, avoiding the need for a human anatomical gift or organ donation, except for one thing . . .
The trachea and bronchi need a special architecture to avoid collapse. Because of the Bernoulli principle, these conduits could collapse during inspiration, so nature prevents that by having these pipes surrounded by semi-rigid cartilage rings. Regenerated cadaveric dermis by itself will not work. So instead, these guys used a donated trachea for its gross architecture and mechanical integrity, processed it in the same way that dermal matrices are processed to get rid of cells and immunogens, and then they seeded some host cells, then let it grow in situ. In actuality, the seeding step was largely irrelevant. When collagen-aminoglycan matrices (decellularized cadaveric materials) are implanted, circulating stem cells find them automatically. Pre-seeding could speed up the process by a week or so, but no big deal.
The cells which were seeded were NOT embryonic stem cells. They were just autogenous random marrow cells, some of which will be pluripotential, and able to regenerate tissues according to an embryonic model of tissue histogenesis. Note too that even if these were embryonic omnipotent stem cells, there is no such thing as a tracheal cell. What they implanted was a connective tissue matrix, generated by, and then repopulated by two and only two types of cells: fibroblasts and vascular cells. This is the supporting structure of all organs and tissues. Think of it like reinforced concrete. You can use cement and rebar to make a bridge, a road, a building, and so on, all with different shapes, loads, and functions, but it's all just cement and rebar.