Asnaghi M Adelaide, Candiani Gabriele, Farè Silvia, Fiore Gianfranco B, Petrini Paola, Raimondi Manuela T, Soncini Monica, Mantero Sara
Department of Bioengineering, Politecnico di Milano, Milano, Italy.
J Appl Biomater Biomech. 2011 May-Aug;9(2):73-86. doi: 10.5301/JABB.2011.8562.
Regenerative medicine is a critical frontier in biomedical and clinical research. The major progresses in the last few years were driven by a strong clinical need which could benefit from regenerative medicine outcomes for the treatment of a large number of conditions including birth defects, degenerative and neoplastic diseases, and traumatic injuries. Regenerative medicine applies the principles of engineering and life sciences to enhance the comprehension of the fundamental biological mechanisms underlying the structure-function relationships in physiologic and pathologic tissues and to accomplish alternative strategies for developing in vitro biological substitutes which are able to restore, maintain, or improve tissue, and organ function. This paper reviews selected approaches currently being investigated at Politecnico di Milano in the field of regenerative medicine. Specific tissue-oriented topics are divided in three sections according to each developmental stage: in vitro study, pre-clinical study, and clinical application. In vitro studies investigate the basic phenomena related to gene delivery, stem cell behavior, tissue regeneration, and to explore dynamic culture potentiality in different applications: cardiac and skeletal muscle, cartilage, hematopoietic system, peripheral nerve, and gene delivery. Specific fields of regenerative medicine, i.e., bone, blood vessels, and ligaments engineering have already reached the preclinical stage providing promising insights for further research towards clinical applications. The translation of the results obtained during in vitro and preclinical steps into clinical organ replacement is a very challenging issue, which can offer a valid alternative to fight morbidity, organ shortage, and ethical-social problems associated with allotransplantation as shown in the clinical case reported in this review.
再生医学是生物医学和临床研究中的一个关键前沿领域。过去几年的重大进展是由强烈的临床需求推动的,这些需求可以从再生医学的成果中受益,用于治疗包括出生缺陷、退行性和肿瘤性疾病以及创伤性损伤在内的大量病症。再生医学应用工程学和生命科学原理,以增强对生理和病理组织中结构 - 功能关系背后基本生物学机制的理解,并实现开发能够恢复、维持或改善组织和器官功能的体外生物替代品的替代策略。本文综述了米兰理工大学目前在再生医学领域正在研究的选定方法。特定的以组织为导向的主题根据每个发育阶段分为三个部分:体外研究、临床前研究和临床应用。体外研究调查与基因传递、干细胞行为、组织再生相关的基本现象,并探索不同应用中的动态培养潜力:心脏和骨骼肌、软骨、造血系统、周围神经以及基因传递。再生医学的特定领域,即骨、血管和韧带工程已经达到临床前阶段,为进一步开展临床应用研究提供了有前景的见解。将体外和临床前步骤中获得的结果转化为临床器官替代是一个非常具有挑战性的问题,正如本综述中所报道的临床案例所示,它可以为对抗发病率、器官短缺以及与同种异体移植相关的伦理 - 社会问题提供有效的替代方案。