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再生医学与康复的融合:联邦政府的观点

The convergence of regenerative medicine and rehabilitation: federal perspectives.

作者信息

Rose L F, Wolf E J, Brindle T, Cernich A, Dean W K, Dearth C L, Grimm M, Kusiak A, Nitkin R, Potter K, Randolph B J, Wang F, Yamaguchi D

机构信息

1Clinical and Rehabilitative Medicine Research Program, U.S. Army Medical Research and Materiel Command, Fort Detrick, MD USA.

Department of Veterans Affairs, Office of Research and Development, Washington DC, USA.

出版信息

NPJ Regen Med. 2018 Oct 10;3:19. doi: 10.1038/s41536-018-0056-1. eCollection 2018.

Abstract

Regenerative rehabilitation is the synergistic integration of principles and approaches from the regenerative medicine and rehabilitation fields, with the goal of optimizing form and function as well as patient independence. Regenerative medicine approaches for repairing or replacing damaged tissue or whole organs vary from utilizing cells (e.g., stem cells), to biologics (e.g., growth factors), to approaches using biomaterials and scaffolds, to any combination of these. While regenerative medicine offers tremendous clinical promise, regenerative rehabilitation offers the opportunity to positively influence regenerative medicine by inclusion of principles from rehabilitation sciences. Regenerative medicine by itself may not be sufficient to ensure successful translation into improving the function of those in the most need. Conversely, with a better understanding of regenerative medicine principals, rehabilitation researchers can better tailor rehabilitation efforts to accommodate and maximize the potential of regenerative approaches. Regenerative rehabilitative strategies can include activity-mediated plasticity, exercise dosing, electrical stimulation, and nutritional enhancers. Critical barriers in translating regenerative medicine techniques into humans may be difficult to overcome if preclinical studies do not consider outcomes that typically fall in the rehabilitation research domain, such as function, range of motion, sensation, and pain. The authors believe that encouraging clinicians and researchers from multiple disciplines to work collaboratively and synergistically will maximize restoration of function and quality of life for disabled and/or injured patients, including U.S. Veterans and Military Service Members (MSMs). Federal Government agencies have been investing in research and clinical care efforts focused on regenerative medicine (NIH, NSF, VA, and DoD), rehabilitation sciences (VA, NIH, NSF, DoD) and, more recently, regenerative rehabilitation (NIH and VA). As science advances and technology matures, researchers need to consider the integrative approach of regenerative rehabilitation to maximize the outcome to fully restore the function of patients.

摘要

再生康复是再生医学和康复领域的原则与方法的协同整合,目标是优化身体形态和功能以及患者的独立性。用于修复或替换受损组织或整个器官的再生医学方法多种多样,从利用细胞(如干细胞),到生物制品(如生长因子),再到使用生物材料和支架的方法,以及这些方法的任何组合。虽然再生医学具有巨大的临床前景,但再生康复通过纳入康复科学的原则,为积极影响再生医学提供了机会。仅靠再生医学本身可能不足以确保成功转化为改善最需要者的功能。相反,随着对再生医学原理的更好理解,康复研究人员可以更好地调整康复措施,以适应并最大化再生方法的潜力。再生康复策略可包括活动介导的可塑性、运动剂量、电刺激和营养增强剂。如果临床前研究不考虑通常属于康复研究领域的结果,如功能、活动范围、感觉和疼痛,那么将再生医学技术转化应用于人类时的关键障碍可能难以克服。作者认为,鼓励多学科的临床医生和研究人员协同合作,将最大限度地恢复残疾和/或受伤患者(包括美国退伍军人和军事人员)的功能和生活质量。联邦政府机构一直在投资于专注于再生医学(国立卫生研究院、国家科学基金会、退伍军人事务部和国防部)、康复科学(退伍军人事务部、国立卫生研究院、国家科学基金会、国防部)以及最近的再生康复(国立卫生研究院和退伍军人事务部)的研究和临床护理工作。随着科学进步和技术成熟,研究人员需要考虑再生康复的综合方法,以最大化成果,从而完全恢复患者的功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c946/6180133/17c4a6e54ffb/41536_2018_56_Fig1_HTML.jpg

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