Mississauga Life — Early Spring 2015
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The Future Of Aging
James Tonin

Not just sci-fi: regenerative medicine works.

In 1992, the renowned futurist and healthcare administration expert Dr. Leland Kaiser coined a term that was widely viewed as an intriguing but far-off concept. Kaiser foretold that “a new branch of medicine will develop that attempts to change the course of chronic disease and in many instances will regenerate tired and failing organ systems.” He named this field “regenerative medicine,” and today, some two decades after his visionary prediction, Kaiser’s prophecy is quickly becoming reality.

Last year, a research team working out of the University of Edinburgh in Scotland performed what is being hailed as the first successful attempt at organ regeneration in a living animal. This astonishing feat holds great potential for human application, with some experts in the field going so far as to say it could completely transform the way we age.

Turning Back the Clock
The University of Edinburgh researchers focused their efforts on the thymus, an organ located near the heart which plays a central role in immune system function. Scientists aren’t exactly sure why, but the thymus shrinks as we age, beginning in adolescence. By the age of 70, the average person’s thymus is only 10 percent of its original size, with far-reaching consequences for older people. The decline of the thymus is believed to be a major reason why the elderly are more susceptible to contagious diseases and have a harder time fighting off infections.

To the good fortune of researchers, thymus deterioration follows a similar pathology in mice. Through genetic manipulation, the University of Edinburgh research team was able to restore the thymus back to a more youthful state in an elderly mouse. They achieved this by artificially boosting the subject’s levels of Foxn1, a gene that declines as the thymus shrinks. Sure enough, when the mouse’s Foxn1 levels were raised, its thymus began to revitalize itself, eventually reaching a point where it was almost completely regenerated.

While the breakthrough holds great promise for eventual human application, it’s still a ways off. University of Edinburgh researcher Dr. Nicholas Bredenkamp said that while the discovery was “exciting,” it would also have to be “very tightly controlled” if used in humans, given that the technique could potentially open the door to autoimmune malfunctions, in which the body mistakenly attacks its own healthy tissues. Such possible side effects need to be studied in more detail, but for now, the landmark research is greatly encouraging. Given their success in regenerating the mouse’s thymus, scientists are hopeful that gene therapy could be applied to other key organs, such as the heart and the brain, to restore them to younger levels.

How Noses Can Fix Knees
Another regenerative medicine breakthrough that’s poised to go mainstream applies a new approach to treating serious knee injuries. Researchers working with goats discovered that implanted nasal tissue worked wonders in helping the animals regenerate damaged knee cartilage. In fact, the treatment was so successful that it has already been applied to a small number of human patients, with extremely encouraging results. Preliminary findings of the human surgical trials were published in the August 2014 issue of Science Translational Medicine.

Cartilage loss is one of the major causes of knee degeneration, and scientists have long known that chondrocytes, a type of building block cell that makes cartilage, were capable of reversing this type of damage. However, researchers have struggled for years to achieve consistent results in the use of chondrocytes to build new knee cartilage, until a new hypothesis was tested. This hypothesis surmised that nasal tissue might offer a solution, since it contains hyaline cartilage, a unique type of gristle found on bone endings. Researchers theorized that starting the regenerative process using hyaline cartilage might yield more stable and predictable results. They were right.

This discovery could change the prognosis for millions of people, who would otherwise require artificial knees. While only nine human patients have thus far been treated with the technique and the long-term results are not yet clear, this advance holds major promise for the development of revolutionary new treatments for a wide range of bone and joint conditions, including osteoarthritis.

What’s Next for Regenerative Medicine?
While regenerative medicine is still in its relative infancy, the field is gaining momentum as researchers chalk up breakthrough after breakthrough.

Scientists are now looking to pluripotent cells as a possible avenue to a much broader range of potential applications. Pluripotent cells are unique in their ability to grow into just about any other type of cell found in the human body. Doctors have been able to regress regular cells into pluripotent cells in laboratories for about a decade, but the actual mechanisms behind these transformations are not yet clear.

Once researchers succeed in unlocking the mysteries of pluripotent cells, a proverbial Pandora’s box of breakthroughs could follow. Limbs, joints, bones, appendages, eyes, skin, and hair could all be replaced as they age. Previously incurable organ injuries and degeneration could become a thing of the past, as pluripotent cells might one day be used to effectively grow new organs in controlled conditions using the patient’s own tissues, eliminating any possibility of the body rejecting the transplant. Optimists hold that this research could be the beginning of the end for progressive conditions like Alzheimer’s and major killers like heart disease. For now, though, regenerative medicine is still transitioning from the stuff of science fiction into a major player in the brave new world of the health sciences.