A Late Tissue Engineering Year in Review for 2012

Some publicity materials are presently doing the (late) rounds for a January review of progress in tissue engineering over the course of 2012. The review paper is open access, so I'm assuming that this is the standard process of picking a paper at some point after it is published and allowing open access for a while to draw some attention to the journal in question. Still, it's an interesting read, providing a perspective from inside the field on what is actually important enough to mention.

The merging of tissue engineering and regenerative medicine (TERM) forms an enormously broad, energetic, and important field of medical research. Not a week goes by without something new and vital happening in a regenerative medicine laboratory somewhere in the world, and vast sums of money flow into advancing the state of the art. Arbitrary tissues and organ structures grown from a patient's own cells are not so far ahead in the future now, and neither are ways to coerce the body to rebuild itself from the inside out. There is a certainly a sense of excitement among those involved.

Tissue Engineering and Regenerative Medicine: Recent Innovations and the Transition to Translation

The first challenge in conducting this review was the sheer number of recent publications in the TERM field. [The] number of TERM articles continues to rise with nearly 4000 original articles published in 2010, compared to a mere 360 a decade earlier. This can be partially attributed to the increasing use of the same common terminology, particularly for the more recent "regenerative medicine." Still, there is no doubt that our field is expanding and capturing a larger portion of the work done across the biomedical sciences.

Many seemingly discordant lines of research have now become intertwined in TERM and constitute the fabric of our field, with these concepts arising from the blurring of boundaries between traditional disciplines. While this point is sometimes easy to forget, much of what we now consider commonplace in TERM was only a short time ago separated by barriers of dogma and discipline. As these lines continue to blur, and multi-disciplinary research becomes more the rule than the exception, our field is experiencing tremendous growth.

The pace of growth is now so fast that it impossible for most of us to keep up with the field as a whole, or even a small subset of it. For example, a TERM search specific to "cartilage" returns more than 450 articles published in 2011 alone, meaning that one would need to read more than one article per day just to stay abreast of this small portion of the TERM terrain.

We found considerable innovation in a number of traditional TERM fields, but also new ideas that are beginning to take hold in emerging focal areas. For instance, in the realm of tissue replacement, we are now seeing not just scaffolds of ever-increasing complexity derived from standard engineering methods, but also complex scaffolds predicated on natural designs (and native tissues themselves, once decellularized). In the broader field of regenerative medicine, we are seeing developmental biology begin to address not just the formation of tissues, but the specific role that endogenous stem cells play in both generative and regenerative processes. Integrating these basic science findings with novel materials that specifically recruit endogenous populations may provide a next wave in smart biomaterials for tissue repair. Likewise, new cell sources, most prominently iPSCs, have come to the fore, making autologous cell-based therapies for any tissue a real possibility.

Finally, our objective screen showed that ours is truly a translational field, and that TERM advances are being reduced to clinical practice at an ever-increasing rate. [Both] the quantitative nature of these outcome measures and levels of evidence in support of these applications are advancing as well. Together, these advances are now beginning to change the lives of small subsets of the population, and in the future, these novel approaches will be able to address a host of diseases and instances of tissue degeneration that were heretofore untreatable.

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