The Wild West in Biotech and Regenerative Medicine

The ABCs of Biotech for Christians - Nineteenth in a series - R is for Regenerative Medicine

Definitions come into play as we study Regenerative Medicine (RM). Which body parts can be regenerated? Can blood? Bone? Can skin, tissues, organs?

To regenerate is to cause a thing to come to life again. It was dead or nearly so, and a treatment revitalizes it to make it whole and functioning as it originally was.

Is the term “rejuvenate” the same as “regenerate”? It was not selected by the scientific community to describe their work in this medical frontier. Perhaps RM was chosen as the opposite of degenerative, which describes many conditions and diseases.

Frontier is a good word to help us appreciate the work in the labs and clinics of doctors and researchers of RM. Like the pioneers and gold diggers of past generations who set forth to find a better life in the American west, so today this new field beckons those who want to see new horizons in healthcare and healing.

Blood

A healthy person’s blood will replace itself. That is regeneration. After donating a pint of blood, plasma is replaced within about 24 hours and the red cells in four to six weeks. But the person with leukemia (for example), a cancer that harms the body’s ability to make healthy blood cells, needs RM.

An excellent article describes conversion of leukemia cells into iPSCs (see previous post) for study of how they cause cancer. RM is also at work to try to convert skin cells into the type of stem cell (hematopoietic) that could regenerate the blood.

Bone marrow transplant with its many drawbacks is a last resort, but RM is working on a way to make it work without chemotherapy or radiotherapy. Currently, a bone marrow transplant, also called a blood stem cell transplant, can cure some cases of leukemia and some other blood or immune disorders.

Bone

The human body will regenerate a full bone within 10 years, but what if you break a bone or lose bone through osteoporosis? Can TERM (Tissue Engineering and Regenerative Medicine) help? Or, what if a disease or the process of aging destroys the cartilage in your body so that your joints have no cushioning?

This video describes the structure of bone and the below describes how RM is bringing relief to people with degenerative bone disease using stem cells derived from the patient’s own bone marrow. It’s less invasive than joint replacement.

The video was produced by a major medical clinic, but these therapies are offered by doctors locally in metro areas. However, as stated by the doctor, the procedure does not actually regenerate cartilage, though this is under study.

Japan is a leader in bone tissue RM. However, the most I have been able to determine from research on the internet is that RM is rejuvenating bone health, but so far, not regenerating tissues. This is why there is such a demand for pluripotent stem cells in medical research. More on that in the next post.

Skin

Regrowth of skin is critical for burn victims and others with severe wounds. Much progress is being made by RM for these needs. Whereas “allogenic” skin (from “skin banks” that preserve skin from corpses for use by burn victims) provided some help, today there are skin substitutes that combine a person’s own (autologous) skin with dermal scaffolds (invented coverings to provide a way for skin to heal). These have been proven to close wounds in burns over more than 90% of total body surface, but they do not repair vascular and lymphatic networks, hair follicles, and other aspects that skin normally has. Use of stem cells to engineer such improvements is underway… “skin substitutes constructed from a combination of stem cells and biomaterials remain a promising solution for the future”. An example of a clinical trial is here.

Tissues and Organs

For these, wonderful but not dramatic progress has been made in RM. This excerpt describes the state of the art:

Currently, tissue engineering plays a relatively small role in patient treatment. Supplemental bladders, small arteries, skin grafts, cartilage, and even a full trachea have been implanted in patients, but the procedures are still experimental and very costly. While more complex organ tissues like heart, lung, and liver tissue have been successfully recreated in the lab, they are a long way from being fully reproducible and ready to implant into a patient. These tissues, however, can be quite useful in research, especially in drug development. Using functioning human tissue to help screen medication candidates could speed up development and provide key tools for facilitating personalized medicine while saving money and reducing the number of animals used for research.

This same article goes on to describe how regenerating a new kidney from a patient’s own cells may not be far off based on successful experimentation on rats that used a donor organ to scaffold growth of new tissue that was able to perform like a kidney. The next step would be to try this procedure in humans.

Taking a procedue from a lab dish to an animal and then to a human is known as translational medicine. Step by step, processes are developed with the ultimate goal of improving the health of humans.

Did you know that scientific researchers believe the major obstacle to their progress comes from the religious community?

People like me are not opposed to progress and I applaud researchers who sincerely desire to better the human condition through improving our health prospects. But using body parts from people who are not yet dead, or from aborted fetuses, with the insistence that —they were already dead anyway, so what difference does it make— is not a Christian concept.

Progress in RM should not need to depend on destruction of human life. The bright future circles its wagons on adult stem cells. In the next post we will revisit the Stem Cell controversies.

A bitter flavor for health

The ABCs of Biotech for Christians - Eighteenth in a series - Q is for Quinine

Quinine holds a special place in science history as the first chemical compound ever used successfully against infectious disease. During the American Civil War, its importance in treating malaria led to the first large-scale drug manufacturing operations and the first federal drug-testing program.

Quinine is derived from the bark of the Cinchona tree, an evergreen native to the Andes tropical forests, by isolating it from the bark through a process that also crystalizes its alkaloids— which are naturally occurring organic compounds with a nitrogen base. Quinine has healed the sick from kings to the poorest infant, and enabled armies over the centuries to maintain troop vigor and achieve military conquests.

In use since the 1600s, many chemists starting in the 18th century studied quinine to understand its properties, and worked to determine how it might be reinvented in a laboratory for mass production as a pharmaceutical. Though they figured out its molecular structure, and ultimately, in the 1940s, how to synthesize it from coal tar, the vast research led to better chemical discoveries for malaria treatment, though quinine still is used.

Today, biotechnology plays a large role in synthesizing and producing alkaloids for commercial use on an industrial scale. The discoveries of biotech and molecular biology make it convenient to transfer and propagate genes in plant cells, among other processes, to commercially produce alkaloid related drugs.

An aside: This webpage explains how to make a transgenic plant.

In current clinical trials, quinine is being studied “To investigate the effect of oral sham feeding and intragastric delivery of a bitter tastant on food intake.” In other words, this is research to determine whether quinine could assist obese people to eat less. It is also under study to discover how it interacts or reacts with other compounds and medicines for more effective treatments for a range of illnesses.

Despite the wonderful progress in medicinals, in 2016, there were an estimated 216 million cases of malaria in 91 countries, an increase of 5 million cases over 2015, and malaria deaths reached 445,000 in 2016, a similar number (446,000) to 2015. In 2016, nearly half the world’s population was at risk of malaria. The latest World Malaria Report may be viewed on WHO's website.

There is no vaccine against malaria, though some progress in vaccines has been reported.

The story of Elisha and the pottage made for the prophets’ families comes to mind. There was a famine in the area so the stew was made with whatever was found in the field including wild gourds. Upon eating it, the prophets’ sons cried out, “There is death in the pot!” (2Ki 4:40) So Elisha cast some meal or flour into the pot, and remedied the poisoned stew.

I am not likening quinine to the meal that was cast into the stew. Then as now, the flour is symbolic of the bread of life, Christ, who must assist to bring health back, and with His help, biotechnology can find new ways to heal. It is true, though, that Christ is a bitter flavor to many.

Angel fish
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...and every living creature that moveth, which the waters brought forth abundantly, after their kind, and every winged fowl after his kind ... the living creature after his kind, cattle, and creeping thing, and beast of the earth after his kind ...the beast of the earth after his kind, and cattle after their kind, and every thing that creepeth upon the earth after his kind: and God saw that it was good. -Genesis 1

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A SistersSite eBook

Flesh and Bone and The Protestant Conscience is an e-book on Amazon.com. It is 99¢ and in the Amazon lending library as well. It is also available here in PDF format. The book description follows.

Would you let your conscience be your guide?

Does God care if the skin and bone of the dead are passed along to the living for medical uses? Is organ donation OK with God? Should you sign a Living Will?

Did you know that dead organ donors are often anesthetized before their organs are removed? Do you know the current definition of death? The conscience cannot function without facts.

As we ponder the ethics of in vitro fertilization, stem cell research and man-made chimeras, our thoughts trail off. How then should we live? (Ez 33:10)

How should a Christian think about euthanasia by starvation when doctors and the state attorney general all agree it is time to withhold feeding from a brain injured patient? Some things are family matters, but someday it may be our family.

Here is a small book to help you think about whether you want to sign your driver's license, donate a kidney, cremate your loved one, and many other practical questions that may arise in the course of your healthcare decisions or watch over others.

It offers a special focus on the doctrine of the Resurrection that is related to such decisions. Sunday School classes and Bible Study groups could use this book to facilitate discussion about the issues covered.