In 2008, the U.S. government funded a multi-million dollar medical research effort in support of today’s soldiers. The collaborative, national program—the Armed Forces Institute of Regenerative Medicine (AFIRM)—employs the science of regenerative medicine and tissue engineering to develop new treatments for wounded soldiers. Today, the lives of thousands of injured U.S. troops in Iraq and Afghanistan have been saved because of body armor, shorter evacuation times, and improved battlefield medicine. But when these soldiers return home, they are missing limbs. They are burned, scarred, and otherwise disfigured. As recently reported in PittMed, the injured-to-killed ratio in all American wars, from the Revolution to Gulf War I, was 2.5 to 1. In Afghanistan and Iraq, that number is around 9 to 1.
There are more than a dozen projects at the McGowan Institute that are a part of AFIRM focusing on effective wound-healing technologies. A few of these projects include the following principal investigators and their research:
- Kacey Marra, PhD, Assistant Professor of Surgery, University of Pittsburgh: Dr. Marra is working on a tube that will train severed nerves to regrow.
- Charles Sfeir, DDS, PhD, Associate Professor at the University of Pittsburgh Department of Oral Medicine and Pathology; Prashant Kumta, PhD, Edward R. Weidlein Chair at the University of Pittsburgh Swanson School of Engineering and Professor in the Departments of BioEngineering, Chemical and Petroleum Engineering, and Mechanical Engineering and Materials Science; and Elia Beniash, PhD, Associate Professor at the University of Pittsburgh School of Dental Medicine: This craniofacial team is exploring a calcium phosphate powder that can be mixed with any liquid—water, saline, even blood—and daubed onto an exposed wound to regrow bone. The substance would behave a lot like Plaster of Paris and could even be applied with a finger.
- William Wagner, PhD, Deputy Director of the McGowan Institute for Regenerative Medicine, Professor of Surgery, Bioengineering and Chemical Engineering at the University of Pittsburgh, and Director of Thrombosis Research for the Artificial Heart and Lung Program: Dr. Wagner is studying a biocompatible patch to treat compartment syndrome, caused when injury-induced inflammation—say, in biceps shredded by shrapnel—causes enough pressure that blood vessels constrict and the tissue dies. Surgical incisions release the pressure. Dr. Wagner’s patch, seeded with stem cells or special growth proteins, can be sewn directly onto the incised compartment and stimulate regrowth.
Many of the therapies mimic processes already found in nature, says Alan Russell, PhD, Director of the McGowan Institute for Regenerative Medicine, University Professor of Surgery with secondary appointments in the Departments of Chemical Engineering, Bioengineering, and Rehabilitation Sciences & Technology. “The salamander can regrow its heart—if you cut part of the heart out, it will regrow. Why does it happen in a salamander and not in a human—and could it?” says Dr. Russell.
“People ask, ‘How can you grow a new limb?’ Well, we did it once before—we did it in the womb. If we can understand a lot more about the biological signals that happened then and happen in animals like salamanders and newts, we can begin the process of creating these kinds of therapies,” adds Dr. Russell.
The key says Stephen Badylak, DVM, PhD, MD, Deputy Director of the McGowan Institute for Regenerative Medicine, Professor in the Department of Surgery, and Director of the Center for Pre-Clinical Tissue Engineering, is getting the signaling right. Normally, cells around a wound tell each other to scar. “We’re trying to get the tissue to think, ‘I’m not injured. I just need to grow more tissue.’”
It all sounds ambitious, but that’s the point, says Dr. Badylak, who likens AFIRM to the Manhattan Project or the Apollo missions. “This is not just an incremental advance in a particular disease problem,” he says. “This is true tissue regeneration, replicating what you do as a fetus. Everything we’ve been taught ever since we started going to school is that human beings cannot regenerate limbs—it’s a fact. So the first thing we’ve got to do is to get over that mindset.”
Regenerative medicine is a promising field that has early success in the regeneration of several tissues and organs for repair or replacement. Regenerative medicine encompasses many novel approaches for the treatment of damaged tissues and organs by using therapies that prompt the body to autonomously regenerate, and by using the patient’s own cells on biodegradable materials for the creation of engineering tissues or organs for therapy. The McGowan Institute, as part of AFIRM, is dedicated to repairing battlefield injuries through its research and the use of these regenerative medicine therapies.