Facilitated endogenous repair: making tissue engineering simple, practical, and economical.
Facilitated endogenous repair is a novel approach to tissue engineering that avoids the ex vivo culture of autologous cells and the need for manufactured scaffolds, while minimizing the number and invasiveness of associated clinical procedures. The strategy relies on harnessing the intrinsic regenerative potential of endogenous tissues using molecular stimuli, such as gene transfer, to initiate reparative processes in situ. In the simplest example, direct percutaneous injection of an osteogenic vector is used to stimulate bone healing. If necessary, additional progenitor cells and space-filling scaffolds can be provided by autologous bone marrow, muscle, fat, and perhaps other tissues. These can be harvested, processed, and reimplanted by simple, expedited, intraoperative procedures. Examples of repair of experimental osseous and osteochondral lesions in laboratory animals are described. If successful, these strategies will provide methods for tissue regeneration that are not only effective but also inexpensive, safe, and clinically expeditious. Although orthopaedic examples are given here, the technology should be more generally applicable.
Evans
Chris H
CH
Center for Molecular Orthopaedics, Harvard Medical School, Boston, Massachusetts 02115, USA. cevans@rics.bwh.harvard.edu
Palmer
Glyn D
GD
Pascher
Arnulf
A
Porter
Ryan
R
Kwong
Francois N
FN
Gouze
Elvire
E
Gouze
Jean-Noel
JN
Liu
Fangjun
F
Steinert
Andre
A
Betz
Oliver
O
Betz
Volker
V
Vrahas
Mark
M
Ghivizzani
Steven C
SC
D000818:Animals; D006801:Humans; D023822:Tissue Engineering / Q000191:economics* / Q000379:methods* / Q000639:trends; D014945:Wound Healing / Q000502:physiology*