title: Facilitated endogenous repair: making tissue engineering simple, practical, and economical.
abstract: 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.
authors.affiliation: Center for Molecular Orthopaedics, Harvard Medical School, Boston, Massachusetts 02115, USA. cevans@rics.bwh.harvard.edu
authors.forename: Chris H
authors.initials: CH
authors.lastname: Evans
authors.forename: Glyn D
authors.initials: GD
authors.lastname: Palmer
authors.forename: Arnulf
authors.initials: A
authors.lastname: Pascher
authors.forename: Ryan
authors.initials: R
authors.lastname: Porter
authors.forename: Francois N
authors.initials: FN
authors.lastname: Kwong
authors.forename: Elvire
authors.initials: E
authors.lastname: Gouze
authors.forename: Jean-Noel
authors.initials: JN
authors.lastname: Gouze
authors.forename: Fangjun
authors.initials: F
authors.lastname: Liu
authors.forename: Andre
authors.initials: A
authors.lastname: Steinert
authors.forename: Oliver
authors.initials: O
authors.lastname: Betz
authors.forename: Volker
authors.initials: V
authors.lastname: Betz
authors.forename: Mark
authors.initials: M
authors.lastname: Vrahas
authors.forename: Steven C
authors.initials: SC
authors.lastname: Ghivizzani
mesh_terms: D000818:Animals; D006801:Humans; D023822:Tissue Engineering / Q000191:economics* / Q000379:methods* / Q000639:trends; D014945:Wound Healing / Q000502:physiology*