Tissue Engineering: New Treatment Possibilities for Otolaryngologists

A new era in efforts to treat patients with tissue loss or organ failure is under way, which has the potential to revolutionize the treatment of many diseases and conditions that otolaryngologists treat. As seen by Brian Nussenbaum, MD, of the Department of Otolaryngology in Washington University School of Medicine in St. Louis, advances in patient care have traditionally focused on surgical techniques, medical devices, and pharmaceuticals. However, he thinks that new and ongoing developments in the field of regenerative medicine may provide improved methods for replacement, repair, and restoration of tissue and organ function. Regenerative medicine is commonly called tissue engineering. Although both fields share a common goal, the field of tissue engineering, strictly speaking, incorporates principles of engineering in combination with applying biologic agents to generate new tissues. Currently, momentum building behind tissue engineering is moving beyond the innovators and pioneers of this field into the broader medical community and industry, and one day, is hoped to reach the people that will benefit from this shift the most-patients in need of care.

The Potential of Tissue Engineering

Brian Nussenbaum, MD

The introduction of tissue engineering approaches will represent a new era in our efforts as doctors to treat problems associated with tissue loss or organ failure, said Dr. Nussenbaum. Speaking to participants at the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) meeting in September who attended a miniseminar on tissue engineering, Dr. Nussenbaum emphasized that research and clinical activity in tissue engineering rapidly expanded starting in the 1990s and currently is progressing in virtually every field of medicine, with strong financial backing from industry.

According to Dr. Nussenbaum, any tissue engineering approach must take three critical components into consideration: signaling molecules, cells, and scaffold design. The investigator’s choice for each of these components depends on the characteristics of the type of tissue being repaired. (For a more detailed description of these components and how they work see www.nature.com/embor/journal/v5/n11/full/7400287.html .) Given these components, there are three major categories of potential regenerative therapies currently under investigation: recombinant protein therapy, cell therapy, and gene therapy.

Progress in each of these types of regenerative therapies is occurring, but all have limitations that will need to be overcome. According to Dr. Nussenbaum, recombinant protein therapy is limited by the large amounts of protein generally required, cell therapy is limited by safety issues, and gene therapy is similarly limited by safety issues along with immunological issues related to the use of delivery vectors.