From left, Ben Salatin and Juan Vazquez of the University of Pittsburgh, demonstrate the first prototype of a robotic wheelchair.

“Regenerative medicine: it’s not futuristic medicine anymore,” said Dr. Alan Russell, founding director of the McGowan Institute for Regenerative Medicine at the University of Pittsburgh.

Russell shared his overview of regenerative medicine during the State of Science Workshop Nov. 17 in Heaton Pavilion’s Joel Auditorium at Walter Reed Army Medical Center. Scientists, research pioneers along with leaders in regenerative medicine and rehabilitation presented the latest findings.

The concept of regenerative medicine is to replace or regenerate human cells, tissues or organs to restore or establish normal function, according to the Armed Forces Institute of Regenerative Medicine (AFIRM), established by the Department of Defense to develop new products and therapies to treat severe injuries suffered by U.S. servicemembers in current wars.

Current AFIRM projects include the development of engineered human ear and nose replacements, along with a skin substitute to improve recovery from large area burns.

The first clinical trials using technology for the ear could start in about a year, according to Col. Robert Vandre, project director for AFIRM.

Vandre said two patients involved in studies at the U.S. Army Institute of Surgical Research located at Brooke Army Medical Center at Fort Sam Houston, Texas, were able to regenerate and grow missing muscle using a surgical implantation of extracellular matrix (ECM), a biologic agent devoid of cells used as a structure for tissue to grow within. Plans for the clinical trial currently underway include implantation of the allogeneic material that does not require anti-rejection drugs in 15 more patients.

“When the wrecking ball of trauma or disease comes along and destroys tissue, the way we heal typically throughout our body is to create a scar in response to that. Regenerative medicine is about harnessing the body’s natural ability to heal itself and accelerating that to a clinically relevant time scale,” Russell explained.

Russell opened the symposium with a review of regenerative medicine and the potential impact of regenerative rehabilitation. The workshop also covered topics in living tissue, tissue engineering, cell signaling for regeneration and hand transplantation.

Research shows ECM placed in different locations in the body acquires a tissue-specific response. As it degrades, it releases material that acts as a magnet for native tissue. Because of ECM’s rapid decline, normal rehab won’t work, according to Russell.

Studies using ECM to replace missing Achilles tendons in dogs show the animals had to assume exercise immediately after surgery; if immobilized the ECM dissolved.

“We have a very short window —six weeks —where your community must be involved,” Russell told rehabilitation and military leaders. He explained the need for regenerative and rehabilitative medicine to work together to create an interdisciplinary effort to shorten the time between the lab and bedside.

“Regenerative rehabilitation is different but inevitable and will reshape health care over the next two decades,” Russell said.

“It’s really interesting science and we want to make sure, again, as new discoveries are made in the labs across the country, that we’re prepared for them and thinking about how we can use them to care for injured servicemembers,” explained Col. Paul Pasquina, chief of the integrated Department of Orthopedics and Rehabilitation at Walter Reed and a co-founder of the symposium.

Col. Janet Harris, who leads AFIRM headquarters, Fort Detrick, Md., agreed with Pasquina.

“That’s part of why we have these scientific conferences —to bring bench researchers together with some of the providers that are taking care of our Soldiers to make sure that their research is focused in on clinically relevant, practical solutions to try to take care of soldiers and to try to keep that into focus,” Harris said.