Growing Body Parts

Morley Safer Reports On The Amazing Science Of Regenerative Medicine Growing Body Parts

(CBS) This story was originally published on Dec. 13, 2009. It was updated on July 25, 2010.

Thousands wait in vain for organ transplants; soldiers return from battle horribly maimed. There is only so much medicine can do, but we may be on the path to a new technology in which quite literally, we will be growing new body parts.

It’s called “regenerative medicine,” where cells in the human body are manipulated into regrowing tissue.

As we first reported last December, researchers have so far created beating hearts, ears and bladders. Biotech companies and the Pentagon have invested hundreds of millions of dollars in research that could profoundly change millions of lives.

Wake Forest Institute for Regenerative Medicine
McGowan Institute for Regenerative Medicine
Web Extra: Making Body Parts
Web Extra: Growing and Ear
Web Extra: Kaitlyne’s Story

Dr. Anthony Atala runs the Wake Forest Institute for Regenerative Medicine in North Carolina. You name the body part, chances are Dr. Atala is trying to grow one.

“Currently at the institute we’re working on over 22 different tissues and organs,” Dr. Atala told 60 Minutes correspondent Morley Safer.

According to Atala, they are working on regenerating bladders, kidneys, lungs and more. “The possibilities really are endless,” he said.

“Are you suggesting a remarkable future when organs fail, we simply replace them and live to 120? 150?” Safer asked.

“Well, the hope for the future is that if you do have a patient who has organ failure, you don’t want that patient to die because you’re waiting for an organ,” Atala said. “People are dying every day on the transplant wait list. So the hope of the field is that some day we can provide replacement tissues and organs that can be used to help them survive.”

Atala presides over the world’s largest lab devoted to bioengineering body parts. He has made everything from components of fingers to kidneys – it’s enough to make Dr. Frankenstein jealous.

Atala says every organ in our body contains special stem cells that are unique to each body part. The key to regeneration, he says, is to isolate and then multiply those cells until there are enough to cover a mold of that particular body part.

Atala showed Safer a bladder that was growing in the lab. “And you can see here that we actually create the three dimensional mold first. This is actually coated with cells and it’s done one layer at a time. It’s very much like baking a layer cake.”

It’s sort of surgery as pastry making.

“But, how do those cells know – it’s a really stupid question, I understand – but how do the bladder cells know they should be functioning as bladder cells?” Safer asked.

“The cells know exactly what to do. Every single cell in your body has all the genetic information to create a whole new you. So if you place that cell in the right environment, it’ll be programmed to do what it’s supposed to do,” Atala explained.

He says some body parts are simpler to make than others.

“And you can see here the mold shaped like an ear. And then what we do is we start seeding these with cells. And then this is actually the fully engineered ear,” he said. “The molds are designed to degrade over time. So as the tissue forms the mold goes away.”

“If that was for a child, would that grow with the child?” Safer asked, looking at the mold.

“Yes,” Atala said. “The body does recognize them as their own and it does grow with the child.”

Depending on the body part, Atala says the whole process can take six to eight weeks.

Atala showed Safer a beating, engineered heart valve. He says that human testing of heart valves and blood vessels will begin within five years. He has already grown and transplanted livers in mice.

Asked if the mouse livers are functioning, Atala said, “Yeah. And the tissue actually starts making what you’re supposed to see. Like for the liver, we actually are able to see the functionality that you would expect from the liver.”

And there’s Kaitlyne McNamara, a college student who was born with Spina bifida which caused her bladder to fail. Nine years ago, Kaitlyne, along with eight other patients, received new bladders grown from their own cells outside the body.

She says the procedure changed her life. “I never even knew I could get this far. I’m just living a normal adult life.”

(CBS) In Pittsburgh, researchers are taking a different approach: at the McGowan Institute for Regenerative Medicine they are trying to trick the body into actually repairing and regenerating itself.

“I would imagine when people ask you what you do for a living, it’s not the easiest thing in the world to explain,” Safer asked Dr. Steven Badylak, the institute’s deputy director.

“No, it’s not. So, now, I just say we, I make body parts. It gets their attention,” Dr. Badylak replied with a chuckle.

He and his team are convinced that the key to regeneration is finding the switch in our bodies that tells our cells to grow when we are still in the womb.

“The accepted wisdom is that we’re born with what we have and that’s it. You know, the body doesn’t grow new parts,” Safer remarked.

“Well the human body. ‘Cause there certainly are examples of species that regrow their arms and legs like a newt or a salamander. But, as a human early enough in gestation, we can do the same things. We can regrow major body parts. Limbs even, if it’s early enough,” Badylak explained.

“In essence, is what you’re doing trying to find the key to turning that process back on?” Safer asked.

“Yeah,” Badylak said. “If we could make the body or at least the part of the body that’s missing or injured think that it’s an early fetus again. That’s game set and match.”

Badylak says he now has the material that might be a step towards that. It is called ECM (Extra Cellular Matrix), which he gets, from of all places, pig bladders.

Badylak told Safer ECM exists in all of us and in all species. “It’s loaded with signals that instruct cells to do things, as well as serving as a structural support.”

“And where do pig bladders come into it?” Safer asked.

“They are a convenient source because it’s a throwaway product for the agricultural community. And so, we can get rid of the cells. And the remaining Extra Cellular Matrix is proven to be very instructive to the body,” Badylak said.

Asked if humans are closely related to pigs, the doctor said, “Probably closer than we’d like to admit.”

He says that ECM could regrow virtually every tissue in the body.

When doctors at the University of Pittsburgh were treating a patient with cancer of the esophagus who was too weak to face complicated surgery, they turned to Dr. Badylak and his ECM.

“Our therapy of choice right now is to remove the esophagus and pull the remaining stomach up through the chest and attach it to what’s left in the throat,” Badylak explained. “So, the treatment’s as bad as the disease. So, what we have done is said, ‘Can we take a regenerative medicine approach to allow surgeons and go in and just resect the cancer? And instruct the remaining esophagus to regrow itself as opposed to respond to injury and form a scar?'”

(CBS) Dr. Blair Jobe operated on 76-year-old Erwin Schmidt last April.

Jobe removed the cancerous lining of the esophagus and inserted a sleeve of ECM. Instead of forming a scar that would block his esophagus, doctors believe the ECM instructed his cells to regrow a new lining.

Today Schmidt is cancer free. “I’m eating real good, I feel terrific, and I’m starting to put weight on. No pain, no nothing,” Schmidt told Dr. Jobe.

“So essentially you gave him a new esophagus,” Safer remarked.

“We’re very excited by this. And I think, you know, in my heart I feel that this will change the way we do things ultimately,” Jobe said. “But I think right now it’s too early to claim victory.”

Based on that success, Jobe and his colleagues hope to start a full clinical trial soon.

And then there is the military. The Pentagon has invested $250 million in regenerative research aimed at helping soldiers with severe battle injuries, regrowing muscle and skin for burn injuries, as well as transplant technology for lost limbs.

Dr. Steven Wolf is the chief of clinical trials at the Army’s Institute for Surgical Research.

“I would imagine that the patient group that you’re dealing with are a particularly positive one. They’re young, eager men who suffer these horrible losses and want to get as much of their lives together as they can,” Safer remarked.

“Absolutely. They want to go back. Most of these guys do. They say, ‘Hey, fix me up so I can go back,'” Dr. Wolf replied.

Beginning this month, Wolf is leading a clinical trial that could one day make that possible. Army surgeons will implant ECM in the limbs of severely injured soldiers in hopes of restoring muscle lost to roadside bombs.

“What we’re doing with this project is putting this ECM, in there, and then hoping that it populates and then it becomes muscle,” Wolf explained.

“It also, in a place like this, goes by the name of pixie dust, correct?” Safer asked.

“Right. Well, it is somewhat magical, isn’t it?” Wolf remarked. “The whole notion of, well, we’re gonna put this powder in there. And it’s gonna make a new thing. And there is a lot of biological support of that whole notion, so it’s not magic, you know. But it certainly seems that way.”

Asked what he is hoping to achieve with this research, Wolf said, “Well, we’re not gonna, you know, just show up and go, ‘Hey, okay, here’s your leg. We’ll stick it on.’ What we hope is that we can replace certain tissues that can improve function. That’s the first thing to do is make ’em function as well as possible.”

(CBS) Which is what Isais Hernandez says ECM did for him: he was so severely wounded by a mortar round that amputation of his leg seemed likely.

Wolf operated on Hernandez last year as a first test of ECM in this type of injury. He placed ECM in Hernandez’ thigh, which grew entirely new muscle in a wound that had once exposed the bone.

His physical therapist Johnny Owens says the muscle growth is clear.

Asked if he feels the difference, Hernandez told Safer, “Yeah, I mean, it doesn’t feel, it doesn’t get as tired as quickly or shaky before. After doing some other workouts, I’d have to break. And now I don’t have to break anymore.”

“Must be giving you a lot of pleasure to see that kind of progress?” Safer asked Owens.

“It does, yeah,” he replied. “And this is one, early on, I think there’s a lot of potential to see bigger and better things.”

“When you saw that this, to some extent, worked, were you surprised?” Safer asked Dr. Steven Wolf.

“Part of my job is to be a scientist and to be somewhat objective, right?” Wolf replied.

“You’re also a human being,” Safer pointed out.

“Exactly. Exactly,” Wolf agreed, laughing. “Of course we were excited. You know, and that ‘Did it fail miserably?’ No. In fact, it seemed to work. Eureka!”

“If this works it could really change trauma medicine, yes?” Safer asked.

“In terms of muscle loss. Now all right, what happens if we put that by a nerve? What happens if we put that by bone? What happens if we put that by your heart? What happens by so? You see, it opens a lot of doors if it actually works,” Wolf said.

The military is also using regenerative techniques in hand replacements for amputees. Doctors at the University of Pittsburgh have successfully transplanted a hand taken from a cadaver onto the arm of Marine Josh Maloney who lost his right hand working with dynamite.

Using cell therapy and a bone marrow transplant from the donor, doctors were able to get Josh’s body to accept the new hand without many of the anti-rejection drugs that are almost always toxic.

Maloney says the surgery has given him his life back. To Dr. Wolf, it’s the least medicine can do.

“These guys, they were protecting us. They took the hit for us, and they deserve our respect for that reason,” Wolf said. “And from my perspective, they deserve our very best effort to do the best we know how to do, and then further, to do the best that we don’t even know yet how to do.”

Click Here to Watch the 60 Minutes Video, ‘Growing Body Parts.’

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