Creating possibilities: Wake Forest Institute for Regenerative Medicine manufactures organs and tissues from human cells in hopes of curing diseases and reducing waits for transplants.

AuthorSaylor, Teri
PositionSPONSORED SECTION: LIFE SCIENCES HANDBOOK

Inspiration can strike anywhere and at any time. Anthony Atala found his about 25 years ago in a study involving his patients, ages 4 to 19, who were suffering from spina bifida. A congenital birth defect, it keeps vertebrae from properly forming around the spinal cord. That causes weak leg muscles, paralysis, orthopedic problems and seizures. It also causes bowel and bladder pressure and leakage due to nerve damage, which can lead to life-threatening kidney impairment.

Atala, a pediatric urologist at Boston Children's Hospital in the early 1990s, was determined to improve the lives of his young patients by reducing the pressure on their bladders. He had to reconstruct the bladder to do that. It had been attempted before with intestinal tissue, a procedure pioneered about a century ago. But its ability to absorb nutrients, combined with the bladder's role of holding waste, subjected patients to other ailments such as osteoporosis, cancer and kidney stones. So he came up with a different-approach. If he could grow bladder tissue from a patient's cells, he would have normally functioning tissue that wouldn't be rejected by the patient's body.

Creating tissues and organs from a few human cells was science fiction about 25 years ago, but Atala, who now is the W.H. Boyce professor and chairman of Winston-Salem-based Wake Forest University's urology department and director of Wake Forest Institute for Regenerative Medicine, rewrote that story. In his New England laboratory, he and his team found a way to grow bladders. The process starts by extracting cells through a small, minimally invasive biopsy. "We create structure in a mold, and the cells will expand outside the body." Once they've multiplied in a soup of nutrients, the structure is sewn onto the patient's bladder. Since the first successful implantation in 1999', Atala and his team have performed the procedure on hundreds of patients in clinical trials.

Atala's approach needs further study before it can be widely used. To date, the institute is still awaiting FDA approval, and more clinical trials of the bladders are scheduled for later this year. But he is excited about the possibilities. "We have shown that regenerative-medicine techniques can be used to generate functional bladders that are durable. This suggests that regenerative medicine may one day be a solution to the shortage of donor organs in this country for those needing transplants."

The institute's physicians and scientists...

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