[LUM#2] Tomorrow, healing
Targeted, long-lasting medicine that no longer merely relieves, but has the luxury of repairing. Thanks to advances in stem cell research, regenerative medicine is set to revolutionize the medical world.
Are you suffering from osteoarthritis? Get back the knees you had in your twenties with brand-new cartilage. Alzheimer's stalking you? Replace your failing neurons with more efficient ones. Is your heart threatening to give out? Change it! Science fiction? No, the promise of regenerative medicine. Its aim: "to repair a lesion or a diseased organ by replacing the failing cells with healthy ones ", explains Christian Jorgensen. This targeted medicine means that certain diseases can be cured completely, rather than simply treating the symptoms with drugs.
The fabulous potential of stem cells
In Montpellier, this medicine of the future is conjugated with the present: researchers at theInstitute for Regenerative Medicine and Biotherapy(IRBM) are at the cutting edge of this discipline. Their main material? Stem cells. These cells have the unique ability to give rise to different cell types, enabling the production of cartilage, neurons, heart, liver, skin...
There are two types: multipotent stem cells, which can differentiate into a limited number of cell types, and pluripotent stem cells, which can produce all the cells in the body (see box). And how do they do this? " Thanks to a cocktail of molecules that induce their differentiation into a specific tissue," explains the director of the IRMB. A "liver" cocktail to obtain liver cells, a "heart" cocktail to obtain cardiomyocites, the choice is yours. The advantage of this technique is that the cells can be taken from the patient himself and reinjected after differentiation, without the risk of his immune system rejecting the graft.
Numerous clinical trials are underway to test these new therapies. In Montpellier, researchers are treating patients suffering from osteoarthritis of the knee as part of the Adipoa European clinical trial led by Christian Jorgensen. " We use mesenchymal stem cells, a type of multipotent cell found throughout the body ", explains the researcher. These cells are injected directly into patients' knees to regenerate damaged cartilage. An initial trial on 18 patients produced very encouraging results: 80% of them had seen a gain in functionality and a reduction in pain within nine months of the injection. " We have now launched a second, larger trial on 150 patients, the results of which we expect at the end of 2018."
Create organs
Osteoarthritis, heart attacks, heart failure, macular degeneration, Alzheimer's and Parkinson's diseases... The list of diseases that can be targeted by stem cells is growing all the time. But regenerative medicine has even greater ambitions. In its sights: the creation of organs. " We know how to produce heart cells. We also know how to reconstitute the matrix of a human heart from collagen fibers using a 3D printer. By using these cardiac cells to 'colonize' this matrix, we can create a human heart, an organoid that we can envisage transplanting into a patient without any risk of rejection ", explains Christian Jorgensen, who believes that this dream could become reality within 5 years... perhaps in Montpellier. " We have all the infrastructure we need to be at the cutting edge of regenerative medicine, thanks to a platform that brings together medicine, robotics, chemistry and imaging. Montpellier is a leader in this field ", enthuses IRMB's director. To meet one of our society's major challenges: living longer, but above all in better health.
Researchers " reset
Access to pluripotent stem cells has long been limited, since they are only found naturally in embryos. Now, however, researchers are able to manufacture them. Their recipe? They take a small sample of skin from a patient and extract cells which they then genetically "reprogram". " It's like pressing a reset button to put the cell back to zero," says Christian Jorgensen. The result is "induced pluripotent stem cells" or IPS, which can be transformed into any cell type. This technique won the 2012 Nobel Prize in Medicine for its inventor, Japanese researcher Shinya Yamanaka.
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