Growing organs. Artificial cultivation of people. one step closer
Modern medicine can work real miracles. Every year, scientists find more and more new methods of therapy for various pathological conditions, and the latest technical achievements are of particular interest. Doctors are sure that very soon they will be able to treat diseases at a distance, undergo diagnostics of the whole organism in a matter of minutes and prevent diseases using modern computer technologies. And such a seemingly fantastic, as the cultivation of human organs for transplantation, is gradually becoming a reality.
To date, scientists are conducting many active developments and research that relate to the organs of the human body. Probably, each of us has heard that in the modern world a huge number of people need organ or tissue transplantation, and no amount of donor materials can cover this need. Therefore, scientists have been developing technologies that can cope with such a situation for several years. And today, the active development of the method of "growing" organs continues. In this case, stem cells of the body are used as the starting material, capable of adapting to the characteristics of any organ.
Artificial cultivation of human organs
To date, several technologies have already been invented for the active cultivation of organs from stem cells. Back in 2004, scientists managed to create fully functional capillary vessels. And in 2005, full-fledged cells of the brain and nervous system were grown. In 2006, Swiss doctors managed to grow heart valves, and British doctors managed to grow liver tissue cells. In the same year, the Americans created a full-fledged organ - the bladder, and in 2007 the cornea of the eye was obtained. A year later, scientists managed to grow a new heart, using the frame of the old one as a basis. For such a scientific experiment, the heart of an adult rat was used, which was placed in a special solution that removed all muscle tissue from the organ. Next, the resulting scaffold was seeded with cardiac muscle cells obtained from a newborn rat. Two weeks later, the organ became capable of pumping blood.
To date, many doctors are confident that soon transplantation will no longer be an expensive operation for the elite, only a nominal fee will be needed to obtain an organ.
So over the past few years, a number of surgical interventions have been carried out to transplant an artificially grown trachea, on which the patient's own cells isolated from the bone marrow were applied. Thanks to such cells, the recipient's body does not reject the transplanted organ, it normally takes root and adapts itself to new conditions. This operation allows patients to breathe and speak on their own again.
Growing human organs for transplantation by another method
Another modern achievement of science is 3D printing of organs. Such a wonderful technique is carried out using a special biochemical machine. The very first experiments were carried out on classic inkjet printers. Scientists have found that the cells of the human body are the same size as drops of standard ink. If you translate these data into numbers, you get a size of 10 microns. And with bioprinting, ninety percent of the cells remain viable.
To date, specialists have managed to print auricles, heart valves, and vascular tubes. Among other things, a 3D printer allows you to create bone tissue, and even skin, suitable for further transplantation.
The printing of organs is carried out using a special photosensitive hydrogel, a special powder filler or liquid. The working material is fed from the dispenser drop by drop or by a constant stream. This is how soft or cartilaginous tissues are created. To obtain a bone implant, layer-by-layer fusing of polymers of natural origin is carried out.
cultivation
British scientists came to grips with the problems of dentistry, or rather orthodontics. To date, doctors are actively developing a technology for restoring lost teeth - this implies that the tooth will be grown independently directly in the patient's oral cavity.
At first, dentists will create a “tooth germ” using gum epithelium and stem cells. This manipulation is carried out in a test tube. After the cells are stimulated with a special impulse that will make them turn into the desired type of tooth. Then such a germ, being in a test tube, is formed. Only after that it is placed inside the oral cavity. There it is implanted and reaches the desired size on its own.
So, today there is not a single variety of biological tissues that modern science would not try to grow. But, despite the successes achieved, it is not yet possible to replace artificially grown analogues - this is a matter of the future.
Folk recipes
Traditional medicines will help to avoid the need for organ transplants. They can be used to treat a wide variety of pathological conditions, including dangerous kidney failure, which often requires a kidney transplant.
With such a pathological condition, healers are advised to combine equal proportions of crushed lingonberry leaves, flax seeds, calendula flowers and tricolor violet grass. Brew a couple of tablespoons of the resulting collection with one liter of boiling water. Boil such a remedy for ten minutes on a fire of minimum power, then pour it into a thermos for twelve hours. Strained drink take a quarter-half glass three times a day about an hour before a meal.
The feasibility of using folk remedies must be discussed with the doctor.
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The first operation to transplant organs from the cells of the patient himself will take place in Krasnodar, and now the last preparations for it are being completed. In total, two such transplantations have been carried out in the world, while for Russian surgeons this is the first experience. Previously, only donor organs were transplanted in the country.
"This is an artificially grown trachea, which will also be coated with the patient's own cells," explains Vladimir Porkhanov, chief physician of the Krasnodar Regional Clinical Hospital No. 1.
The framework for the future organ was constructed in the American and Swedish laboratories from a nanocomposite material.
This is an exact copy of the trachea of a patient who needs surgery. Outwardly, it looks like a tube made of elastic porous plastic, on which doctors plant the patient's own cells isolated from the bone marrow. In 2-3 days, the base of the trachea is formed. The patient's body not only does not reject it, but on the contrary, the transplanted organ itself begins to adapt to the new conditions.
“Then the cells will differentiate, create their own microenvironment, produce tissue. After all, a cell, when alive, many processes take place in it. This will take place in your body,” says transfusiologist, employee of the cultivation laboratory of the Krasnodar Regional Clinical Hospital No. 1 Irina Gilevich.
Paolo Macchiarini is studying the course of a future operation with the surgeons of the Krasnodar hospital point by point. He is the author of a technique for transplanting an artificially grown trachea. The first operation was carried out last year in Sweden. It lasted 12 hours. How long this transplantation will take, the doctors do not say. After all, for the first time in the world, not only an artificial trachea, but also part of the larynx will be transplanted.
“During the operation, an excision will be performed and all scar tissue will be removed, that is, it will be necessary to remove part of the larynx, then a cavity will be released and a trachea will be placed in this place. It is very difficult, because the vocal cords are nearby,” explains the professor of regenerative surgery at the Karolinska Institute ( Sweden) Paolo Macchiarini.
Artificial organs will be transplanted to two patients. These are people who received tracheal injuries several years ago. During this time, he underwent many operations, after which there was no improvement. Transplantation for such patients is the only chance for recovery and a full life.
So far, the life of patients is scheduled and mainly consists of prohibitions: you can’t swim, you can’t talk and even laugh. The airways are open, there is a tracheostomy in the throat - a special tube through which patients are now breathing.
“After this operation, the patient will be able to speak and breathe calmly on her own,” says Paolo Macchiarini.
In the future, scaffolds for artificial organs are planned to be created in Russia as well. Professor Macchiarini, together with the Kuban Medical University, won a government mega-grant for research work on the regeneration of respiratory and lung tissues. Now a laboratory is being built on the territory of the university, in which scientists will study the mechanisms of regeneration.
“Here they will work out methods and technologies for cell isolation, seeding cells on these scaffolds, growing cells and working out scientific moments,” says Sergey Alekseenko, rector of the Kuban State Medical University.
The results of scientists' research will make life easier for seriously ill people, they no longer have to wait for a suitable donor. In the future, scientists plan to use a similar technique when transplanting skin, artificial arteries, heart valves and more complex organs.
On the Day of the medical worker, which is celebrated today, at 17:20 Channel One will show the ceremony of presenting the national award "Vocation". It is awarded to the best doctors for outstanding achievements.
Artificial human organs will soon be grown in a clinic under construction at the Kirov Military Medical Academy in St. Petersburg. The decision to build the clinic was made by the Minister of Defense. The multidisciplinary center is planned to be equipped with the most modern equipment, which will allow the most detailed study of stem cells. The scientific and technical department, which will deal with cellular technologies, has already been formed.
“The main direction of the department's work will be the creation of a biological bank and the creation of opportunities for growing artificial organs,” says Yevgeny Ivchenko, head of the department for organizing scientific work and training scientific and pedagogical personnel of the academy. “Russian scientists have been working on artificial organs for a long time.”
Two years ago, the head of the department of the Federal Scientific Center for Transplantology and Artificial Organs named after Academician V.I. Shumakova Murat Shagidulin announced the creation of an artificial analogue of the liver suitable for transplantation. Scientists were able to get an artificial liver and test it in preclinical conditions. The organ was grown on the basis of a cell-free framework of the liver, from which all tissues were removed in advance using a special technology. Only the protein structures of the blood vessels and other components of the organ remained. The scaffold was seeded with autologous bone marrow and liver cells. Experiments on animals showed that if the grown element was implanted in the liver or mesentery of the small intestine, it promoted tissue regeneration and gave a complete restoration of the function of the damaged organ. Animals were models of acute and chronic liver failure. And the grown element made it possible to double the survival rate. One year after implantation, all animals were still alive. Meanwhile, about 50% of the individuals in the control group died. Seven days after implantation in the main group, the biochemical parameters of liver function were already at the normal level. After 90 days after transplantation into the mesentery of the small intestine, scientists found viable hepatocytes and new vessels there, which had grown through the frame of the element.
“Research in the field of creating such complex bioengineered organs as the liver, kidneys, lungs and heart has been carried out in recent years in leading scientific laboratories in the United States and Japan, but they have not yet advanced beyond the stage of studying on an animal model,” comments the head of the Department of Experimental Transplantology and artificial organs of the Murat Shagidulin Center. “Our animal experiments went well. Three months after the transplant, healthy liver cells and new blood vessels were found in the bodies of the animals. This spoke of the ongoing process of regeneration of the transplanted liver and the fact that it took root.”
Japanese scientists from the University of Yokohama have managed to grow a liver a few millimeters in size. They were able to do this thanks to induced pluripotent stem cells (iPSCs). The grown liver works like a complete organ. According to the head of the research team, Professor Hideki Taniguchi, the mini-liver copes with the processing of harmful substances as efficiently as a real human organ. Scientists hope to begin clinical trials of artificial livers in 2019. The new organs created in the lab will be transplanted into patients with severe liver disease to maintain normal liver function.
Somewhat earlier, Japanese scientists in the laboratory approached almost the latest discovery - the creation of fully functioning kidneys that can replace the real ones. Prior to this, artificial kidney prototypes were created. But they could not pass urine normally (they swelled from pressure). However, the Japanese corrected the situation. Experts have already quite successfully transplanted artificial kidneys to pigs and rats.
Dr. Takashi Yooko and his colleagues at the Jinkei University School of Medicine used stem cells to not only grow kidney tissue, but also grow a drainage tube and a bladder. In turn, rats, and then pigs, were incubators in which embryonic tissue was already developing and growing. When the new kidney was connected to the bladder that existed in the body of the animals, the system worked as a whole. Urine went from the transplanted kidney to the transplanted bladder, and only then did it enter the animal's bladder. Observations showed that the system worked eight weeks after transplantation.
According to scientists, in the future, it may be possible to create full-fledged vocal cord implants for people. The researchers collected tissue fragments from four people suffering from problems with the vocal cords. In these patients, the ligaments were removed. Tissue was also taken from one deceased donor. Specialists isolated, purified and grown mucosal cells in a special three-dimensional structure that mimics the environment of the human body. In about two weeks, the cells fused and formed a tissue resembling the elasticity and stickiness of real vocal cords. Then the specialists attached the resulting vocal cords to an artificial trachea and passed humidified air through them. When the air reached the ligaments, the tissues vibrated and produced sound, as if it were under normal conditions in the body. In the near future, doctors are waiting to consolidate the results obtained on people who need it.
Medical scientist at work
For many years, scientists around the world have been working on creating working tissues and organs from cells. The most common practice is to grow new tissues from stem cells. This technology has been developed for many years and consistently brings success. But it is not yet possible to fully provide the required number of organs, since it is possible to grow an organ for a particular patient only from its stem cells.
Scientists from the UK have succeeded in what no one has been able to do so far - to reprogram cells and grow a working organ out of them. This will allow in the foreseeable future to provide organs for transplantation to all who need it.
Growing organs from stem cells
Growing organs from stem cells has been familiar to physicians for a long time. Stem cells are the progenitors of all body cells. They can replace any damaged cells and are intended to restore the body. The maximum number of these cells occurs in children after birth, and with age their number decreases. Therefore, gradually the body's ability to self-healing is reduced.
Many fully functioning organs from stem cells have already been created in the world, for example, in 2004, capillaries and blood vessels were created from them in Japan. And in 2005, American scientists managed to create brain cells. In 2006, human heart valves from stem cells were created in Switzerland. In the same 2006, liver tissue was created in Britain. Until today, scientists have dealt with almost all tissues of the body, even grown teeth.
A very curious experiment was carried out in the USA - they grew a new heart on a frame from the old one. The donor heart was cleared of muscles and built up new muscles from stem cells. This completely eliminates the possibility of rejection of the donor organ, as it becomes "one's own". By the way, there are suggestions that as a frame, it will be possible to use the heart of a pig, which is anatomically very similar to a human one.
A new way to grow organs for transplant (Video)
The main disadvantage of the existing method of growing organs is the need for their production of the patient's own stem cells. Not every patient can take stem cells, and even more so, not everyone has ready-made frozen cells. But recently, researchers from the University of Edinburgh managed to reprogram the cells of the body in such a way that they allow them to grow the necessary organs from them. According to forecasts, the widespread use of this technology will be possible in about 10 years.
