13 December 2013

Unique regenerative designs will restore the affected organs

The Man from the Matrix

Irina Krasnopolskaya, Rossiyskaya Gazeta

Some human organs and tissues have an amazing ability to recover. For example, skin, mucous, liver. However, much more often the affected organ or tissue needs to be very effectively helped in this. How? The observer of "RG" talks about this with the deputy director for scientific work of the Research Institute of Uronephrology and Human Reproductive Health of the First Moscow State Medical University named after Sechenov, Professor Andrey Vinarov.

– Andrey Zinovievich, for the first time in the country, your specialists performed an operation to restore a narrowed section of the urethra to a 62-year-old man. Similar interventions have been carried out and are being carried out for children, but this has never been done for an adult. Or am I wrong?

Andrey Vinarov: You are not mistaken! This is really the first time this has been done in our country. Such operations are performed abroad, although infrequently. But their technology is well developed.

– Reveal the essence of this operation.

Andrey Vinarov: There are various methods of treating this painful disease. Although it practically does not cause pain, it significantly reduces the quality of life. Traditionally, the treatment is used to augment the narrowed area of the urethra, or its dissection with an endoscope, or various reconstructive plastic surgery. They are effective, but they are often accompanied by relapses, and then repeated interventions have to be carried out again. There are situations when these methods are ineffective. And that's where the serious problems begin: how to help the patient?

– And how to help?

Andrey Vinarov: It would be ideal to remove the affected area of the urethra and replace it with a new one. Previously, one could only dream of such a thing. But we live in the age of regenerative medicine development. Unfortunately, we are not ahead here. Although for the first time about the possibility of the existence of stem cells, and therefore about regenerative medicine, a Russian histologist, professor from St. Petersburg Alexander Alexandrovich Maksimov spoke. However, after the October coup, he was forced to take revenge on the streets. He left the country and continued his research overseas.

Another of our scientists, who first described the stem cells of Alexander Yakovlevich Friedenstein, is now revered by the whole world. Unfortunately, few people know about him here. There is no prophet in his homeland. That's why regenerative medicine "came" to us from abroad. Before performing the operation, we interned at the Wake Forest Institute of Regenerative Medicine (North Carolina). The director of this institute, who was nominated for the Nobel Prize in Medicine this year, Professor Anthony Atala, came to us in Moscow. And this was the beginning of joint work with the scientists of our First honey. A special agreement was signed by the Rector of our University, Corresponding member of the Russian Academy of Medical Sciences Peter Glybochko and Professor Anthony Atala.

– Is this cooperation ongoing, or does it have some kind of expiration date?

Andrey Vinarov: It is only gaining momentum. We have a plan for further joint research in the field of regenerative medicine. And the operation performed is within the framework of these studies.

– Learn more about these studies.

Andrey Vinarov: A year ago, on the initiative of Pyotr Vitalievich, several research groups were created at the university, whose work is related to biomedical, cellular and bioengineering technologies. Our group was faced with the task of creating a technology for the use of tissue engineering for the treatment of narrowing of the urethra. In just a year, we conducted laboratory experiments and experiments on animals. Our group included specialists from the Research Institute of Molecular Medicine, the Research Institute of Uronephrology and Human Reproductive Health and our students. The effectiveness and safety of using a special cell-free matrix based on the human cadaveric artery was proved on rats and then on rabbits. Thus, we have obtained a framework for replacement urethroplasty. According to the study protocol, a patient was selected. An informed consent to participate in this study has been signed.

– Surely there were ethical issues involved here?

Andrey Vinarov: Of course. Such operations are not carried out anywhere in the world without the permission of the ethics committee and the approval of the Academic Council of the university. After all, it is necessary to transfer the cells of the mucous membrane of the patient's cheek to the created frame. 6 weeks before the operation, a fragment of the cheek mucosa measuring 0.5x0.5 cm was obtained by biopsy under local anesthesia. This fragment was sent to a unique "clean" cell laboratory.

In a special nutrient medium, we received the necessary number of cells. Then they were transplanted to the frame. The result was a tissue-engineered design, which then allowed for an operation to restore the affected urethra. The postoperative period proceeded without complications. The wound healed quickly enough. After 4 weeks, the patient returned to normal life.

– The operation is unique. The conditions for its holding are also unique. This is the case when there can be no talk about the widespread introduction of such techniques. What is in the future?

Andrey Vinarov: In the future, our university will have an entire Institute of Regenerative Medicine. Tissue engineering should definitely come into the field of articular cartilage treatment. After all, according to the World Health Organization, every 3rd person in the world suffers from joint diseases. And deforming arthrosis accounts for 50% of all orthopedic diseases. However, to date, various methods of treatment of articular cartilage are ineffective. And here in the future, most likely, regenerative medicine will ensure success. In the same way as for the restoration of damaged trachea, liver, chronic non-healing skin ulcers, for the restoration of bone tissue.

Portal "Eternal youth" http://vechnayamolodost.ru13.12.2013

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