INTRODUCTION:

Regeneration is a mechanism that can maintain functional integrity of tissues. It maintains or restores the original structure and function mainly by two process namely

· Maintenance or homeostatic regeneration

· Injury –induced regeneration

Generally, patients have a short list of options for treating illness like long term drug therapy, organ transplantation, and medical devices usage etc.¹ But now people prefer for regenerative medicine in developed countries. It holds the promise of regenerating damaged tissues and organs by stimulating previously irreparable organs to heal themselves and by implanting the grown tissues and organs, when body cannot heal themselves.² It works mainly by combination of 3 elements namely living cells, an extra cellular matrix to support the living cells (scaffold) and cell communicators (signaling systems) which stimulate the cells and their surrounding environment to grow and develop into new tissue.³ Diseases which are untreatable like diabetes, heart disease, renal failure, and osteoporosis and spinal cord injuries. Regenerative medicine has mainly two advantages. They are

· It has the potential to regenerate, so that they return to full functionality.

· To produce tissues invitro for transplantation when regeneration not possible.

Need for regenerative medicine:

Regenerative medicine differs from other current therapies in providing a permanent cure for failing or impaired tissues. It is in very need and in increasing demand for mainly 3 reasons⁴

· It increases the quality of life and care for patients.

· It reduces health care costs by eliminating chronic disease (as in the case

· of diabetes), by generating pancreatic islets in vivo or growing invitro and

· implanting them.

· It reduces the growing gap between the numbers of donors for organs.

· End organ failures can be overcomed⁵

Benefits of regenerative medicine:

Regenerative medicine has various benefits. Some of them are, novel methods of insulin replacement and pancreatic islet regeneration for diabetes, autologous cells for regeneration of heart muscle, immune system enhancement by engineered immune cells and novel vaccination strategies for infectious disease, nerve regeneration technologies using growth factors and stem cells and synthetic nerve Guides for spinal cords and peripheral nerve injuries etc.⁶Small intestinal sub mucosa is increasingly used by surgeons for reconstructing ligaments to treat incontinence,⁷use of cord blood cells in treating conditions such as brain injury, type1diabetes stroke and hearing loss,⁸platelet rich plasmas therapy for hair loss treatment.⁹

Regenerative medicine products are complex and require a great deal of laboratory study. In order to generate these products, first they have to understand how tissues interact with each other.¹⁰

Areas of regenerative medicine:

Regenerative medicine has 4 areas. They are, Bio-medical engineering (medical devices and artificial organs)which deals with the usage of biomedical devices that mimic the function of tissue or organ.¹¹Tissue engineering which involves growing various cell types often obtained directly from patient on to 3 dimensional scaffolds which are implanted into the patient.^12-14 Gene therapy-it involves the treatment by a specific protein and then to deliver the gene coding for that protein to the effected cells.¹⁵

Cellular therapy which involves the transplantation of tissue cells to replace defective cells and attempt to restore normal function. Based on source it is of 3 types.¹⁶

· Autologius cell therapy

· Allogenic cell therapy

· Xenogenic cell therapy

FIRM (Federal Initiative of Regenerative Medicine):¹⁷

Federal government in US has made an initiative in regenerative medicine which allocates the funds for research. The goal of firm is to produce mass customization of tissues on demand. It has 2 major goals

· To give new generation of health care therapies, that has countless applications towards curing of diseased conditions.

· To establish new global industry.

Risks and side effects:

All surgery brings risk including regenerative medicine. There is often post-operational complications like pain or discomfort, temporary bruising and swelling, feverish temperature, extra bleeding, increased numbness and heamatomas can occur.¹⁸These risks and side effects are mainly due to the induced epigenetic changes.¹⁹

CONCLUSION:

It has the next evolution of medical technology which is now in sight and has the potential to become reality in the next 20 years. FIRM offers an opportunity to bring the U.S.A to fore front of regenerative medicine. Coupled with necessary funding and direction, our nation can also maintain its preeminence in biotechnology. By doing so, we can make tissue and organ failure a relic of the past by 2020.

REFERENCES:

1. http://www.hhs.gov/reference/newfuture.shtml

2. http://www.nih.gov/about/researchresults for the public/Regen. pdf

3. http://www.organogenesis.com/tissue_regeneration/promise_tissue_regeneration.html

4. http://www.hhs.gov/references/newfuture.shtml

5. http://www.medscape.com/medline/abstract/16826790.

6. http://www.medscape.com/viewarticle/550282_2

7. http://www.hhs.gov/reference/newfuture.shtml

8. http://en.wikipedia.org/wiki/Regenerative_medicine

9. www.thebald truth.com/hair-loss/future treatments_regenerative_ medicine/#more- 1207

10. http://www.hhs.gov/reference/newfuture.shtml

11. http://regenerative medicine.net/what.html