Puglise 1

Tissue Engineering

AnnaMarie Puglise

Mrs. Sally Spear

January 3, 2018
 Puglise 2

Tissue engineering is said to "[bring] together biology, medicine, and engineering in

order to create products that can restore, maintain, or enhance tissue and organ function"

(National Institutes of Health). In layman's terms, it's the scientific process of combining cells

from a patient to form tissues, and in some cases an entire organ for medical purposes. This

innovative idea can change someone's life forever. Since the tissue is made from the own

person's cells, there is no need to worry about an immune response against it, an issue that can

sometimes occur when using a cadaver (skin from a deceased donor.) Attaching a basic skin

graph to a burn victim or replacing the tissues of someone who has an ulcer is a life-changing

treatment, and it all can be done by using the patient's own cells as a resource. Tissue

replacement is transformative, but perhaps the greatest advantage of this new method comes

from its impacts on organs. The medical field has slowly been able to work itself up from the

"simple" organ, the skin, to the bladder, and now potentially some of the more complicated ones-

the pancreas and heart (Tissue Engineering). Organs are in limited supply due to the fact that

there simply aren't enough replacements for the number of organs that are needed- a hard hitting

fact when you consider 80% of people in line for a transplant are in need of just kidneys (C.O.

Design). This new advancement in the medical field can potentially save many lives in the future

by giving an organ to someone who otherwise wouldn't be able to get one. The concept of tissue

engineering is relatively new and has only been around since the eighties (Tissue Engineering),
 Puglise 3

so it will take a while to advance to the level needed for a successful recreation of the most

complex of organs. There's a bright and exciting future for tissue engineering and it continues to

advance every day; there is now the concept of printable tissue from ink made of smart gel and

human cells (Tissue Engineering). Because it's such a new idea and there's always room for

improvement, and becoming a tissue engineer would be a stable choice and is likely to yield

rewarding results.

The idea of tissue engineering came about in the 1980's by Yuan-Cheng Fung who "[laid]

the foundations for the development of skin and blood vessel substitutes" (Tissue Engineering).

At first there were many failed attempts because it is hard to produce and maintain an organ that

is outside of the body and have it cooperate and act in the same way that a naturally created

organ would. In addition to that, the immune response of the patient needs to be diluted in order

for the body to accept the foreign object (Shier). The body's immune system is trained to attack

any potential threats to the health of the body, so when a foreign object- in this case the

engineered tissue- is inserted and the body doesn't recognize it, there's a risk that the body could

treat it as a threat and attack or reject it. The act of the body rejecting the new tissue and/or organ

is called transplant rejection (Medline Plus). In a case of tissue engineering the chances of a

transplant rejection happening are significantly decreased when the new tissue or organs is

produced from the cells of the patient themselves since the material isn't foreign and the body

would recognize it. Reproducing a body part that accurately replicates the true body part is a

difficult task. On top of the issue of transplant rejection, in order for a tissue to be functional it

must be strong and able to withstand pressure, flexible, and smooth enough to prevent blood

clots from forming around it (Shier). The "easiest" and first step in recreating an organ is skin

since it's a relatively simple two-layer and two-dimensional structure. Eventually, an engineer by
 Puglise 4

the name of Nicolas L'Heureux found a way to make arteries out of surrounding a biodegradable

tube with smooth muscles cells surrounded by fibroblasts. The tube would eventually disappear

and the hole would be filled with endothelial cells which give a smooth inner surface. These

fibroblasts would eventually secrete collagen which reinforces the structure and allows it to

attach to other structures (Shier). This method is the process of making new blood vessels or

essentially a vein. This is just one example of the many advancements that are being made every

day in the field of tissue engineering.

Tissue engineering is a branch under the larger field of regenerative medicine in which

the body uses its own systems to rebuild damaged tissues and organs (Tissue Engineering and

Regenerative Medicine). The actual process of making a tissue starts on a very microscopic

level. Cells secrete and make their own support structures using extra-cellular matrix and build

off of one another. These cellular matrices are essentially signals and messages that each cell

sends to one another as a type of communication that makes the certain cells surrounding it react

a certain way (Benefits of Tissue Engineering). This process is already a part of the natural

human reaction of regenerating new cells or healing which occurs in skin and is the reason why

our skin is healed after we get a scratch or cut. By figuring out how cells use this process to heal,

engineers can replicate their response to signals, and manipulate this to generate their own

structures, for example an entire organ. As a part of the organ system, cells make up tissues

which then make up organs. The process of connecting these cells into tissues is called

scaffolding. Scaffolding is using artificial or natural materials to mimic a biological process.

Once engineers can figure out how to completely manipulate the cellular-matrixes they can use a

scaffold method to form tissues. All they would need to do is provide a base, either a cadaver

tissue or tissue from the patient, and an artificial setting to introduce the cells in. From there they
 Puglise 5

should make sure the environment is right such as temperature and moisture and a tissue should

self-assemble! The development of using a scaffold from a human has proven itself promising,

and has already produced results of heart, liver, lung, and kidney tissue (Tissue Engineering and

Regenerative Medicine). After the forming of tissues is the forming of organs, which is the step

of biomedical engineering that has just barely been achieved.

Since tissue engineering is a task that has puzzled the world of medicine for decades now,

it should come as no surprise that becoming a tissue engineer takes a plethora of training, time,

and money. A bachelor's degree in chemistry or biology is a great start, but a graduate degree

will provide more opportunities. Tissue engineering falls under the canopy of biomedical

engineering and can make an annual salary anywhere from $90,000 to $100,000 (Salary and

Career Info). Tissue engineering is perhaps one of the most promising careers for one's future as

long as one is patient and content with trial and error. Since it is relatively new, there is still so

much to be invented and innovated and there is high reward for something new to be discovered,

however this discovery might not come easily because there is a lot of room for error. Once one

has become a tissue engineer, he/she should find work fairly quick since there is an increased

demand for biomedical engineers. The job is very taxing and rare and many people aren't up for

the challenge because it takes a lot of time, energy, training, and effort for a payoff that might

not come until very far into the future (Marshall).

If one is willing to account for the cost of it, tissue engineering has an extremely

promising future in areas of the medical field that have no solutions as of now. Tissue

engineering can benefit patients in many areas in the future that currently have no long-term full

recovery. There are no currently solutions for destructed articular cartilage in the joints of people

with osteoarthritis, sport related injury, or more importantly damaged cartilage in the vertebral
 Puglise 6

disks of spines (Williams). Tissue engineering is being looked at as a very promising candidate

for cartilage regeneration. An example of how tissue engineering has already been found to be a

success is in the area of skin. The benefits of engineering skin are skin-graphs for burn victims or

people who have lost a lot of skin during surgeries to remove tattoos and people who have

arthritis with a loss of collagen in between their joints. Using tissue engineering in this area

would provide "a cheaper and better alternative to cadaver skin-graphs" (Benefits of Tissue

Engineering). In addition, outside of the human body it can provide a safe way to do toxicity

testing for cosmetic companies without having to use a live subject (Shier). Using engineered

human tissue can provide reliable results without having to harm people or animals. Skin is one

of the only organs that has the ability to self- repair, so the aid of engineering would only further

this naturally process even more. This being said, there are many conditions where it's

impossible for the skin to repair itself, such as burns or ulcers that can be caused by diabetes or

bed sores that are common in the elderly where the skin is far too damaged to repair itself

naturally. These improvements have already been tested and has given some success (Williams).

Nerve guides and growth factors can also be used to re-stimulate damaged nerves that can be

caused after wear-and-tear as the body gets older, or from tragedies. Perhaps the most promising

when it comes to nerve damage repair, is the hope that tissue engineering holds for the

deterioration of the nervous system in diseases such as Alzheimer's and Parkison's in which there

are no known cures (Williams). If tissue engineering can eventually repair nerve damage, then it

should be able to prevent diseases in which disruption of nerves is the leading cause, such as

Alzheimer's and Parkison's.

With benefits, there of course comes drawbacks. As discussed, tissue engineering is "the

persuasion of the body to heal itself" (Williams). It essentially uses the body's own material to
 Puglise 7

regenerate new cells and tissues in order to heal or replace previously damaged areas. This

concept is revolutionizing, but when put into place it is very unlikely to yield satisfying results.

Even when the body gets a cut and repair itself naturally, it isn't replaced by the same tissue that

was originally there- it is replaced by scar tissue which is thicker and more fibrous. In a point

made by David Williams, switching on these regenerative cells won't do much to benefit the

body's natural healing process that has already been put in place. Tissue engineering is a concept

that can save the lives of many and "could address medical conditions for which there are no

successful therapies" (Williams). But with such high reward comes a high risk, and since tissue

engineering is such a new idea the likely hood of there being such life-threatening risks is higher

now than the benefits. There is also the setback of having little supply. As of now, there are only

two sources for the stem cells required to make the tissues: from the patient or from a donor. The

most promising source would be that from an embryo, but there are tight restrictions on these

cells. With transmitting cells from donors, there is also the introduction of new DNA. There can

be disease transmission such as "cancer, blood disorders, and genetic conditions" (Williams).

Also, once a cell is taken outside of the human body, it runs a huge risk of modification. The

likely hood that a cell would get tainted while outside of the body and genetically manipulate is

fairly high and these modifications could lead down a long path of catastrophic chain of events.

The biggest risk of all would be the performance of the end result. There is a high chance that

even after all of the tedious time and effort on a microscopic level, that the work might not pay

off in the end. The tissue that could be created might not hold adequate properties to that of the

original tissue which could lead to life-threatening results. Ultimately, there is a lot of

speculation surrounding the world of tissue engineering. Groups of companies have invested

money on clinical trials and tests, but have unfortunately ended in bankruptcy because the results
 Puglise 8

simply don’t cover the costs (Williams). There is a lot of investment and research, but the results

are essentially unsellable until there is a product available in order to cover the costs of the

development. The question arises if tissue engineering will ever be cost effective and the answer

is probably not. There are too many factors that apply including technology, the economy, and

other medical advancements that determine if tissue engineering is ultimately the best fit for the

future of these unsolvable solutions (Williams.)

In conclusion, tissue engineering as a form of regenerative medicine sounds extremely

promising for the future of medical advancements in which no other solutions have been found.

There are undoubtfully challenges that will occur in order for it to become affordable and

accessible to everyone in the future, but that is to be expected with any and every new

improvement that is being made in the medical field- especially one that is in as early of a stage

as tissue engineering is. Being able to create organs from a simple cell is a huge step in the

medical field that could potentially kickstart even more achievements that wouldn't be possible

without it. The effort that it takes in order to make tissue engineered products obtainable is well

worth it to give organs and tissues, but more importantly a second chance at life, to those who

otherwise wouldn't have that opportunity.

Works Cited
“Benefits Of Tissue Engineering.” Trends.

Marshall, Hillary. “Tissue Engineering: A Growth Area.” Tissue Engineering: A Growth Area,
21 Sept. 2001.

“Salary and Career Information for Tissue Engineering Professionals.” Study.com, Study.com.

Shier, David, et al. Hole's Human Anatomy & Physiology. WCB/McGraw-Hill, 1999.

“Tissue Engineering and Regenerative Medicine.” National Institute of Biomedical Imaging and
Bioengineering, U.S. Department of Health and Human Services, 2 Feb. 2017.

“Tissue Engineering.” Biotechnology: In Context, 25 Aug. 2017.

“Transplant Rejection.” MedlinePlus Medical Encyclopedia.

Williams, David. “Benefit and Risk in Tissue Engineering.” Materials Today, Elsevier, 17 Apr.
2004.

Wilson, Mark. “Infographic: Just How Hard Is It To Get An Organ Transplant?” Co.Design,
Co.Design, 28 Apr. 2017.
Puglise 10