The Latest Advancement in Regenerative Medicine Is Lab-Grown Vaginas

Medical research continues to succeed in engineering organs. But that’s not enough.

Yes, that is what the headline implies.
National Journal
Brian Resnick
April 10, 2014, 2:30 p.m.

Add nos­trils and va­gi­nas to the read­ily ex­pand­ing list of hu­man tis­sues doc­tors can now grow in labor­at­or­ies and suc­cess­fully im­plant in pa­tients.

Two long-term stud­ies just pub­lished in the in­flu­en­tial med­ic­al journ­al The Lan­cet out­line the suc­cess doc­tors have achieved in trans­plant­ing both body parts. In the first study, doc­tors at Wake Forest Uni­versity har­ves­ted cells from the gen­it­als of four teen­age girls born with a syn­drome that res­ults in un­der­developed sexu­al or­gans, coaxed those cells in­to a re­gen­er­at­ive state, grew them on a scaf­fold, and then trans­planted the res­ult­ing tis­sue.

After eight years of fol­low up, “the or­gans con­tin­ue to func­tion as if they were nat­ive tis­sue and all re­cip­i­ents are sexu­ally act­ive, re­port no pain, and are sat­is­fied with their de­sire/arous­al, lub­ric­a­tion, and or­gasm.”

In the second study, five people had their nos­trils re­con­struc­ted with their own car­til­age. That tis­sue was har­ves­ted from their own noses, and coaxed in­to ex­pand­ing in volume by a factor of 40. It was then im­planted. The re­search con­cludes that “the clin­ic­al re­con­struc­tion of the nas­al [lobe] after re­sec­tion of a non-melan­oma skin can­cer is safe and feas­ible.”

While these find­ings are cer­tainly eye­brow-rais­ing — and lend hope to those suf­fer­ing with dis­fig­ur­a­tion — the more im­port­ant as­pect of their pub­lic­a­tion can be found in an op-ed pub­lished along­side the re­search.

Drs. Mar­tin A. Birch­all, and Al­ex­an­der M. Sei­fali­an write that these find­ings can be just as frus­trat­ing as they are prom­ising. This re­search is con­sidered dis­rupt­ive medi­cine, and dis­rup­tions can take a very, very long time to make their way in­to main­stream medi­cine. And the high cost of de­vel­op­ing such tech­no­logy of­ten poses road­b­locks. Birch­all and Sei­fali­an write:

MRI scan­ners con­tin­ue to im­prove gen­er­a­tion­ally. These changes, which im­prove the pa­tient’s ex­per­i­ence and ac­cur­acy of dia­gnos­is, are sus­tain­ing in­nov­a­tions: they im­prove an ex­ist­ing sys­tem that is un­der­stood by pa­tients and that sup­ports spe­cial­ised in­dustry, doc­tors, and health-care sys­tems. By con­trast, tis­sue en­gin­eer­ing, and the vari­ous shades of re­gen­er­at­ive and cel­lu­lar ther­apies it part­ners, is a dis­rupt­ive tech­no­logy. …

Early auto­mobile tech­no­logy, al­though highly in­nov­at­ive, was the pre­serve of those who could af­ford it for many years. It was only when Henry Ford’s mass pro­duc­tion brought auto­mo­biles to every­one’s street, in num­bers yet at af­ford­able cost, that the in­dustry of the horse-drawn car­riage passed away. These two Lan­cet stud­ies show that those who prac­tise con­ven­tion­al tis­sue re­con­struc­tion and or­gan trans­plant­a­tion, and the health-care and com­mer­cial in­dus­tries which sup­port them, should fi­nally be tak­ing the quirky min­nows of tis­sue en­gin­eer­ing quite ser­i­ously. Dis­rupt­ive in­nov­a­tion might be nigh.

As I wrote in Novem­ber, it will be some time be­fore lab-grown or­gans are com­monly avail­able. Clin­ic­al tri­als for new pro­ced­ures take dec­ades. And “private in­dustry is go­ing to have to raise mil­lions and mil­lions of dol­lars not around the sci­ence, but around the prac­tic­al­ity,” Wil­li­am Wag­n­er, dir­ect­or of re­gen­er­at­ive medi­cine at the Uni­versity of Pitt­s­burgh, told me then.

Road­b­locks in­volving time and money are not ex­clus­ive to re­gen­er­at­ive medi­cine. Take an­ti­bi­ot­ic re­search. Ap­provals of new an­ti­bi­ot­ics are cur­rently at their low­est rate, at a time when threat of drug-res­ist­ant strains haven’t been high­er. Or even sun­screen. In­gredi­ents that European com­pan­ies have been us­ing for years, which work bet­ter than the ones cur­rently avail­able in the United States, are stuck in reg­u­lat­ory limbo.

That’s why Birch­all and Sei­fali­an provide a good re­mind­er: Let’s turn some of these gee-whiz stud­ies in­to real­ity.

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