Regenerative Medicine

Question 1

Define regenerative medicine

Answer 1

branch of translational research in tissue or cell engineering and molecular biology

Question 2

What processes does regenerative medicine deal with?

Answer 2

replacing,
engineering or
regenerating

human cells/tissues/organs: restore or establish normal function.

Question 3

What is the basis of regenerative medicine, how is this achieved and why is it important?

Answer 3

What: engineering of tissues and organs
How: by stimulating the body’s own repair mechanisms
Why: to functionally heal previously irreparable tissues or organs

Question 4

Define translational medicine

Answer 4

• connects basic medical research with clinical treatment
• interdisciplinary branch of the biomedical field supported by three main pillars:
  1. bench-side
  2. bedside
  3. community

Question 4

What could potentially solve the problem of the shortage of organs available for donation, and the problem of organ transplant rejection?

Answer 4

Using regenerative medicine to derive and grow an organ/cells from the patient’s own tissues or cells (patient acts as both donor and recipient)

Question 5

Other than self-healing via cell therapy, what else can we do with regenerative medicine with regards to organs or tissues?

Answer 5

Grow tissues and organs in the laboratory to implant them when the body cannot heal itself.

Question 6

Other than medicinally, where else does regenerative medicine show promise?

Answer 6

Anti-aging medicine and products

Question 7

What is the function of cell therapy?

Answer 7

To restore the lost function rather than produce a new organ

Question 8

List and describe anti-aging medicines as a form of cell therapy. (5)

Answer 8

1. ** Hyaluronic acid** in anti-aging and disease
2. Using platelet rich plasma as anti-aging agent in regenerating skin cells
3. The anti-aging industry offers several hormone therapies (focus on estrogen)
4. Diets and supplements
5. Convalescent plasma in the era of COVID-19

Question 9

What is hyaluronic acid (HA)?

Answer 9

• Naturally occurring, linear polysaccharide
• composed of repeating disaccharide units ofD-glucuronic acid andN-acetyl-D-glucosamine
• linked byβ-1-3 andβ-1-4 glycosidic bonds

Question 10

What is the primary component of the extracellular matrix?

Answer 10

Hyaluronic acid

Question 11

State the role of HA in the skin, and its affiliation with water.

Answer 11

1. Forms an important structural element in the skin
2. holds water extremely well

Question 12

List the regions where HA is found in high concentrations. (6)

Answer 12

1. synovial joint fluids
2. vitreous humor of the eyes
3. hyaline cartilage
4. intervertebral disc nucleus pulposus
5. umbilical cord
6. connective tissues

Question 13

Describe the role of HA in wound healing, tissue repair and regeneration.

Answer 13

• HA-rich wound matrix facilitates cell motility and proliferation, which is essential for wound repair.
• Facilitates scarless wound healing processes.

Question 14

What is HA used for, medicinally? (5)

Answer 14

1. supplementation of impaired synovial fluid in arthritic patients
2. in aesthetic medicine such as dermal fillers
3. in soft tissue surgery such as vocal fold augmentation
4. as scaffold for tissue regenerative applications
5. hydrogels

Question 15

Describe the functions of hydrated and dehydrated HA.

Answer 15

Hydrated: intact HA (hydrogel structure) maintains the tissue in a hydrated state

Dehydrated: the degraded HA (also incorporated into hydrogel) released into the wound promotes cell proliferation, cell
migration and angiogenesis.

Question 16

What can impair the “vampire procedure”?

Answer 16

Systemic inflammation - cytokines and other inflammatory molecules remain in plasma
Smoking - impurities in plasma

Question 17

Describe the basis of the “vampire procedure”.

Answer 17

• a microneedling treatment with the addition of platelet-rich plasma (PRP) from recipient’s own body
• recipient’s blood sample is centrifuged; PRP is collected from sample and used aesthetically

Question 18

What are the 2 different types of hormone therapy in regenerative medicine? (menopausal)

Answer 18

1. Bioidentical Hormone Replacement Therapy
2. Estrogen replacement

Question 19

What are the contraindications of hormone therapy?

Answer 19

Stroke (thrombo-embolic stroke)
Hypercoagulation (Abnormal clotting)

Question 20

What are the different types of strokes one may get?

Answer 20

1. thrombo-embolic stroke - artery is blocked by a thrombus (blood clot) that forms there
2. hemorrhagic stroke - due to bleeding in your brain from a torn or ruptured blood vessel

Question 21

Describe how fibrin changes due to estrogen.

Answer 21

• Soluble fibrinogen converts to insoluble fibrin fibres
• Control: network of fibres
• Control + oestrogen =
  thickened matted deposit
  causing heart attack or stroke

AKA: Leads to the formation of thicker and more branched fibrin fibers; fibrin morphology changes as estrogen levels increase

Question 22

Spontaneous platelet activation during hyperactivation of
haematological system

Answer 22

• Cause hyperactivation
• Platelets activated by pseudopodia
• Female using HRT or contraceptives should be very careful in case oestrogen affects platelet and RBCs

Question 23

What is convalescent plasma therapy (hyperimmune immunoglobin)?

Answer 23

an experimental treatment that some doctors are using for people with severe coronavirus disease 2019 (COVID-19).

Question 24

What is the basis of convalescent plasma therapy wrt COVID-19?

Answer 24

1. No FDA-approved treatment for COVID-19 2. But, people who've recovered from COVID-19 have antibodies — proteins the body uses to fight off infections — to the disease in their blood. 3. The **blood from people who've recovered** is called convalescent plasma. 4. Plasma is the liquid portion of the blood. 5. Researchers hope that convalescent plasma can be **given to people with severe COVID-19 to boost their ability to fight the virus**. 6. It also might help keep people who are moderately ill from becoming more ill and experiencing COVID-19 complications.

Question 25

SANBS

Answer 25

SA clinical trial: SANBS Starting on 4 May 2020, the SANBS began taking appointments from volunteers who wish to book appointments to donate convalescent plasma. What does the SANBS hope to achieve with the clinical trial? Currently, there is not enough scientific evidence to prove whether COVID-19 convalescent plasma is a safe and effective treatment for patients with the virus. Well-designed clinical trials will help provide the information necessary to prove whether convalescent plasma is a safe and effective treatment. The results from the clinical trial will inform future decisions on the wider availability of convalescent plasma. It will be an important contribution to research on a global scale that could help patients in South Africa and around the world.