The lab-grown cartilage. Image: Department of Biomedicine, University of Basel
What a week it's been for regenerative medicine. Alongside the news that scientists successfully transplanted lab-grown vaginas into women born without them, comes the announcement that other researchers have successfully reconstructed five patients' noses using lab-grown cartilage.
It’s the first time this kind of surgery has been done successfully, and along with the vagina study, it’s a huge boost to the field of regenerative medicine.
The nasal surgery was conducted by scientists at the University of Basel in Switzerland and published in the most recent edition of the Lancet. Five male and female patients aged 76 to 88 had their noses reconstructed with cartilage grown from cells taken from their own nasal septum, which was then implanted into the nostril. All patients had lost part of their nose after surgery to remove skin cancer tumours that are common in that area.
“After 1 year, all patients were satisfied with the aesthetic and functional outcomes and no adverse events had been recorded,” the researchers wrote in their findings.
In this trial, the patients weren’t given a whole new nose like we’ve recently seen grown from stem cells in the UK (though that’s not yet transplanted onto the face, currently growing on a patient’s arm as doctors await the go-ahead from regulatory authorities).
Rather, they just needed a piece of cartilage the right size and shape to fill in the missing part of the nose. In their paper, the researchers explain that they took a six millimetre biopsy from the patients’ noses and multiplied the cells. They were then seeded to a collagen membrane and ended up as a 25mm by 25mm graft, which was shaped to fit the individual.
The method offers a lot of advantages over the current standard treatment, which usually involves removing cartilage from the patient’s septum, ear, or rib for implant. That’s a pretty invasive procedure requiring more surgery, not to mention pain.
As the first in-human trial of the new technique, we can’t expect to see lab-grown cartilage in general use any time soon, but it’s a step in that direction. Unfortunately, it’s still a very specialist procedure, which means patient satisfaction isn’t the only factor to consider. The authors wrote in their discussion, “One important question to be addressed in future studies is the cost-effectiveness of a cell-based treatment when compared with the harvest of autologous native tissues,” and added that engineering tissue is a high-cost process.
Nevertheless, it’s a significant breakthrough that has obvious implications outside of this specific nasal surgery. “Our study opens the way to a controlled trial in which the long-term outcome of the procedure is prospectively compared with that of the gold-standard surgery and to the clinical assessment of engineered cartilage in other challenging facial reconstructions, such as those of heminose or complete nose, eyelid, or ear,” they said.
Suddenly, growing personalised organs from our own cells doesn’t seem quite so futuristic. Now we’ve got vaginas and noses down, you can count on scientists to be working on everything in between. Next step: functioning replacement organs-in-a-box.