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•Nikhil Bhalerao
•RahulKumar Bhol
   •Girija Paranjpe
    •Sonali Jadhav
   •Pallavi Bodkhe
Tissue Engineering
 Tissue engineering is TECHNOLOGY.
 Similar to REGENARATIVE MEDICINES.
 Regenerative medicines means use of STEM CELLS.
 STEM CELLS:
            1. Embryonic stem cells
            2. Adult stem cells
Tissue Engineering
Sources of cells
 Primary source – cells from individual(patient)
 Secondary source- cells from cell bank

 Autologous cells- cells from same person

 Allogenic cells-cells from same species

 Xenogenic cells- cells from another species

 Syngenic cells- cells from clones
Scaffolds
 Cells are implanted or 'seeded' into an artificial
  structure capable of supporting three-dimensional
  tissue formation. These structures typically are
  called as scaffolds
 Scaffolds usually serve at least one of the following
  purposes:
   Allow cell attachment and migration
   Deliver and retain cells and biochemical factors
   Enable diffusion of vital cell nutrients and expressed
    products
Requirements for scaffolds
 High porosity and an adequate pore size
 Biodegradability
 rate at which degradation occurs has to coincide as
  much as possible with the rate of tissue formation
 Inject ability
Carbon Nanotube
 Carbon nanotubes are
 among the numerous types
 for tissue engineering
 scaffolds

 They are-
 biocompatible,
 can be functionalized
 with biomolecules.
Methods for tissue engineering
scaffolds:
Solvent Casting & Particulate Leaching (SCPL)
 It allows for the preparation of porous structures with
  regular porosity, but with a limited thickness
 Polymer- polylactic acid
 Solvent- dichloromethane
 Porogen- sodium chloride, crystals of
  saccharose, gelatin spheres or paraffin spheres
Gas Foaming
 To overcome the need to use organic solvents and solid
    porogens
   Disc-shaped structures made
   Exposed to high pressure CO2 for several days
   Pressure inside the chamber is gradually restored to
    atmospheric levels
   Pores are formed by the carbon dioxide molecules that
    abandon the polymer
Emulsification/Freeze-drying
 This technique does not require the use of a solid
    porogen
   A synthetic polymer is dissolved into a suitable solvent
   Water is added to the polymeric solution to obtain
    emulsion
   Emulsion is cast into a mold and quickly frozen
   Frozen emulsion is subsequently freeze-dried to
    remove the dispersed water and the solvent
Thermally Induced Phase
Separation (TIPS)
Electro spinning
CAD/CAM Technologies
 Three-dimensional structure is designed using CAD
 software. The porosity can be tailored using
 algorithms within the software
Tissue culture
 Includes creation of functional tissues and biological
  structures in vitro
 It requires extensive culturing to promote
  survival, growth and inducement of functionality
 The major problem is maintaining culture conditions
Bioreactors
 •Bioreactor is a
 device that
 attempts to
 simulate a
 physiological
 environment in
 order to promote
 cell or tissue
 growth in vivo
Applications of Tissue Engineering
 Therapeutic cloning for tissue repair
 Coronary Heart Disease
   Myocardial Infarction
   Congestive Heart Failure
   Dysfunctional Heart Valves
   Peripheral Vascular Disorders
   Abdominal Aortic Aneurysms
 Neurological
   Stroke
   Parkinson’s Disease
   Alzheimer’s Disease
   Epilepsy
   Traumatic Brain and Spinal Cord Injury
   Multiple Sclerosis
 Orthopedic
   Non-union Fractures
   Cartilage Damage and Repair
   Ligament Damage
   Vertebral Disc Damage
   Bone Graft Materials
 Urological
   Incontinence
   Kidney Disease
   Bladder
 Dental
   Missing teeth
   Periodontal disease
 Skin/Integumentary
   Burns
   Diabetic Ulcers
   Venous Ulcers
   Plastic Surgery
 Ophthalmology
   Cornea
   Retina
 Gastrointestinal
   Esophagus
   Stomach
   Small Intestine
   Colon
 Ear, Nose and
 Throat/Respiratory/Cardiopulmonary
   Trachea
   Respiratory Epithelial Cells (Nasal Turbinates)
 Cancer
Organ Transplantation
 Bioartificial liver device:
 Artificial pancreas:.
 Artificial bladders:
 Cartilage:
 Artificial skin constructed from human skin cells
  embedded in collagen
  -Artificial bone marrow
 -Artificial bone
 -Artificial penis
 -Oral mucosa tissue engineering
Some Interesting Things…
In vitro meat
Skin gun heals skin burns
Bullet Proof Skin
Living Doll
Tissue engineered Toys
Market scenario
 Treatments via cell therapy and tissue engineering constitute a $6.9
  billion worldwide market.
 Market is predicted to grow nearly $32 billion in less than ten years.
 Market is growing at rate of 16%.
 Market demand increasing for innovative product.
 Over the 2009–2018 period,
 - organ transplantation segment is expected to grow by 46%.
 - dental decay and disease segment expected to grow by 21%.
 Increase in Indian tissue engineering market due to Medical tourism
 Apligraf, by Organogenesis, is the first manufactured
 living human organ in 1997

 Different product categories:
   − Skin substitutes
   − Orthopedic cartilage and bone replacement
   − Cardiovascular substitutes
   − Organs (e.g. kidney, liver, lung)
   − Nervous system
   − Soft tissue
Tissue engineering market
Major Market segment:
  Orthopedics:
  Cardiology:
  Wound healing:
  Diabetes:
  Neurodegenerative diseases:
Market segment and
opportunities
Orthopedics:
 Orthopedic segment grow at nearly 15% per year
 This market include spine, bone grafts, and bone substitutes.
 Regenerative medicine therapy is favorable.
 Orthopedic treatment is most popular area in Indian medical tourism.
 Cardiology:
 Regenerative medicine with applications in cardiology and vascular medicine
  will rank among the three fastest growing segments .
 As CHD (and CVD) rates increase, estimate increases to 17.9 million by 2030.
 In 2005, India was estimated to have 3.5 crore CHD patients while in 2010, the
  number stood at 4.6 crores.
 The most promising area for regenerative medicine is the treatment of
  myocardial infarction
Wound healing
 Globally, 500,000 surgeries were performed to treat
  diabetic ulcers
 500,000 surgeries to treat venous ulcers
 45,000 burn surgeries
 940,000 plastic surgeries are performed each year
 The most common application for regenerative medicine is
  for the treatment of burns.
Diabetes:
 The number of people with diabetes globally will likely
  double between 2003-2030.
 An estimated 285 million people, corresponding to 6.4% of
  the world's adult population, will live with diabetes in 2010
 Surgical transplantation of pancreatic islet cells is
  promising application
Neurodegenerative diseases:
 18 million people worldwide with Alzheimer’s disease.
 20 million people each year will suffer from stroke.
 6.3 million people have Parkinson’s disease.
Challenges:
 Quality control of the materials used in various
  surgical applications
 Acquiring a fundamental understanding of tissue
  differentiation mechanisms
 The industry is challenged to develop tissue-
  engineered products for a number of surgery-
  related applications,
 Ethical issue.
.
Major market players
Future:
 Technical advances in the various components of the
  industry will contribute to market growth.
 Focus on the safety and efficacy standards.
 Continued development of artificial organs with
  appropriate support structures.
 Focus on disease areas that have the most patients and
  the largest unmet needs
Problems with Tissue engineering
 Complexity using Human tissue implants
    Variability of cells grown.
    Standardization of process
    Irreversible process
    Risk assessment in clinical trials & commercialization.
 Ethical problems
Ethical problems
•Using Xenogenic cells: Species boundaries crossed
•Using Human embryonic cells: Unethical to use human
embryo & aborted fetus.
•Use of human embryo with large scale cultivation for profit
•Rights of Tissue Donors:
       -Profit making
       -Information
Ethical Problems
 Role of Cell banks:
    Privacy of Donor
 Prolonging of life through Tissue engineering:
   Set goal for raising life span through tissue engineering
 Playing THEE!!!
 Organ trafficking
 Cost of using Technology.
Organizations in TE
 Society for Tissue Engineering and Regenerative
    Medicine (India) (STERMI)
   Society for Biomaterials & Artificial organs
   Society for regenerative medicines & tissue
    engineering (SRMTE)
   European tissue repair society
   Tissue & cell engineering society
   Tissue engineering & Regenerative Medicine
    International Society
Tissue Engineering

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Tissue Engineering

  • 1. •Nikhil Bhalerao •RahulKumar Bhol •Girija Paranjpe •Sonali Jadhav •Pallavi Bodkhe
  • 2. Tissue Engineering  Tissue engineering is TECHNOLOGY.  Similar to REGENARATIVE MEDICINES.  Regenerative medicines means use of STEM CELLS.  STEM CELLS: 1. Embryonic stem cells 2. Adult stem cells
  • 4. Sources of cells  Primary source – cells from individual(patient)  Secondary source- cells from cell bank  Autologous cells- cells from same person  Allogenic cells-cells from same species  Xenogenic cells- cells from another species  Syngenic cells- cells from clones
  • 5. Scaffolds  Cells are implanted or 'seeded' into an artificial structure capable of supporting three-dimensional tissue formation. These structures typically are called as scaffolds  Scaffolds usually serve at least one of the following purposes:  Allow cell attachment and migration  Deliver and retain cells and biochemical factors  Enable diffusion of vital cell nutrients and expressed products
  • 6. Requirements for scaffolds  High porosity and an adequate pore size  Biodegradability  rate at which degradation occurs has to coincide as much as possible with the rate of tissue formation  Inject ability
  • 7. Carbon Nanotube Carbon nanotubes are among the numerous types for tissue engineering scaffolds They are- biocompatible, can be functionalized with biomolecules.
  • 8. Methods for tissue engineering scaffolds: Solvent Casting & Particulate Leaching (SCPL)  It allows for the preparation of porous structures with regular porosity, but with a limited thickness  Polymer- polylactic acid  Solvent- dichloromethane  Porogen- sodium chloride, crystals of saccharose, gelatin spheres or paraffin spheres
  • 9. Gas Foaming  To overcome the need to use organic solvents and solid porogens  Disc-shaped structures made  Exposed to high pressure CO2 for several days  Pressure inside the chamber is gradually restored to atmospheric levels  Pores are formed by the carbon dioxide molecules that abandon the polymer
  • 10. Emulsification/Freeze-drying  This technique does not require the use of a solid porogen  A synthetic polymer is dissolved into a suitable solvent  Water is added to the polymeric solution to obtain emulsion  Emulsion is cast into a mold and quickly frozen  Frozen emulsion is subsequently freeze-dried to remove the dispersed water and the solvent
  • 13. CAD/CAM Technologies  Three-dimensional structure is designed using CAD software. The porosity can be tailored using algorithms within the software
  • 14. Tissue culture  Includes creation of functional tissues and biological structures in vitro  It requires extensive culturing to promote survival, growth and inducement of functionality  The major problem is maintaining culture conditions
  • 15. Bioreactors •Bioreactor is a device that attempts to simulate a physiological environment in order to promote cell or tissue growth in vivo
  • 16. Applications of Tissue Engineering  Therapeutic cloning for tissue repair  Coronary Heart Disease  Myocardial Infarction  Congestive Heart Failure  Dysfunctional Heart Valves  Peripheral Vascular Disorders  Abdominal Aortic Aneurysms
  • 17.  Neurological  Stroke  Parkinson’s Disease  Alzheimer’s Disease  Epilepsy  Traumatic Brain and Spinal Cord Injury  Multiple Sclerosis
  • 18.  Orthopedic  Non-union Fractures  Cartilage Damage and Repair  Ligament Damage  Vertebral Disc Damage  Bone Graft Materials  Urological  Incontinence  Kidney Disease  Bladder
  • 19.  Dental  Missing teeth  Periodontal disease  Skin/Integumentary  Burns  Diabetic Ulcers  Venous Ulcers  Plastic Surgery  Ophthalmology  Cornea  Retina
  • 20.  Gastrointestinal  Esophagus  Stomach  Small Intestine  Colon  Ear, Nose and Throat/Respiratory/Cardiopulmonary  Trachea  Respiratory Epithelial Cells (Nasal Turbinates)  Cancer
  • 21. Organ Transplantation  Bioartificial liver device:  Artificial pancreas:.  Artificial bladders:  Cartilage:  Artificial skin constructed from human skin cells embedded in collagen -Artificial bone marrow -Artificial bone -Artificial penis -Oral mucosa tissue engineering
  • 24. Skin gun heals skin burns
  • 28. Market scenario  Treatments via cell therapy and tissue engineering constitute a $6.9 billion worldwide market.  Market is predicted to grow nearly $32 billion in less than ten years.  Market is growing at rate of 16%.  Market demand increasing for innovative product.  Over the 2009–2018 period, - organ transplantation segment is expected to grow by 46%. - dental decay and disease segment expected to grow by 21%.  Increase in Indian tissue engineering market due to Medical tourism
  • 29.  Apligraf, by Organogenesis, is the first manufactured living human organ in 1997  Different product categories: − Skin substitutes − Orthopedic cartilage and bone replacement − Cardiovascular substitutes − Organs (e.g. kidney, liver, lung) − Nervous system − Soft tissue
  • 31. Major Market segment:  Orthopedics:  Cardiology:  Wound healing:  Diabetes:  Neurodegenerative diseases:
  • 32. Market segment and opportunities Orthopedics:  Orthopedic segment grow at nearly 15% per year  This market include spine, bone grafts, and bone substitutes.  Regenerative medicine therapy is favorable.  Orthopedic treatment is most popular area in Indian medical tourism.  Cardiology:  Regenerative medicine with applications in cardiology and vascular medicine will rank among the three fastest growing segments .  As CHD (and CVD) rates increase, estimate increases to 17.9 million by 2030.  In 2005, India was estimated to have 3.5 crore CHD patients while in 2010, the number stood at 4.6 crores.  The most promising area for regenerative medicine is the treatment of myocardial infarction
  • 33. Wound healing  Globally, 500,000 surgeries were performed to treat diabetic ulcers  500,000 surgeries to treat venous ulcers  45,000 burn surgeries  940,000 plastic surgeries are performed each year  The most common application for regenerative medicine is for the treatment of burns.
  • 34. Diabetes:  The number of people with diabetes globally will likely double between 2003-2030.  An estimated 285 million people, corresponding to 6.4% of the world's adult population, will live with diabetes in 2010  Surgical transplantation of pancreatic islet cells is promising application Neurodegenerative diseases:  18 million people worldwide with Alzheimer’s disease.  20 million people each year will suffer from stroke.  6.3 million people have Parkinson’s disease.
  • 35. Challenges:  Quality control of the materials used in various surgical applications  Acquiring a fundamental understanding of tissue differentiation mechanisms  The industry is challenged to develop tissue- engineered products for a number of surgery- related applications,  Ethical issue. .
  • 37. Future:  Technical advances in the various components of the industry will contribute to market growth.  Focus on the safety and efficacy standards.  Continued development of artificial organs with appropriate support structures.  Focus on disease areas that have the most patients and the largest unmet needs
  • 38. Problems with Tissue engineering  Complexity using Human tissue implants  Variability of cells grown.  Standardization of process  Irreversible process  Risk assessment in clinical trials & commercialization.  Ethical problems
  • 39. Ethical problems •Using Xenogenic cells: Species boundaries crossed •Using Human embryonic cells: Unethical to use human embryo & aborted fetus. •Use of human embryo with large scale cultivation for profit •Rights of Tissue Donors: -Profit making -Information
  • 40. Ethical Problems  Role of Cell banks:  Privacy of Donor  Prolonging of life through Tissue engineering: Set goal for raising life span through tissue engineering  Playing THEE!!!  Organ trafficking  Cost of using Technology.
  • 41. Organizations in TE  Society for Tissue Engineering and Regenerative Medicine (India) (STERMI)  Society for Biomaterials & Artificial organs  Society for regenerative medicines & tissue engineering (SRMTE)  European tissue repair society  Tissue & cell engineering society  Tissue engineering & Regenerative Medicine International Society