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Chapter 9 - Development of materials for regenerative medicine: from clinical need to clinical application
- Edited by Jan de Boer, University of Twente, Enschede, The Netherlands, Clemens A. van Blitterswijk, University of Twente, Enschede, The Netherlands
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- Book:
- Materiomics
- Published online:
- 05 April 2013
- Print publication:
- 02 May 2013, pp 155-176
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Summary
Scope
Given the demographic challenges of an ageing population combined with rising patient expectation and the growing emphasis placed on cost containment by healthcare providers, economic regenerative medicine approaches for regeneration of damaged and diseased organs and tissues are a major clinical and socio-economic need. The scope of this chapter is to use skeletal regeneration as the exemplar to discuss classical and high-throughput screening approaches to biomaterials development for regenerative medicine, including choice and design of materials based on clinical need, biological assessment and regulatory issues.
Basic principles: development of materials for regenerative medicine
The increase in an ageing population in developed countries is accompanied by a growing need for replacement and repair of damaged organs and tissues. Transplantation of the patient’s own tissue is still considered the gold standard in many applications, but limited availability, and complications associated with harvesting of the so-called autograft, are becoming an important drawback. Tissues and organs from human or animal donors present issues of disease transmission and functional failure. Alternative strategies, based on biological growth factors, cell therapy and tissue-engineered constructs, are being explored as alternatives to the patient’s own tissue, but their use is hampered by biological instability and high costs. These issues demonstrate the need for strategies based on biomaterials, which are often synthetic, and thus less prone to instability problems. In addition, the fact that (synthetic) biomaterials can often be produced in large quantities and thus be available off-the-shelf is an important advantage when coping with an increasing need for regenerative approaches.
30 - The developmental environment: experimental perspectives on skeletal development
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- By Richard O. C. Oreffo, University of Southampton, Helmtrud I. Roach, University of Southampton
- Edited by Peter Gluckman, University of Auckland, Mark Hanson, University of Southampton
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- Book:
- Developmental Origins of Health and Disease
- Published online:
- 08 August 2009
- Print publication:
- 20 April 2006, pp 406-414
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Summary
Introduction
Osteoporosis is a multifactorial skeletal disorder characterised by low bone mass and microarchitectural deterioration of bony tissue, with a consequent increase in the risk of fracture (Jordan and Cooper 2002). The bone mass of an individual in later life depends upon the peak obtained during skeletal growth, and the subsequent rate of bone loss. Preventive strategies against osteoporotic fracture may be aimed at either increasing the peak bone mass attained or reducing the rates of bone loss. As shown in the previous chapter, epidemiological studies have indicated that poor growth during fetal life, infancy and childhood is associated with decreased bone mass in adulthood and an increased risk of fracture (Cooper et al. 1995, 1997, Fall et al. 1998). These relationships appear to be mediated through the programming of metabolic and endocrine systems governing bone growth, by environmental influences acting during critical periods of intrauterine or early postnatal development (Barker 1995, 2000, Barker and Martyn 1997, Godfrey and Barker 2001). In particular, maternal nutrition appears to be important in determining skeletal size at maturity. However, to date, there is little understanding of the cellular and molecular mechanisms whereby environmental modulation in utero could lead to an altered skeletal development among the offspring. This review will examine the benefits and information gained from animal models of intrauterine programming (maternal dietary modulation) with respect to the skeletal development of the young offspring, peak bone mass and bone quality of aged offspring, and will correlate to other animal studies undertaken ex utero and, as appropriate, to the human scenario.