WASHINGTON, DC—The ability to grow or repair damaged tissue or organs through regenerative medicine is transforming the field according to a DoD official at the 2010 MHS Conference. “Regenerative medicine is going to change the way that we practice medicine and dentistry in the future. It is actually changing the way that we are practicing right now in the defense health program,” said Army Col Robert Vandre, DDS, project manager at the Armed Forces Institute of Regenerative Medicine (AFIRM).

Regenerative medicine is a way to treat diseases and injuries that uses artificial organs, specially-grown tissues and cells (including stem cells), and laboratory-made compounds. With severely wounded servicemembers returning from war with disfigurement or severe burns, among other problems, AFIRM was created in 2008 to pursue regenerative medicine treatments to help servicemembers.

AFIRM is made up of two civilian research consortia that include numerous universities working with the US Army Institute for Surgical Research (USAISR) in Fort Sam Houston, TX. One consortium is led by Rutgers University and the Cleveland Clinic, and the other is led by the Wake Forest Institute for Regenerative Medicine and The McGowan Institute for Regenerative Medicine at the University of Pittsburgh.

Funding for AFIRM comes from the Army Medical Research and Materiel Command, with additional funding from the Navy, Air Force, NIH, VA and various other public and private entities.

Regenerative Research

AFIRM’s five major areas of emphasis are limb repair, craniofacial repair, burn repair, scarless wound repair, and compartment syndrome repair. “These are the top external types of battlefield injuries,” said Vandre.

For example, limb repair is an important area of research because injuries caused by blast injuries in theater often result in the loss of large regions of tissue in the middle portion of the limb. In these cases, the limbs are not functional. Civilians also incur limb trauma in accidents. AFIRM scientists would like to develop new regenerative medicine therapies to help save and rebuild injured limbs.

Burn injuries are another problem for servicemembers and civilians, and AFIRM scientists are working to improve burn wound management. Vandre pointed to successes in regenerative medicine that have already occurred in recent years. In 2008 an AFIRM-funded scientist from the Rutgers-Cleveland Clinic Consortium completed the first face transplant. The patient, a civilian named Connie Culp, had been injured by a shotgun blast that destroyed her entire mid-face. Culp received new skin, nose, cheekbones, hard palate, and teeth from a donor.

In another achievement, surgeons at the University of Pittsburgh Medical Center performed their first unilateral hand transplant in March 2009 on a Marine, followed by the nation’s first bilateral hand transplant on May 4, 2009.

AFIRM is providing funding for clinical trials scheduled in FY 2010 that include more transplants. Other clinical trials include a study involving Avita Medical Ltd’s ReCell Spray-On Skin which allows for cells to be sprayed on a burn patient in place of skin grafting.

Another clinical trial uses autologous engineered skin grafts, a process in which a small section of healthy skin from a burn patient that can be expanded significantly in a tissue culture lab in order to cover a patient’s large burns. This eliminates the need for extensive and repeated skin grafting.

Scientists are also exploring a surgical procedure involving the transfer of fat from a patient in order to reduce damage caused by scarring and increase mobility. “We are looking for patients now who can use fat injections,” Vandre said.

All of the projects are designed to help injured military patients, but will also benefit civilian patients in the future. Vandre emphasized that regenerative medicine could really change medicine in the future. “If you could grow a heart with some cells, taking some cells out of someone’s back and grow a new heart, that changes the whole ball game.”

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