When we think of organs, we tend to focus on those located inside the body, like the heart or brain. But the largest organ is actually external: our skin. It comprises approximately 16% of our body mass, and it is our main point of contact with the world.
Not only does the skin function like a barrier, protecting us from the elements, but it also informs our decisions by giving the brain sensory feedback from the environment. Additionally, It is an essential part of our identity and self-esteem. The American Academy of Dermatology has found an increased risk of depression in those suffering from diseases that modify the appearance of the skin, such as vitiligo and acne. And, considering that the beauty industry is valued at 532 billion USD, it is clear just how important it is for people to care for their skin.
Unfortunately, accidents that cause damage to the skin, either wounds or burns, are common. Some of these injuries can be life-threatening and require immediate medical care, but even mild cases can leave a lasting impact on patients both physically and psychologically. As the World Health Organization warns, they often result in stigma and rejection.
Researchers are currently working on stem cell-based therapies that could help them regenerate skin using a patient’s own cells. These procedures have the potential to allow patients to recover from injuries or disease, both in functional and aesthetic terms.
How regenerative medicine could cure skin wounds and burns
In order to understand how scientists are working to regenerate skin both in clinical trials and in the real world, we must look at the tools that they have at their disposal. First, we will review how researchers can generate skin grafts from skin cells located in hair follicles. Then, we will look at iPSCs, one of the most promising advancements in the field of regenerative medicine.
Extracting keratinocytes from hair follicles
For a long time, scientists have taken skin samples from subjects to be used as diagnostic tests. They have also been implanted in other areas to treat wounds and burns. This is commonly done through punch biopsies, which are invasive procedures. Fortunately, there is another more convenient path towards isolating skin cells, specifically keratinocytes, and using them to generate epidermal sheets. They can be sourced from hair follicles like those collected at Acorn during cell banking.
The greatest advantage that these cells bring is that they are easily isolated, highly proliferative, and grow quickly in the lab. That is why cultured keratinocytes have been used for more than 20 years in the treatment of burns and other skin wounds such as ulcers. Products based on this technology, such as Epicel® and Epidex® have increased the survival rates of burn patients.
Taking advantage of Induced Pluripotent Stem Cells
Induced pluripotent stem cells or iPSCs are adult, fully differentiated cells that are reprogrammed to behave like embryonic stem cells. This transformation, which entails the use of transcription factors (proteins that control the activity of genes), essentially unlocks the cells’ potential. Being pluripotent means that they have the ability to develop into any cell type in the body. This includes skin cells such as keratinocytes, melanocytes, and fibroblasts.
According to a study published in the Journal of Investigative Dermatology by Dr. Jason Minella and his colleagues from the University of Colorado School of Medicine, by combining the elements that compose human skin, all derived from iPSCs, researchers could regenerate fully functional human skin. This means that subjects would recover nerve function as well as the appearance of healthy skin. Furthermore, since these therapies would use a patient’s own cells, the likelihood of rejection would be vastly reduced.
Discussing the use of iPSC-generated keratinocytes, Dr. Minella and his team emphasize the importance of two studies, one led by Dr. Ruifeng Yang from the University of Pennsylvania and the other by Dr. Ophelia Veraitch from Keio University School of Medicine in Japan. In both trials, researchers transplanted iPSCs into immunodeficient mice and weeks later observed newly generated hair follicles. What this suggests is that scientists should soon be able to create all major components of human skin in a lab and eventually use them for therapeutic purposes.
How regenerative medicine could cure skin diseases
Scientists have developed technologies that allow them to use iPSC-generated keratinocytes to form the outermost layer of the skin. They have been able to do this both in vitro and in vivo (directly in the subject). The first option could help with drug screening, allowing scientists to determine the adequate treatment for patients without them having to experiment in their own bodies.
The second option would allow for the creation of replacement tissues for patients using their own cells once these are corrected for disease-causing mutations. What this means essentially is that scientists could identify the genes that lead to the development of skin disease in a patient, grow that person’s own skin in the lab, replace that faulty genetic code, and transplant the healthy tissue into the patient. Once this technology is perfected, iPSCs would constitute an ideal source for generating unlimited supplies of patient-specific healthy skin grafts.
While iPSCs have shown great promise, they are not the only avenue for the regenerative treatment of skin diseases. In 2017, researchers from Ruhr University Bochum in Germany used gene editing to regenerate an entirely functional epidermis on a seven-year-old child suffering from Epidermolysis bullosa, a genetic skin disorder. Through a skin biopsy, the scientists took a sample of the boy’s cells and modified their genetic code. Then, they turned the cells into transgenic transplants. The transplants were successfully applied to 80% of the boy’s body surface.
These procedures provide a blueprint for future therapies focused on a variety of skin diseases. Just imagine the impact this can have on people who suffer from conditions for which no current therapies exist. This concept takes medical treatment to the next level, making it fully personalized thus ensuring its efficacy and avoiding immune rejection.
Where we are at the moment
In addition to the cell-based skin products now available for the treatment of burns and wounds, there are a large number of clinical trials taking place at the moment. These trials are focused on the use of stem cells for skin regeneration. Teams of researchers around the world are making strides towards safe and effective applications of these technologies. It is just a matter of time before they become widely available and can help the millions of people who have experienced injuries, burns, or skin diseases in Canada and around the world.
How you can take action today
There are many applications for stem cells besides regrowing skin, including treatment for heart disease, Alzheimer’s, and spinal cord injury. To ensure that you can take advantage of these potential treatments you must provide scientists with a cell sample. This should ideally be done while they are at their youngest and healthiest. This means that when it comes to cell banking, time is of the essence.
Preserving your cells at Acorn will shield them from aging so that they maintain their therapeutic potential. To learn more about the ways you can have your cells collected, click here.