Regenerative medicine is the cutting edge of biotech, an emerging field that has the potential to revolutionize the medical world and change the way we treat injuries and illnesses. It’s also an area of great interest to many investors. A recent survey performed by the Alliance for Regenerative Medicine (ARM) found that the combined regenerative medicine field generated $4.7 billion through deals, acquisitions and public and private investments from March 2013 to March 2014. There are more than 247 companies being tracked by ARM which are developing 460 products and sponsoring more than 700 clinical trials.
Technologies used in regenerative healing have the potential to transform treatments for chronic diseases such as diabetes and heart disease, and in the future may even be used to heal previously untreatable diseases, such as ALS and Parkinson’s.
Right now, right here in Texas, regenerative medicine is being used to heal wounds caused during warfare, especially IED-related injuries. Thanks to improved body armor, speedy evacuations and greatly improved medical care for critical injuries, more service members are surviving battle injuries, but the flip side is that military physicians are treating more injuries that were once considered non-restorable. And that’s where Lt. Col. Michael Davis, M.D., sets his sights.
Davis currently works at the San Antonio Military Medical Center and is the deputy commander of the US Army Institute of Surgical Research, which is the DOD’s largest combat casualty care research facility. He also works closely with the 59MDW Science and Technology Division at Wilford Hall Ambulatory Surgical Center. Davis served as Chief of Reconstructive Surgery for Operation Enduring Freedom in Afghanistan, where he came face-to-face with the severity of modern wartime injuries.
“What struck me when I was deployed was that we don’t have a lot to offer [wounded warriors] long term to restore extremity injuries and cranial and maxillofacial injuries,” Davis says.
After returning from his deployment, Davis focused his energies on restorative and regenerative medicine, a field where he has been making great strides to improve the outcomes for severely injured veterans. One of his foremost areas of work is reconstructive transplantation, which involves face and hand transplants that can vastly improve wounded service war fighters’ lives.
“The goal is to be able to transplant any tissue to restore normal form and function,” Davis says. “Scars from burns or direct blast injuries can often limit patients’ movement, they can be very disfiguring, and regenerative techniques can offer a way to regenerate tissue that has normal function, rather than disfiguring and limiting scars.”
But these types of transplantation are new and come with their share of challenges.
“Although prosthetics are advancing, they cannot yet duplicate the complex movements and tactile function of the hand,” Davis says. “How do you duplicate that?” Transplants can duplicate these functions but the obstacle is getting the body to safely accept the transplant without the need for dangerous systemic immunosuppression.
A Focus on Regenerative Healing
Regenerative medicine relies on three components: tissue matrices, advanced stem cell work and growth factors that direct or enhance the stem cells’ production. Davis suggests thinking of regenerative healing in terms of growing a plant. The soil is the matrix, the stem cells serve as the seeds and the growth factors are the water, fertilizer and sunlight.
“It takes all three of those things to create an environment that’s conducive to healing and restoring form and function in a way that’s meaningful – muscle and bone,” Davis says.
The most prominent area of Davis’ success so far lies in face and hand transplants. But his biggest stumbling block to these surgeries involves immunosuppression. For a patient’s body to accept a transplant, doctors must often suppress the patient’s immune system. This suppression puts the patient’s health at risk, which is easy to justify when dealing with a life-threatening injury, but becomes a grey area when a life is not at stake.
“When they have something like the loss of a hand or a disfigured face, it becomes an ethical dilemma whether you should go down the path of risking the health of the patient by giving them systemic immunosuppression,” Davis says.
Reverse Engineering Healing
Lately Davis has been delving into modulating immunity in donor tissue to try and eliminate the need for immunosuppression in transplant patients. Davis knows that the road to successful transplants without immunosuppression will be paved with research.
“There’s a lot of regulations, and rightly so, in regards to the FDA for some of these regenerative medicine treatments because they could, theoretically, for instance, cause cancer,” Davis says, stating that research is the key to bringing transplant technology to patients. “The potential is clearly there to enhance healing and there’s no limit to what can be done with regenerative medicine using stem cells, matrices and growth factors.”
In the future, Davis hopes to be able to manipulate donor tissue instead of the transplant recipient’s system to avoid these potential side effects.
“If we can unlock the whole immune modulation and eliminate the need for immunosuppression, then you can reconstruct like tissues with like tissues,” Davis says.
Much of the work Davis does is empirical. When a treatment works, he looks backwards through the process to figure out why it worked and then tries to enhance the results even more. In one example, Davis performed fat transfers in plastic surgery to reconstruct contour defects in a woman who had a lumpectomy for breast cancer along with radiation treatment. As a result, the radiation rejuvenated the area where stem cells were transplanted along with the transferred fat.
These types of advanced therapies also hold huge potential for the private sector, creating numerous opportunities for commercialization and investment in numerous areas, from treating chronic illness to rehabilitating physical injuries. Some private companies are looking even deeper into the future, working to develop regenerative treatments for debilitating illnesses such as cancer and blindness.
The Importance of Collaboration
Davis’ mission is an honorable one: getting the best possible results for wounded warriors who return from theatre with devastating injuries.
“That’s why I’m here,” he says. “I believe we owe them everything we can do to restore and give them back their lives.”
Davis balances research and clinical work to achieve the best possible results. Right now, he is mostly focused on getting around the need for immunosuppression. To help him achieve this goal, Davis is working with contacts from other disciplines to bring in new ideas and share knowledge.
“Sometimes the best things happen when you get people from a lot of different backgrounds together,” Davis says.
Davis feels that collaboration between researchers, clinicians, engineers, physicists, biologists and surgeons can help expand the depth of work in regenerative medicine and get the best possible outcomes. To this end, he has participated in numerous collaborative events, including a joint event with the University of Texas at San Antonio designed to inspire cooperation within the local medical community to improve care for civilians as well as members of the military.
He has also participated in RegenMed SA, which was designed to bring collaboration to the medical field in San Antonio and move beyond competition between the industrial, academic and military sectors.
This is something Davis also strives for within his own sector as well. In the past, competition between medical researchers in the military has been stiff, as the teams competed for funding. The annual Military Health System Research Symposium now serves to bring these researchers together to share their problems and successes in a more united way.
“The environment has changed quite dramatically where we now collaborate more than we compete,” Davis says.
Stepping away from Texas, Davis has worked with the transplant team at the University of Pittsburgh to swap surgical expertise for engineering know-how and combine resources to further improve research and results.
Davis will be a presenter at the World Stem Cell Summit in San Antonio, hoping to share his mission for reconstructive transplantation on a worldwide stage in an attempt to further push research in regenerative medicine to reach the best possible results.
The Future of Regeneration
The military applications of regenerative medicine are where Davis’ passions lie. His father was in the Air Force, and Davis was born on a military base. In college, he developed an interest in biology and medicine and dedicated the remainder of his extensive education to serving injured service members.
“I could be doing restorative medicine outside of the military, but it wouldn’t have the drive that this work does,” Davis says. “The impetus wouldn’t be there.”
Despite Davis’ dedication to treating wounded warriors, he strongly believes that moving forward in the field of regenerative medicine holds far-reaching benefits for injured civilians as well. Whether injuries have been caused by an automobile accident, cancer or an IED, regenerative medicine can be the key to restoring proper function to any tissue that has been lost or severely damaged.
“People come up to me and say thank you for your service, but I don’t see myself as a hero at all,” Davis says, modestly. “These are the people who risk their lives every day and suffer devastating injuries … I just take care of them to get the best outcome, which they deserve.”
May 16, 2015 Comments Off on The Texas Migration Miracle
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