ROBERT SIEGEL, host:
Now, a striking achievement by doctors in Europe. The doctors rebuilt part of woman's windpipe using her own stem cells. The procedure saved the woman's lung, and it's one indication that stem cells can be useful in regenerating tissue. NPR's Joanne Silberner explains.
JOANNE SILBERNER: Thirty-year-old Claudia Castillo had a history of tuberculosis. It scarred her airways to the point where she could barely breathe. The only conventional option was losing one of her lungs, says Anthony Hollander of University of Bristol in England, or a lung transplant and long-term anti-rejection treatment.
Professor ANTHONY HOLLANDER (University of Bristol, England): That would have had devastating consequences for her quality of life and her life expectancy. And for a young mother, 30 years old, with two children, that was really not a good outlook at all.
SILBERNER: Hollander was one of a team of researchers from England, Spain and Italy who decided that the best thing they could do for Castillo was to replace a damaged part of her windpipe with a trachea engineered in the laboratory. They started with a trachea from an organ donor. The plan was to strip the tissue from the trachea, leaving just fibrous tissue behind to serve as a scaffold. Then they would coat that with stem cells taken from bone marrow in Castillo's hip. The hope was that the stem cells would produce a windpipe that they could transplant and one that Castillo's body wouldn't reject.
Professor HOLLANDER: We knew we had all the right range of techniques, but we really didn't know if we were going to be able to make them all work together at the same time in a way that was going to be effective for the patient. It was a really uncertain outcome.
SILBERNER: It took a lot of cooperation. Hollander and his colleagues, for example, prepared the stem cells in England. An Italian team developed the technique for growing the cells on the scaffolding. At that point, the action moved to Spain.
Professor HOLLANDER: Once in Barcelona, the cartilage cells were seeded onto the surface of the donor windpipe, which had already had the donor cells removed.
SILBERNER: Castillo received the engineered airway in June. Today, she's reportedly breathing just fine. The research is described in the online version of the journal "The Lancet." Castillo's problem is a rare one. It hits maybe a few hundred people a year in the U.K., a few thousand in Europe. But airways damage can come from many causes - cancer, trauma, or people can be born with problems. So there are lots of people trying to figure out how to generate healthy windpipes, including Anthony Atala, head of the Wake Forest Institute of Regenerative Medicine. He's using fully developed cells, though, rather than stem cells. In both procedures, the point is to avoid rejection.
Dr. ANTHONY ATALA (Director, Wake Forest Institute of Regenerative Medicine): These technologies are basically using the patient's own cells so there are really no major issues in terms of taking donor cells or cells from other sources.
SILBERNER: Embryos, specifically, which have proved quite controversial. Eric Genden of Mount Sinai Medical Center says he's done 12 airways implants using fully grown cells.
Dr. ERIC GENDEN (Mount Sinai Medical Center): When we see something like this, we're excited, but we are also very careful because short-term results, while exciting, are not the end result. The end result is going to be long-term function.
SILBERNER: And he says there's no other way than trying different procedures to see which one works best. In the U.K., Anthony Hollander says two more volunteers are lined up for the stem cell procedure, and if things go well, their research group would like to move up to the voice box. But for that one, they'll need to get not only airway cells to grow, but muscle cells as well. Joanne Silberner, NPR News.
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