Scaffolds in Tissue Engineering
This article was originally published in Start Up
Stem-cell-related strategies may predominate these days in tissue engineering, but cell therapy companies know that providing the right microenvironment for nurturing tissue growth remains a difficult and essential challenge. Thus, start-ups remain committed to the developent of cellular matrices that provide the appropriate structure, environment, and bioactivity to encourage tissue growth. The four start-ups profiled in this issue represent a cross-section of strategies.
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If there's one word that ought to sum up the goal of cell therapy today, it's sustainability. Certainly that's the hope of using living cells to restore health and function to diseased tissues so that they perform as the body intended them to. But more to the point, in today's tough financing environment for venture-capital-backed start-ups, sustainability is the watchword for companies facing 15- to 20-year development curves. Tissue-engineered three-dimensional organs are complex, decades-long projects. Embryonic stem cells are much simpler in concept but are far from a commercial reality. Between those two extremes of tissue-engineering, however, there exist some well-defined opportunities, notably in the treatment of blood vessel disease. Start-ups Pervasis and Cytograft are gaining clinical validation in those areas.
Technologies for total joint repair, the backbone of the orthopedics industry, have occupied most of the development resources of orthopedic companies, but there are gaps in the continuum of care when it comes to tendon and ligament repair. ACL reconstruction and rotator cuff repair thus are attractive niches for start-ups, worth anywhere from $500 million to $1 billion. Soft tissue repair expertise is outside the core skill-sets of big ortho, but those companies have been willing to partner and acquire smaller innovative players. Today, the opportunity is even more attractive; sports medicine--the realm of soft tissue repair--enjoys an economic resiliency not seen in total joint replacement. Ligament tears more closely resemble trauma applications, which must be treated as soon as possible.
Dermagraft is often mentioned as an example of a failure in tissue engineering, illustrating the difficulty of achieving return on investment in this field. The product was only a market failure, however; clinicians say that it worked to heal difficult wounds, and that it was just a product ahead of its time. Now small company Advanced BioHealing has given new life to the bioengineered dermal substitute, abandoned by Smith & Nephew, by supporting it with the focus, and the unique marketing and manufacturing skills that tissue-engineered products require. In the process, it believes it has created assets and skill-sets from which other tissue-engineering start-ups might benefit.