Understanding the Role of the Immune System in Improving Tissue Regeneration Proceedings of a Workshop (2022) / Chapter Skim
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1 Introduction
1 Introduction
Pages 1-6
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During normal homeostasis processes, such as cell turnover, the immune system's essential role in facilitating tissue repair and regeneration is well characterized. However, in the context of a cell-damaging event, such as injury, less is known about the specific mechanisms that activate the immune system to shift the balance toward tissue regeneration.
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Among the fundamental research questions to be explored are whether modulating a patient's own immune system could improve regenerative medicine outcomes and, more broadly, whether the use of regenerative medicine approaches to activate the immune response and promote tissue repair could feasibly contribute to therapeutic success. To address these and other gaps in the understanding of promising approaches to manipulate the immune system and/or the regenerative medicine product to improve outcomes of tissue repair and regeneration in patients, the Forum on Regenerative Medicine at the National Academies of Sciences, Engineering, and Medicine convened a two-day virtual public workshop titled "Understanding the Role of the Immune System in Improving Tissue Regeneration." During the workshop, participants explored open questions about the role of the immune system in the success or failure of regenerative medicine therapies.
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organ or bone marrow transplantation) about the role of the host's immune system in accepting a graft to inform whether manipulation of a graft can impact the acceptance or rejection of it; • topics such as potential approaches for modulating critical immune system pathways and communication mechanisms between the immune system and damaged and/or diseased tissues; • the application of these lessons learned to the development and use of re generative medicine products, for example: ˚ biomarkers what immune factors and pathways play a role in regeneration; ˚ status or response that may be useful for assessing a patient's immune to regenerative medicine therapies; ˚ modify immune responses; and scaffolds, biomaterials, and other bioengineering tools that may ˚ imaging technologies to leverage immune surveillance in patients and evaluation of the results of regenerative therapies.
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In her remarks, Nadya Lumelsky, chief of the Integrative Biology and Infectious Diseases Branch and director of the Tissue Engineering and Regenerative Medicine Research Program at the National Institutes of Health's National Institute of Dental and Craniofacial Research, provided an orientation to the workshop. The goal of regenerative medicine is to repair and regenerate tissues compromised by disease, injury, or aging.
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She recalled compelling stories shared by parents during a previous workshop convened by the Forum on Regenerative Medicine to explore novel clinical trial designs for gene-based therapies, in which parents described experiences their children endured with immune suppression protocols for genebased therapies (NASEM, 2020)
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. Speakers discussed the interaction between the microbiome and graft-versus-host disease, the potential to engineer direct differentiation in pluripotent stem cells to mesenchymal stem cells, and the value of a reverse translation approach -- "from bench to bedside and back to the bench" -- in developing therapies with better patient outcomes.
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