By: Rear Adm. Michael Anderson, U.S. Navy
The Medical Officer to the U.S. Marine Corps
Rear Adm. Michael Anderson, U.S. Navy The Medical Officer to the U.S. Marine Corps
The most significant challenge in the coming decades will be to care for wounded from today’s wars and Navy medical research has made many notable enhancements in battlefield medical care and we continue to make new discoveries that will help our wounded men and women.
In recent years, we have discovered many new innovations including improvements to wound management, heterotopic ossification which is the process by which bone tissue forms outside of the skeleton, and diagnostic imaging of the flow of blood through specific areas of the body that have been wounded. We are now making some good progress in regenerative medicine.
Certain types of animals such as newts and starfish have the ability to regrow limbs that are lost due to amputation. Fetal tissue maintains the ability to regenerate and certain adult tissue does as well, the liver for example. But this ability has been lost in higher animal species.
About 15 years ago, a discovery by Ellen Heber-Katz at the Wistar Institute in Philadelphia brought tissue regeneration a step closer to reality in mammals. She discovered that a certain type of mouse that had been used for several years to study Lupus had the ability to regrow small injuries to the ear. She observed ear hole punching lead to complete closure and regeneration of cartilage, muscle, skin and even hair.
This discovery demonstrated regeneration was possible in adult mammals. The science of tissue and limb regeneration or Regenerative Medicine spring-boarded from her observation.
The Navy launched a research effort in 2004 to characterize these “regenerating” mice to see why they had this ability but similar mice did not. This effort became the Regenerative Medicine Department at the Naval Medical Research Center (NMRC), Silver Spring, Maryland. The Regenerative Medicine Department conducts pioneering work from studies of the “regenerating” mice to growing new tissues such as bone or cartilage in the laboratory from adult stem cells.
While the ability to regrow limbs in injured people may be years away, NMRC scientists have applied the discoveries made in the biology of stem cells and tissue regeneration to studies in wound healing and enhancing the care of wounded warfighters. We have determined that many factors such as site and severity of injury play a role in determining if regeneration of tissue such as skin occurs and that these need to be considered in the larger context of the inflammatory response to injury, such as battlefield trauma.
The translation or application of basic science into the practice of medicine has become a cornerstone effort for the department. We now have a better understanding of how wounds heal and can predict which wounds will develop complications.
In parallel with these efforts several military and civilian groups have undertaken similar approaches to understand the body’s ability to heal. These efforts have included such experiments to regenerate bone, skin, nerves, and transplant tissues; and repair burned tissue.
All of these approaches aim to direct our intrinsic ability to restore function which has been programmed in our genetic code but has been either lost as we evolved or impaired by environmental factors. If this ability is even partially realized the potential for both treating military wounds and medicine as a whole is enormous.
However with all such efforts, time and diligence is needed to reach such a potential but will continue to work diligently in this field of research as our people deserve nothing less than our best.
Editor’s note: The U.S. Navy Medical Department provides all care of the U.S. Navy, Marine Corps, their families and veterans
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