ByKristin Hanson
This article was originally published on Nov. 8 on giving.jhu.edu
Between 2001 and the beginning of 2018, more than 1,500 U.S. military service members lost limbs in the line of duty. Although technology has improved the prosthetic devices these people can use, a stubborn obstacle remains: the fragility of human skin.
"Skin was never meant to hold this kind of pressure," says Lee Childers, the senior scientist for the Extremity Trauma and Amputation Center of Excellence at Brooke Army Medical Center in San Antonio, Texas.
"Think about it like a blister on your foot. It's painful, but you can still get by," he continues. "In an amputation, it's a blister on your residual limb. You can't use your prosthesis until the blister is completely healed. If it's your leg [that is affected], you can't walk for two or three weeks. Think about how that would impact your life."
What if there were a way to make the skin at an amputation site tougher, like the palm of your hand or the sole of your foot? Luis Garza, an associate professor of dermatology at Johns Hopkins and leader of the Veteran Amputee Skin Regeneration Program, is developing a cell therapy that could enable prosthetics wearers to use their devices longer.
"This is an example of personalized medicine," Garza says. "We're taking each person's own cells, growing them up, and inserting them back in."
Garza's postdoctoral research focused on skin stem cells. In 2009, he and his department chair, Sewon Kang, began having conversations about how that work could help the increasing numbers of veterans coming back from war with amputations. Garza and his team received grants from the U.S. Department of Defense, National Institutes of Health, and Maryland Stem Cell Fund that have moved the program forward in the past decade.
Garza's team spent the summer of 2019 testing "normal" subjectsthose without amputationsto perfect the procedure, including the dose, content, method, and frequency of the injections. During one appointment, members of Garza's team took biopsies of skin from a subject's scalp and sole. The cells went to a lab where they were grown under an FDA-approved protocol and passed through quality control tests.
In a second appointment, subjects completed a questionnaire and underwent baseline measurements of their skin's thickness and strength. Garza's team then injected a site on the subjects' skin with the stem cells grown from their cells in the lab.
Image caption: Luis Garza, associate professor of dermatology at Johns Hopkins, leads the Veteran Amputee Skin Regeneration Program.
"We're hoping that these stem cell populations will engraft in the new skin," Garza says.
The subjects returned to Hopkins several months later to go through the questionnaire and measurements once more, and Garza's team documented changes.
Confident in the results they gleaned from the normal subjects, Garza's team enrolled its first subject with an amputation in August. Moving from the normal population to the amputation-affected population quickly unearthed some aspects of the therapy Garza didn't anticipate.
"When we talked with him, he said 'I don't want to mess with my one remaining footdo you have to take skin from there?' And we said, 'Actually, no, we could do your palm,'" Garza says.
His team then tested the biopsy and growth of palm cells from subjects in the normal population. "We're moving away from having our product informed purely by biology to letting our therapy development be shaped by the user."
Although federal grants have supported much of the program's progress, private philanthropy has played a role, too. Corporations like Northrop Grumman, foundations like the Alliance for Veteran Support, and grateful patients with and without ties to the armed forces have contributed nearly $300,000. Those gifts have enabled the program to persevere through gaps between federal grants.
Private funds will be increasingly important as the project enters its next phase: extension to military medical centers around the country. Garza's team must prove that the safeguards to protect cells on their round-trip voyage from a test site to Hopkins are effective. They also must secure approval by local institutional review boards for clinical studies.
"Soldiers are used to getting orders, but you can't order someone to be part of a [medical] study," Garza says. "There are hard medical ethics questions around how to make this open to them but ensure they don't feel obligated. We've been working on that for a year, and we probably have another six months or so to go."
Childers stands ready for whenever the program's extension is a go. He will lead the study at Brooke Army Medical Center and feels motivated by the prospect of helping many of the veterans he works with every day.
"We do everything we can to serve those who serve us. This can enable people to return to duty and be redeployed if they choose," he says. "This is game-changing technology that will have an impact for our service members, but also others who live with amputation."
That population includes the hundreds of thousands of Americans who've undergone amputations for complications of diabetes, who must use a wheelchair, or who wear ankle or foot orthoses for help with walking, among others.
"Having the ability to transform skin anywhere you want to target on the body will have gigantic implications across the entire spectrum of our society in many ways," Childers says.
There's a lot of work to be done before such benefits reach the public, Garza cautions. With continued support from donors and the military community, though, he's optimistic about the program's future.
"The challenges are pretty big, but I think within five years, it could happen," he says. "That's the hope."
Disclaimer: The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of the Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force and Department of Defense or the U.S. Government.
Here is the original post:
Serving those who serve - The Hub at Johns Hopkins
- 001 Jaenisch: Stem cells [Last Updated On: November 29th, 2011] [Originally Added On: November 29th, 2011]
- 002 2011 Summit: Stem Cells, Reprogramming and Personalized Medicine, Rudolf Jaenisch, MD - Video [Last Updated On: December 15th, 2011] [Originally Added On: December 15th, 2011]
- 003 Craig Venter: Understanding Our Genes - A Step to Personalized Medicine | CIRM Spotlight on Genomics - Video [Last Updated On: January 29th, 2012] [Originally Added On: January 29th, 2012]
- 004 'Personalized medicine' gets $67.5M research boost [Last Updated On: January 31st, 2012] [Originally Added On: January 31st, 2012]
- 005 Harper government invests in personalized medicine [Last Updated On: January 31st, 2012] [Originally Added On: January 31st, 2012]
- 006 Statement - Rx&D Applauds Government of Canada for Investing in Personalized Medicine [Last Updated On: February 1st, 2012] [Originally Added On: February 1st, 2012]
- 007 Study Identifies Cell Subtypes For Potential Personalized Cellular Therapies [Last Updated On: May 11th, 2012] [Originally Added On: May 11th, 2012]
- 008 New UConn Health Center Chief Looks Ahead [Last Updated On: May 29th, 2012] [Originally Added On: May 29th, 2012]
- 009 Personalized Medicine - A Global Market Overview [Last Updated On: August 17th, 2012] [Originally Added On: August 17th, 2012]
- 010 Research and Markets: Personalized Medicine - A Global Market Overview [Last Updated On: August 17th, 2012] [Originally Added On: August 17th, 2012]
- 011 Companion Diagnostics and Personalized Medicine Market Report 2012: Twease.org [Last Updated On: August 24th, 2012] [Originally Added On: August 24th, 2012]
- 012 Timothy J. Triche, MD PhD DBRM Retreat 2012 Genomics and Stem Cell Research - Video [Last Updated On: November 1st, 2012] [Originally Added On: November 1st, 2012]
- 013 Keynote Speaker: Daniel Kraft • Presented by SPEAK Inc. - Video [Last Updated On: November 8th, 2012] [Originally Added On: November 8th, 2012]
- 014 GNS Healthcare, Dana-Farber and Mount Sinai Collaborate to Build Computer Model of Multiple Myeloma [Last Updated On: November 9th, 2012] [Originally Added On: November 9th, 2012]
- 015 Nina Tandon: Could tissue engineering mean personalized medicine? - Video [Last Updated On: December 7th, 2012] [Originally Added On: December 7th, 2012]
- 016 Pastor Chui Adult Stem Cell Breakthroughs Continue - Video [Last Updated On: December 19th, 2012] [Originally Added On: December 19th, 2012]
- 017 Spotlight on Genomics: Understanding Our Genes - A Step to Personalized Medicine - Video [Last Updated On: June 2nd, 2013] [Originally Added On: June 2nd, 2013]
- 018 STEM CELLS Groundbreaking Discovery. The FUTURE of Personalized Medicine ? - Video [Last Updated On: February 2nd, 2014] [Originally Added On: February 2nd, 2014]
- 019 Personalized Medicine Bulletin Personalized Medicine ... [Last Updated On: May 19th, 2015] [Originally Added On: May 19th, 2015]
- 020 Personalized Medicine - Articles [Last Updated On: May 19th, 2015] [Originally Added On: May 19th, 2015]
- 021 Personalized Medicine [Last Updated On: May 19th, 2015] [Originally Added On: May 19th, 2015]
- 022 Personalized Medicine Coalition precision medicine [Last Updated On: May 19th, 2015] [Originally Added On: May 19th, 2015]
- 023 Personalized medicine and pharmacogenomics - Mayo Clinic [Last Updated On: May 21st, 2015] [Originally Added On: May 21st, 2015]
- 024 Personalized Medicine - Food and Drug Administration [Last Updated On: May 21st, 2015] [Originally Added On: May 21st, 2015]
- 025 Personalized Medicine - Information and Resources [Last Updated On: May 21st, 2015] [Originally Added On: May 21st, 2015]
- 026 Personalized Medicine and its Impact in the Clinic [Last Updated On: May 31st, 2015] [Originally Added On: May 31st, 2015]
- 027 The Koch Institute: Personalized Medicine - David ... [Last Updated On: May 31st, 2015] [Originally Added On: May 31st, 2015]
- 028 Personalized medicine could mean big business for D.C ... [Last Updated On: June 1st, 2015] [Originally Added On: June 1st, 2015]
- 029 How An Integrated Data Approach will Impact Personalized ... [Last Updated On: June 12th, 2015] [Originally Added On: June 12th, 2015]
- 030 Conquering Cancer: Personalized Medicine Is the Future ... [Last Updated On: June 20th, 2015] [Originally Added On: June 20th, 2015]
- 031 The Promise of Personalized Medicine - Vanderbilt Magazine [Last Updated On: June 27th, 2015] [Originally Added On: June 27th, 2015]
- 032 Personalized Medicine, Targeted Therapeutics and Companion ... [Last Updated On: June 28th, 2015] [Originally Added On: June 28th, 2015]
- 033 Pharmacogenomic Testing Services | Personalized Medicine ... [Last Updated On: August 1st, 2015] [Originally Added On: August 1st, 2015]
- 034 Personalized Medicine and Cancer Companion Diagnostics [Last Updated On: August 5th, 2015] [Originally Added On: August 5th, 2015]
- 035 Enthusiasm for personalized medicine is premature ... [Last Updated On: August 9th, 2015] [Originally Added On: August 9th, 2015]
- 036 Personalized Medicine Conferences | Europe | Worldwide ... [Last Updated On: September 5th, 2015] [Originally Added On: September 5th, 2015]
- 037 Personalized Medicine News -- ScienceDaily [Last Updated On: September 10th, 2015] [Originally Added On: September 10th, 2015]
- 038 Welcome to the Indiana Institute for Personalized Medicine [Last Updated On: October 7th, 2015] [Originally Added On: October 7th, 2015]
- 039 Personalized medicine - ScienceDaily [Last Updated On: October 9th, 2015] [Originally Added On: October 9th, 2015]
- 040 Center for Personalized Medicine | Roswell Park Cancer ... [Last Updated On: October 20th, 2015] [Originally Added On: October 20th, 2015]
- 041 Icahn School of Medicine at Mount Sinai - New York City ... [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 042 Clinical Pharmacology & Therapeutics - Wiley Online Library [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 043 Perelman School of Medicine at the University of Pennsylvania [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 044 Personalized medicine: The way forward? - Medical News Today [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 045 Medicine - Wikipedia, the free encyclopedia [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 046 University of Maryland School of Medicine [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 047 Personalized medicine - Bio-Medicine - latest biology and ... [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 048 Personalized Medicine | Labcyte Inc. [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 049 Patent Docs: Personalized Medicine [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 050 Personalized Medicine SFSU [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 051 NIHSeniorHealth: Taking Medicines - Personalized Medicines [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 052 What Is Personalized Cancer Medicine? | Cancer.Net [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 053 Personalized Medicine | Breast Cancer New York & LA [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 054 Precision Medicine - Food and Drug Administration [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 055 Personalized Medicine Conference | Medical Events | 2016 ... [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 056 Personalized Medicine: How the Human Genome Era Will Usher ... [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 057 Personalized Medicine: Redefining Cancer and Its Treatment [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 058 Personalized medicine: Precise genomic solutions for disease [Last Updated On: August 4th, 2016] [Originally Added On: August 4th, 2016]
- 059 Genome | What Is Personalized Medicine [Last Updated On: August 28th, 2016] [Originally Added On: August 28th, 2016]
- 060 Worlds Leading Genomics Conference | Global Meetings ... [Last Updated On: August 31st, 2016] [Originally Added On: August 31st, 2016]
- 061 Worlds Leading Biomarkers Congress | CPD Points ... [Last Updated On: September 19th, 2016] [Originally Added On: September 19th, 2016]
- 062 Personalized Medicine - Swedish Medical Center [Last Updated On: November 29th, 2016] [Originally Added On: November 29th, 2016]
- 063 What Is Personalized Medicine? [Last Updated On: November 30th, 2016] [Originally Added On: November 30th, 2016]
- 064 We Just Got Two Steps Closer to Personalized Cancer Vaccines ... - Mental Floss [Last Updated On: July 5th, 2017] [Originally Added On: July 5th, 2017]
- 065 Personalized Medicine Summit Personalized Medicine ... [Last Updated On: July 5th, 2017] [Originally Added On: July 5th, 2017]
- 066 CURE Pharmaceutical & Therapix Biosciences Signs MOU with Israel's Assuta Medical Center to Develop First-in ... - New Cannabis Ventures (blog) [Last Updated On: July 12th, 2017] [Originally Added On: July 12th, 2017]
- 067 Personalized Medicine Extending to Supportive Needs of Brain Tumor Patients/Caregivers - PR Newswire (press release) [Last Updated On: July 12th, 2017] [Originally Added On: July 12th, 2017]
- 068 Targeted therapy and personalized medicine in hepatocellular ... - Dove Medical Press [Last Updated On: July 12th, 2017] [Originally Added On: July 12th, 2017]
- 069 Growing Demand for Personalized Medicine Driving Therapeutic Drug Monitoring Market - Digital Journal [Last Updated On: August 2nd, 2017] [Originally Added On: August 2nd, 2017]
- 070 MedStar Health Collaborates With Indivumed to Advance Precision Oncology Research - Markets Insider [Last Updated On: August 2nd, 2017] [Originally Added On: August 2nd, 2017]
- 071 Biomedical informatics gets a boost with $2.5 million grant - UB News Center [Last Updated On: August 5th, 2017] [Originally Added On: August 5th, 2017]
- 072 Medicine Is Getting More Precise For White People - FiveThirtyEight [Last Updated On: August 5th, 2017] [Originally Added On: August 5th, 2017]
- 073 Ben-Gurion University scholars uncover the secret to personalized medicine - The Jerusalem Post [Last Updated On: August 5th, 2017] [Originally Added On: August 5th, 2017]
- 074 A Cancer Conundrum: Too Many Drug Trials, Too Few Patients - New York Times [Last Updated On: August 14th, 2017] [Originally Added On: August 14th, 2017]
- 075 PRODIGE: PRediction models in prOstate cancer for personalized meDIcine challenGE. - UroToday [Last Updated On: August 14th, 2017] [Originally Added On: August 14th, 2017]
- 076 Biovista expands Project Prodigy collaborations in personalized medicine - Markets Insider [Last Updated On: August 14th, 2017] [Originally Added On: August 14th, 2017]
- 077 Computing cancer - Pamplin Media Group [Last Updated On: August 17th, 2017] [Originally Added On: August 17th, 2017]
- 078 NIH gives nod to Vibrent Health for precision medicine work - Healthcare IT News [Last Updated On: August 17th, 2017] [Originally Added On: August 17th, 2017]
- 079 Global Research Antibodies Market 2017-2022 - Increasing Demand for Personalized Medicine and Protein ... - PR Newswire (press release) [Last Updated On: August 17th, 2017] [Originally Added On: August 17th, 2017]
- 080 The Entire Medical Industry Is About To Change - ValueWalk [Last Updated On: August 19th, 2017] [Originally Added On: August 19th, 2017]