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Regenerative Medizin

Chancen für die rekonstruktive Kopf-Hals-Chirurgie

Regenerative Medicine in head and neck reconstructive surgery

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Zusammenfassung

Die Verwendung autologer Transplantate gilt als Goldstandard in der Therapie kongenitaler oder erworbener Defekte. Die Gewinnung autologer Transplantate ist jedoch oft limitiert. Die regenerative Medizin zielt auf die intrinsischen, autologen regenerativen Mechanismen des Individuums und vereint die Kentnisse des Tissue-Engineerings, der Zell- bzw. Systembiologie, der Gentherapie und der Stammzellbiologie. Die meisten Ansätze des Tissue-Engineerings basieren auf der Expansion kleiner autologer Zellverbände des Patienten. Tissue-Engineering mit Hilfe von isolierten und amplifizierten Stammzellen stellt eine weitere vielversprechende Möglichkeit zur Herstellung autologer Transplantate dar und so die limitierte Verfügbarkeit zu überwinden. Die Kombination stammzellbasierten Tissue-Engineerings mit der Gentherapie erlaubt es, regeneratives Gewebe im optimalen Umfeld von Regulatorproteinen zu schaffen. Hieraus ergeben sich große Chancen für die Transplantation von Haut, Knochen oder Knorpel. In diesem Beitrag sollen der aktuelle Stand, der mögliche Nutzen, aber auch die Grenzen der regenerativen Medizin für die rekonstruktive Kopf-Hals-Chirurgie herausgestellt werden.

Abstract

Autologous transplantation is regarded as the gold standard in the treatment of congenital or acquired deformities. However, the availability of autologous tissue for transplantation is often limited. Regenerative medicine aims to activate individuals’ own intrinsic regenerative mechanisms and embraces tissue engineering, cell/system biology, gene therapy and stem-cell biology. Most approaches in tissue engineering are based on the expansion of small autologous cell aggregates. Tissue engineering supplemented by isolated and amplified stem cells is another very promising option for producing autologous transplants and getting over the limited availability. The association of stem cell-based tissue engineering and gene therapy allows the creation of regenerative tissue in the optimal ambience of regulatory proteins. This leads to great opportunities in the transplantation of skin, bones or cartilage. This paper presents the current status and the possible benefits, but also the limitations, of regenerative medicine in reconstructive surgery of the head and neck.

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  1. Universitäts-HNO-Klinik Mannheim, Theodor-Kutzer-Ufer, 68135, Mannheim, Deutschland

    F. Riedel, U.R. Goessler, J. Stern-Straeter & K. Hörmann

  2. Klinik für Hand-, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, BG-Unfallklinik Ludwigshafen, Klinik für Plastische und Handchirurgie an der Universität Heidelberg, Ludwigshafen, Deutschland

    K. Riedel

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Riedel, F., Goessler, U., Stern-Straeter, J. et al. Regenerative Medizin. HNO 56, 262–274 (2008). https://doi.org/10.1007/s00106-007-1604-y

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