Cognitive dysfunction, sometimes called “chemo brain,” stemming from chemotherapy is a major adverse condition affecting approximately 14 million cancer patients and survivors in the United States. Although chemo brain has been widely reported by patients and clinicians, the cause of concentration and memory problems in cancer patients is not well understood. Mayo Clinic researchers are studying these effects in preclinical models in search of answers.
“Chemo brain is a frustrating side effect of cancer
treatments,” says Mi-Hyeon Jang, Ph.D., associate professor of neurosurgery and
assistant professor of biochemistry and molecular biology at Mayo Clinic. “Patients
affected by chemo brain describe debilitating thinking and memory problems,
including learning, memory and attention.”
Dr. Jang’s work to understand the cognitive deficits experienced by patients with cancer is funded by Regenerative Medicine Minnesota. This understanding will provide insight into development of novel therapeutic interventions that prevent cognitive dysfunction, resulting in a better quality of life for cancer survivors. To learn more, about Dr. Jang’s research in regenerative medicine, watch this video:
Families, researchers and clinicians recently came together to
raise awareness and celebrate how regenerative research enhances the lives of
individuals with Hypoplastic
Left Heart Syndrome (HLHS), a rare
congenital heart disease.
HLHS is a rare and complex form of congenital heart disease in
which the left side of a child’s heart is severely underdeveloped. Regenerative
medicine strategies for HLHS is one of several approaches the Center
for Regenerative Medicine is studying that
goes beyond disease management to search for and discover therapies that
support the body in repairing, regenerating and restoring itself to a state of
Kids with HLHS, “often don’t meet other people like
themselves,” according to Brianna Tranby, senior research program coordinator
in the Todd
and Karen Wanek Family Program for Hypoplastic Left Heart Syndrome. That’s one reason the annual — and cleverly named — “Feel
the Beat” event is something of a homecoming for HLHS patients and their
families, the HLHS research coordinator tells us. “We had 142 attendees
this year,” she says. “Many had attended the event previously, but
some were first-timers who had never met someone else with HLHS.”
The event was created in 2013 as a way to “bring HLHS families together and thank research participants for their contributions” to ongoing HLHS research, Tranby says. This year, one of those research participants took center stage, literally and figuratively. Naomi Babcock’s story shows how much someone living with HLHS is capable of achieving despite the physical and emotional tolls of the rare condition.
“Naomi is an
18-year-old high school senior with HLHS who’s in full-time training to be a
professional ballerina,” Tranby tells us. During a panel discussion at the
event, Naomi and her mom, Kelly, talked about Naomi’s experiences “growing
up with HLHS, the physical demands ballet has had on her body, and what it’s
been like for her to leave home and take care of herself while also managing
Then Naomi showed her
fellow patients just what was possible, performing a ballet routine for those
attending the event. “I think it was important for other people with HLHS to
see that so they know HLHS is something you can actually live with,” Tranby
says. “You can live to adulthood and still do physical activities. That’s
something that’s really important to our HLHS program at Mayo Clinic and is
what inspires the groundbreaking research we’re doing.”
That research is something Tranby tells us Mayo Clinic cannot do
on its own. “The Todd and Karen Wanek
Family Program for HLHS was started at Mayo
Clinic in 2010,” she says. “Because the condition is so rare, no
single hospital sees many HLHS patients, which makes research challenging.”
So in 2017, Mayo Clinic created a nationwide HLHS Consortium to align centers of excellence and collaborate in clinical
trial research. The consortium, now
up to eight members, includes both hospitals
and patient/family advocacy groups with the shared goal of improving the lives
of people with HLHS through research.
People like Naomi Babcock and 140-some friends who attended this
year’s “Feel the Beat” event.
Platelets spun from a person’s own blood may be a new option for treating baldness in women, according to research at Mayo Clinic’s Florida campus. A pilot study found platelet rich plasma (PRP), a regenerative therapy associated with natural growth factors and tissue healing, regrows hair as well as other treatments on the market. The findings could lead to new options for hair restoration beyond the pills or creams currently available.
occurs when the cycle of hair growth and shedding is disrupted or when the hair
follicle is damaged. There are several causes of hair loss, and not all
treatments work for all hair loss.
alopecia is a type of hair loss known as male- or female-patterned hair loss.
Researchers at Mayo Clinic’s Florida campus recently completed a clinical trial
designed to validate platelet rich plasma to treat hair loss in women. The
results, published in Journal of Dermatological Surgery, found PRP to be effective in
regrowing hair when injected into the skin of the scalp.
alopecia is a challenging problem to treat, and many women are affected by this
disorder,” says Alison Bruce, M.B., Ch.B., a Mayo Clinic dermatologist and
principal investigator of the study. “It is typically very distressing to
women, and there are limited treatment options currently available.”
the current standard of care, is a topical treatment option. However, Dr. Bruce
says the required daily application makes it difficult for patients to use. Alternatively,
PRP uses the body’s own restorative capability to help restore and maintain
hair growth. In this treatment, platelets are isolated from the patient’s own
blood. The resulting concentrated platelets are then injected into the scalp.
In a randomized control trial,
researchers followed 19 women with female pattern baldness. The participants
used topical minoxidil for 12 weeks followed by an 8-week washout between
treatments and PRP scalp injections for 12 weeks.
The Mayo Clinic study uses a high resolution camera and software to digitally count hairs, hair thickness, and hair density.
“Interestingly, both the PRP treatment and minoxidil worked to regrow hair,” says Shane Shapiro, M.D., medical director of the Regenerative Medicine Therapeutics Suites on Mayo Clinic’s Florida campus and co-principal investigator. “We now have scientific evidence that PRP works to temporarily regrow hair, offering patients more options for the treatment of hair loss due to androgenetic alopecia.”
found 21% of the volunteers had bruising or discomfort after PRP, but overall
patient satisfaction was higher when treated with PRP than the minoxidil
treatment. No adverse effects were reported during minoxidil treatment.
“Many dermatology, cosmetic and
regenerative medicine practices commonly promote PRP’s hair regenerating
effect, but more study was needed to prove this,” says Dr. Shapiro. “Our
research supports current literature confirming that PRP is effective in
increasing overall hair count.”
Mayo Clinic Center for Regenerative Medicine seeks to translate regenerative therapies into the clinical practice. This is another example of how regenerative approaches may fill treatment gaps and provide patients additional choices for their health care. The study’s conclusions that both PRP and minoxidil can help regrow hair, may open new opportunities for Mayo Clinic physicians to combine these therapies for possible greater benefit than that of either treatment alone.
A regenerative approach to facial surgery is offering new hope for restoring form and function for people who’ve suffered facial trauma or skin cancer. Skin cancer is the most common form of cancer in the United States, according to the Centers for Disease Control and Prevention (CDC). And for patients with skin cancer on the head or face, surgery can lead to scarring, disfigurement or loss of function. This is especially true for the nose, which is the most common location for skin cancer, and surgery may be the most effective treatment. Brittany Howard, M.D., a Mayo Clinic otolaryngologist and surgeon at Mayo Clinic’s Arizona Campus, is pioneering a new regenerative application for these patients.
“Historically, patients who’ve had surgery to treat cancer
may require total removal of the nose. Even with the most advanced surgical
techniques, patients were left with a nose that was passing aesthetic, but
often nonfunctioning,” says Dr. Howard. “We take for granted the ability to
breathe through our nose and the personal physical identity it provides.”
A standard approach is to build a “new” nose using skin
transplanted from elsewhere on the body, such as a patient’s wrist. However, because the transplanted tissue
includes the skin, which is not normally present within the nose, there can be
breathing issues over the long-term.
As a facial plastics and reconstruction surgeon that also
specializes in head and neck cancer, Dr. Howard is interested in total nasal
reconstruction that not only looks good, but also restores the ability to
breathe normally through the nasal passages.
Dr. Howard specializes in a new method of reconstructing the
nose that involves using tissue transplanted from an individual’s leg to create
a new nasal skeleton and nasal lining that more closely matches the natural
lining of the nose. In later stages, skin is brought from the forehead to
create the external appearance of the nose. The result is both aesthetic and
Because of Dr. Howard’s dual specialty in both cancer reconstruction
and facial aesthetic surgery, she naturally developed a passionate interest in
complex nasal reconstruction that addressed both the function and the
aesthetics of the nose.
“Beyond treating a cancer, I believe that an individual
should be restored to their prior state of form and function,” says Dr. Howard.
“At Mayo Clinic, through the Center
for Regenerative Medicine, I am able to combine regenerative medicine
science with reconstructive and aesthetic surgery techniques to offer my
patient’s state-of-the-art reconstruction goals.”
To complement this work, Dr. Howard and her team are
researching the use of selective fat grafting in nasal reconstructions. Mainly
used for facial rejuvenation, traditional fat grafts restore volume. However,
fat is also rich in stem cells that can stimulate wound and tissue healing. This
research could be used in nasal reconstruction where nanofat grafts (that
contain optimal levels of stem cells) can be used, not for volume, but instead
to affect tissue healing and final outcomes.
This pioneering surgery is offered in patient care at Mayo’s
More than four million American suffer from chronic end stage liver disease, according to the Centers for Disease Control and Prevention, and a liver transplant can mean the difference between life and death for some patients. However, livers are in short supply, and the number of people awaiting new livers far exceeds the number of donor livers available.
the acute shortage of donor livers, Mayo
Clinic Center for Regenerative Medicine has prioritized developing
bioengineered transplantable human livers. Early research published in the
October 14 edition of Nature Biomedical Engineeringdemonstrates for the first time, that
a clinically relevant tissue-engineered liver graft implanted in pigs shows
indications of vascular function similar to a normal donor liver. The research
solves a critical first step in bioengineering transplantable livers and could
accelerate development of bioengineered organs as a viable alternative to donor
In order to
develop the implantable graph, the pig liver is decellularized – a process
which removes all of the cells from the liver. This creates an empty structure,
called a bio-scaffold with the original architecture, mechanical properties and
vascular network of a normal liver. The bio-scaffold is recellularized with
cell types necessary to restore normal function and blood flow, in this case
research discovered that liver cells in the graft show signs of regeneration
like a normal liver. The endothelial cells that line blood vessels change their
appearance and become liver-like so no anti-coagulation is needed to prevent
clotting of the graft,” says Scott Nyberg, M.D., Ph.D., final author on the paper. “This
discovery gives hope that solutions to the organ shortage are on the horizon.”
stage of the research, the native livers are left in similar to kidney
transplants and the graphs are recelluarized with only endothelial cells. The
next step will be to use both endothelial cells and hepatocytes (liver cells)
and remove the native liver to allow for clinically correct placement of the
Clinic’s research in pigs is preliminary, and is not yet ready for human
studies. The research is a collaboration between Mayo Clinic and Miromatrix
Medical to advance the development of
published work solves a problem, essentially to ability to create a functional
vasculature that could bring nutrients to the engineered tissue and take away
the waste, that has delayed the advancement of creating advanced tissues and
organs to help treat patients,” says Jeff Ross, Ph.D., CEO of Miromatrix. “Having
solved this issue, we are now performing the next important step of
transplanting bioengineered livers with functional liver cells into pigs, a
critical next step in moving the therapy into the human clinical trials.”
Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of your bones wears down over time. While the significant pain, limited activity, and decreased quality of life that affect patients with osteoarthritis can usually be managed, the damage to joints can’t be reversed.
“One regenerative medicine option for those suffering from
osteoarthritis is the use of platelet rich plasma, or PRP,” says Dr. Finnoff. “While
there is mounting evidence that PRP injections may reduce pain and improve
function in people with osteoarthritis, we think we can make it better;
therefore, we’re looking to developing a safer, more effective alternative PRP treatment
PRP is made using a patient’s own blood. After the blood is
drawn, it is spun in a centrifuge which separates the cells and blood into
different layers. The concentrated layer of platelets, which is used for PRP, contains
proteins that are involved in the healing process and may also decrease
inflammation; however, PRP also contains some proteins that might trigger
inflammation of the breakdown of tissue.
“Our study involves trying to remove the inflammatory
proteins and those that might be involved in breaking down tissues from the PRP
so it has a stronger anti-inflammatory and healing affect,” says Dr. Finnoff.
“This is done by attaching proteins to tiny beads that bind to the proteins
that we want to remove from the PRP.”
Once a patient’s PRP product is developed, researchers will
then inject the new “purified PRP” back into the injured area to see if it is
effective to relieve osteoarthritis symptoms.
“Right now we treat osteoarthritis symptomatically with
weight loss, diet, exercise, braces, nutritional supplements, medications,
injections, and joint replacement surgery,” says Dr. Finnoff. “If we can
harness the healing potential of our body more effectively, we may be able to
slow the progression of arthritis or even reverse its course, revolutionizing
the treatment of osteoarthritis.”
Dr. Finnoff discusses his research in the video below:
With growing public awareness and broader academic engagement, the prospect of pioneering a change in disease management has propelled the field of regenerative medicine. The ability to build, scale and apply biotherapeutic technologies and solutions that are not cost prohibitive will become increasingly important elements that drive progress in regenerative medicine.
In a recently
published paper, Mayo Clinic consultants discuss the evolution of
regenerative medicine and the potential for biotherapeutics to revolutionize the
reach of regenerative medicine applications.
“As validated regenerative therapies are increasingly
adopted into the practice, there is an opportunity to evolve the healthcare
paradigm and alter the economics of chronic disease management,” says Andre
Terzic, M.D., Ph.D., the Michael S. and Mary Sue Shannon Director, Mayo
Clinic Center for Regenerative Medicine. “At Mayo Clinic, we are paving the way
with new know-how, technology and infrastructure that will make regenerative
medicine more broadly available.”
therapy was fueled by the discovery and practicality of mining adult stem cells
out of bone marrow and adipose (fat) tissue,” says Atta
Behfar, M.D., Ph.D., the director of the Van Cleve Cardiac Regenerative
Medicine Program at Mayo Clinic. “Until recently, regeneration was largely
associated with the use of stem cells to restore function to damaged tissue.”
With ongoing progress, the current cell-centered focus will
be broadened to encompass next generation advances in the science of
biotherapeutics, including antibodies, cytoengineering, gene encoded therapy
and exosome technologies comprising the regenerative medicine platform of the
“The milestones achieved over the two decade journey of
cardiac regeneration have brought us ever closer to the prospect of biotherapies
as a way to achieve the full potential of disruptive therapies for disease
management,” says Dr. Behfar.
Mayo is developing broader regenerative medicine portfolios to
make this a reality. Advanced product manufacturing is enabling a patient-ready
toolkit to help accelerate broad availability of regenerative medicine to
Today, experts across Mayo Clinic have access to resources
that empower any medical, surgical, laboratory medicine or radiology specialty
to advance new discoveries toward regenerative treatments. By integrating process
development and manufacturing with quality control, regulatory and clinical
trial competence, these translational capabilities collectively position the
Center for Regenerative Medicine as an enabler in revolutionizing patient care.
The infrastructure required to achieve rapid translation of
discoveries into broadly available transformative therapies for patients is
essential to developing the future of medicine. The buildout of the Regenerative
Medicine Therapeutic Suites in Florida, the first Discovery
Square building in Minnesota and the Arizona
Forward project are bringing regenerative medicine to patients in new ways
and allowing for powerful collaboration to exist between Mayo and the world.
The grand opening of One Discovery Square opens a new
chapter in biomanufacturing focused on connecting patients with complex medical
conditions with novel biotherapeutic solutions.
The Mayo Clinic Center for Regenerative Medicine Advanced
Biomanufacturing facility is one of the Mayo tenants in the building focused on
the acceleration of new health care products to market by partnering innovation
When it is fully up and running in One Discovery Square, the
facility will seek to develop first-of-their kind therapeutic products, and
together with industry collaborators, move them quickly from the bench to the
bedside for Mayo patients and then others around the world.
A new era of regeneration, biomanufacturing harnesses
biomaterials and biomolecules for use in medicine. The resulting new generation
of health care products has the potential to bring new treatment options to
“In biomanufacturing, technologies have historically come
with significant cost of manufacturing,” says Atta
Behfar, M.D., Ph.D., a cardiologist and deputy director of translation for
the Center for Regenerative Medicine. “Forged with the vision of industry
collaboration, the goal for Discovery Square is to establish transformative
biomanufacturing platforms that will ultimately connect patients with
untreatable conditions with accessible curative technologies.”
The Center for Regenerative Medicine Advanced
Biomanufacturing facility is led by Dr. Behfar and Andre
Terzic, M.D., Ph.D., the Michael S. and Mary Sue Shannon Director, Mayo
Clinic Center for Regenerative Medicine.
“The effort in One Discovery Square will allow us to forge
an ecosystem of innovation by partnering with industry to establish next
generation regenerative technologies at Mayo Clinic. With a focus on scaled and
targeted biomanufacturing platforms, the acility is poised to establish new
regenerative tools adapted for rapid integration into practice,” says Dr.
There are many implications of biomanufacturing in health
care. The Mayo Clinic Center for Regenerative Medicine is leading several
efforts that will advance patient care, including:
Cellular and gene therapy: These two types of therapies offer therapeutic intervention for a range of diseases for which relatively limited clinical options are currently available. Cellular therapies contain cells or tissues derived either from a donor or a person’s own stem cells that employ healing through replacement of function. Gene therapy is the addition of new genes to a patient’s cell to replace missing or malfunctioning genes that are driving disease.
Acellular technology: Acellular — or cell free — technology are biologics that are termed “off-the-shelf.” It means they can be manufactured and stored for long periods of time right at the hospital, as opposed to needing to be frozen, thawed and brought to a patient. Cell free products are less generally expensive for patients and can be used more widely.
Tissue engineering: The goal of tissue engineering is to assemble functional constructs that restore, maintain, or improve damaged tissues or whole organs using scaffolds, cells and biologically active molecules. Tissue engineering uses new approaches to repair, restore or regenerate tissue function lost due to injury, chronic disease and aging.
One of the challenges in biomanufacturing is having the
proper technology and production capabilities in place to meet rigorous
standards for U.S. Food and Drug Administration (FDA) approval. A key component of that is the highly
regulated Current Good Manufacturing Practices (cGMP) laboratory needed to
research and produce these new products, such as cellular and acellular
therapies, pharmaceuticals, medical devices, and engineered tissues. The Center
for Regenerative Medicine Advanced Biomanufacturing facility will feature cGMP
lab space, which is important to assure proper design, monitoring, and control
of manufacturing processes and follows cGMP regulations established and
enforced by the FDA.
“One Discovery Square provides a central location to
develop, translate and apply new biologics that are unique to Mayo Clinic,”
says Dr. Behfar. “Our goal has always
been to get the latest technologies to patients quickly.”