Getting Back to Normal
Can Enhanced Regeneration Maintain Health?
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- bone marrow
- CD34+ cells
- endothelial progenitor cells
- immune tolerance
- stem cells
- type 1 diabetes mellitus
Health is our natural state of being. With rare exceptions we are born healthy and we live much of our lives in a state of virtually perfect health. We are maintained in that naturally healthy state by the normal functioning of all of our tissues and organs and their component cells.
Article, see p 1930
Recently, the power of cells to restore health is being widely recognized. Autologous T cells are being programmed to target specific antigens expressed by previously lethal leukemias, achieving unprecedented apparent cures.1 Conversely, regulatory T cells are being tested in type 1 diabetes mellitus in an attempt to re-establish immune tolerance in this condition,2,3 with some earlier examples of resultant insulin independence.4 In the cardiovascular (CV) arena, the use of a variety of cell types to treat heart failure5,6 and ischemic heart disease7 is being widely tested. This generation of cellular medicine, targeting the reversal of disease, may fundamentally change how medicine is practiced.
Prevention of disease is certainly more attractive than disease treatment to both healthcare payers and patients. A next step for cellular medicine would be to target the maintenance of health, rather than treat clinically evident disease, which presents itself after years, if not decades, of subclinical injury, and represents a state of exhaustion of reparactive capacity. Critical for this mission is an understanding of the mechanisms by which we are maintained in a state of health; implicit in this is a deeper understanding of cellular reparative capacity. The discovery of resident tissue stem cells in adult tissues and circulating stem cells capable of incorporating …