Tissue Engineering

That would be great! if we are still around then, never heard of this, I asked a surgeon once about colon transplants, he said they don't do them and there was no research on the subject, because people can live without their colon

That would be really cool. I had to have my rectum totally removed, so I'm not sure that would ever be an option for me. I wish they could have taken out my bad colon and given me a new one!

I've seen/heard of this as well.

Anyone interested in seeing how far we've come should watch Anthony Atala's TED talk called "Printing A Human Kidney" it's quite miraculous.

My surgeon told me the only reason they don't do colon transplants is the same for all non-vital organs: the risk of lifelong immune suppresents from receiving a foreign organ outweighs the risk of just simply removing the colon and having a jpouch/ostomy.

However, if the colon can be grown, transplantation should be fairly easy. But one has to wonder, why wouldn't the UC just return to the transplanted colon?

The disease, after all, does not 'occur' in the colon. It is an autoimmune disorder in which the body attacks the colon. So in theory, replacing the colon would just give you UC again.

True enough, but you have to think long term here. By the time lab generated replacement organs are the norm, medical science will probably have a much better grasp on auto-immune conditions.

Even if that isn't the case, researchers are looking into the possibility of using different tissue types to grow the new organ (so your new "colon" wouldn't actually be made from colon tissue).

There's also the chance that people who have been colon free for a long period of time wouldn't have a relapse. Your immune system has memory cells in order to allow it to recognize previous invaders. However, these cells don't necessarily last, so your body may just forget it ever hated your colon in the first place.

I'd be more hopeful for the different tissue types being our savior than a better grasp on auto-immune conditions.

They have been running these tests/successfully growing certain organs for over 15 years at Wake Forest, yet the cause of IBD and other auto-immune diseases are still completely unknown.

What is stopping the growing of organs (especially non-vital, which are easier to grow) is not a lack of medical knowledge as is the case with auto-immune disorders. It is a case of the slow medical process and a need for numerous tests and trials before making a certain treatment mainstream.

I was thinking since they intestinal tissue of the pouch begins to take on colon-like attributes over time, perhaps a new "colon" could be grown using stem cells from the tissue of the j-pouch. Simply (ok, not simply) harvest the stem cells you need from the pouch tissue and grow them up on a colon bio-scaffold. In theory it should work, to some extent.

This is just me waxing scientific. My brain takes me to some interesting places if I let it off the leash.

i hope you are right, I would love to get a new colon

I hope I'm right too. However, we're all going to have to wait quite a while. I'd be very surprised if this was possible within the next 5 years. I'd be mildly surprised if it was doable within 10 years. I'd expect it to be an option in about 15 years. I'll be sorely disappointed if it's not available within 20 years.

This is so encouraging. Thanks for posting, please update if you find out more information on this topic. "Hope is a good thing, maybe the best of things, and no good thing ever dies."

15 years and they'll have to clone an entire new body for me
and transplant my brain into it...

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they'll have to clone an entire new body for me and transplant my brain into it...

Be careful about what you wish for. I just saw the movie "The Human Centipede" last night. It is a shocking, disturbing, depraved film that I think tries to send a message about "playing God" with the kinds of body altering surgeries and tissue engineering that is under discussion in this thread. In the end, I think the gruesomeness and depravity of the film obscures any message it is trying to send in that regard. It did get me thinking about this thread though, especially since the unfortunate individuals who are connected to form the "Human Centipede" are deemed to be "matches" who share a common digestive tract..........

I feel like I am in need of therapy just to get this movie out of my system..........it was horrible...

I saw parts of that movie after my first surgery and was also completely disturbed by it. Hopefully tissue engineering would just mean giving us an organ with the capacity to hold stool for more than a few hours rather than having our mouths connected to the anus of another individual. But I feel you bro. That movie SUCKED especially for people like us that are more sensitive to the subject matter.

Interesting posts! Keep us thinking....!

Roberta

wouldn't you still have to take anti-rejection drugs even if it's made from your own cells? It's a neat thought though only how would they get trials past ethics committees when the risks might be too high since you can live without your colon.

There would be no need for anti-rejection drugs because it's your own tissue. That's the entire point of tissue/organ engineering. They've already used this process in a handful of cases to grow and implant new urinary bladders with the patient's own bladder cells.

As far as new colons go, different adult stem cell lines may have to be used and coaxed into becoming colonic tissue, as we're all sort of missing a good supply of actual colonic stem cells. In theory, it would be better if a new "colon" was produced from other tissue types, as our immune systems (for those of us with UC) wouldn't be predisposed to attacking the new organ.

As Stephen Hawking said: "Science is on the verge of changing your life."

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However, if the colon can be grown, transplantation should be fairly easy. But one has to wonder, why wouldn't the UC just return to the transplanted colon?

UC would have just as much chance of returning to a new colon as it would to a j-pouch.

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UC would have just as much chance of returning to a new colon as it would to a j-pouch.

Correct, because the same defective auto-immune system has not been "re-engineered." So you would merely be creating new disease opportunities by creating new tissue, unless you did something to correct the defective autoimmune response that is causing the disease in the first place.

On the other hand, with someone who has had UC for 20 years and has experienced a slow deterioration over that time, you can take the bad colon out, grow a new one, and then you would effectively "buy" the patient another 20 years until the expiration date on the new colon, during which time new treatments may be developed.

We still do not know the exact underlying cause of UC. For instance, if the immune system response is triggered by an underlying virus or bacteria that is laced inside the colon then perhaps installing a new colon without the underling virus (i.e. ecoli, or unknown pathogen or bacteria) would eliminate the problem altogether.

Some very good points being made. In theory, the new colon may never become diseased as the same trigger event may not happen a second time. Perhaps the original colon underwent a random mutation in some membrane protein and the body attacked it for that reason. Perhaps it was a strange infection that got out of hand.

I'm still more in favor of the idea of making a new "colon" out of a different tissue type to avoid the problem entirely. It's not like they would just slap small intestinal tissue on a colon scaffold and call it a day either. Researchers are looking at ways to build a functioning colon replacement out of various tissue types.

SCIENCE!

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the same trigger event may not happen a second time

If this were correct pouchitis would not exist. You may want to look through the pouchitis forum - it's not exactly uncommon. There is no trigger event, it's just the same bacteria in your gut which is causing an immune response that causes inflammation to new tissue - but your ileum instead of your colon.

What you are not understanding is that the so called trigger event that caused UC happened a long time ago and it has permanently screwed up your autoimmune system from what it once was. That is why pouchitis happens, it is the same autoimmune response causing a different disease in new tissue.

The root causes of pouchitis are just as poorly understood as the root causes of UC. If the two disorders had the same etiology, then antibiotics would be an effective treatment for UC (as they are for many cases of pouchitis).

You can't have the same autoimmune response if the original target is no longer present. Your body wont be pumping out anti-colon antibodies if there is no colon left to target.

As for the trigger event, that is also poorly understood. You can't know when the trigger event occurred if you don't know what it was.

I will admit, however, that if the original trigger event could have been due to a bacterial infection. The immune system can make mistakes and the markers the antibodies target on the bacteria could be similar enough to some marker in the colon tissue to cause the continued production of antibodies that would then go on to attack the colon. However, for this same process to happen in the pouch, a new bacterial infection would have to occur and markers in the tissue of the ileum would then have to be mistaken for markers on these new bacteria and the whole cycle of terrible mistakes by the immune system would need to happen all over again. That, of course, could happen but it still isn't the same autoimmune response. Once the colon is removed, that particular autoimmune response is done as the target is gone. Yes, our immune systems are certainly screwed up to some degree but the important question is: In what way? Is there a mutation that simply caused anti-colonic antibodies to be produced? Is this something that has been in my genetic code from the start or did a random mutation occur somewhere along the line in just the right cells? It's theoretically possible that, during an immune response to something else, a mutation occurred that caused immune cells to target markers in the colon instead of the invading material. Theoretically, it may just as easily have been a mutation that caused my immune system to attack my nervous tissue or skin cells. The point I'm rambling on about here is that we just don't know what causes these autoimmune responses in the first place. I'd be more than happy to fill page after page with the workings of the immune system. I spend a good deal of time thinking about all of these myriad possibilities, not because of my new anatomy or the condition that brought it about, but because I've been studying this stuff for the last 10 years. I've been interested in all of this nonsense since before I was ever sick in the first place.

I'm a biologist and my chosen field of study is immunology. I'm not saying that to tout any sort of expertise, but just to make it clear that I understand just fine. There are still too many unknowns about UC and autoimmune diseases in general to be able to say anything with absolute certainty.

Sorry if I'm raving a bit here, but the hard truth is that we still don't know exactly what causes UC or pouchitis. If we did, current treatment methods would be that much more effective.

Thanks for the excellent explanation Epic Scotsman. Very helpful for those that don't understand or misunderstand.

Sue

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1422658/

pretty interesting read

I am going for stem cell treatment for IC (bladder). The trials have been good on curing or fixing IC. They treat the auto-immune part and the bladder. Only one place does it in the US that is open to the public in California and it is a "self paid trial" since the FDA hasn't made it legal. I HATE THE FDA but that is another thread. They list Chron's on their site as well but not sure about that since I deal with Urology.

Anyway I know of a kid who had a colon transplant and a colon can be grown by your cells. But he had FAP, the doctor was an idiot to even do the transplant for FAP. He grew all the polyps back and did eventually died due to desmoids. If you have auto-immune like UC, you can't get rid of the disease by replacing the colon so it would have to tackle that part at the same time. I believe the disease can ruin the new organ.

I am a huge advocate for stem cell research. One reason I will never vote for republicans. ;-)

there is a man in the UK, he is all over the net right now and even on Pinetrist with photos from his colon transplant due to Chron's. He is doing very well with it.

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I am a huge advocate for stem cell research

Same here, J Pouches are nothing but a miserable bandage treatment, and far from a real cure! I'm sick and tired of living with this compromise, stem cells can't come soon enough!!!!!!!!!!!!!!!!!

Stem cell research is awesome, but they're not exactly a magic bullet... yet. I hadn't been able to find any articles about people actually receiving colon transplants. Is there a link you can send me?

As for growing a new colon, I still believe that there would be a chance of the disease not recurring (in the case of UC anyway). The memory cells produced by the immune system don't last too terribly long without constant exposure to the antigen in question. Once the colon is gone, the memory cells would start to die off relatively quickly. Depending on what brought about the autoimmune response in the first place, the disease may not recur in a new, healthy organ (but it certainly could).

Of course, step one is just being able to create a lab-grown colon (they've done it with human bladders already, so I think we're close). Step two will be seeing what happens when they slap that baby in there.

Also, new2thisstuff, I actually read that article awhile back and it is awesome. Here's another article I really like that takes a look at using other tissue types to make a new "colon" (I believe they refer to it as the fecal continence organ). I recommend looking at the PDF (it has charts and such):

http://www.intechopen.com/book...f-colo-rectal-tissue

Here is the guy that is the 11th person to have a bowel transplant. http://pinterest.com/michaelseres/

As far as the kid that had FAP I don't have an article on that I know his grandmother who posts on FB about losing him to a doctor that gave him a colon transplant for FAP when FAP will just grow the same things in the new organ.

Another good article to read http://www.vancouversun.com/he...h/6323110/story.html

I have heard of bowel transplants, but those are usually restricted to sections of small intestine. I do know that researchers have already grown sections of small intestine in the lab, so the proof of concept is there for engineering intestinal tissue. It was only very recently that adult colonic stem cells were able to be isolated and grown in the lab.

I like to look at things this way: Scientific knowledge is increasing at an exponential rate. Astounding and amazing advances that we don't even know about are being made every single day by astounding and amazing people. 30 years ago our only option would have been an ileostomy. 100 years ago, we'd all be dead. With the rate at which we are now advancing, imagine what we could have in 10 years time.

I still think we are in the dark ages so I guess I am opposite. If we are advancing then the words "colon removal" shouldn't even be on the table anymore. when it comes to colon cancer there are no advancements. People post things being done in Mice but that just doesn't even translate properly to humans. I go to Richard Boland, world renowned geneticist and even he will admit they are stuck when it comes to the colon.

I also see studies that are done but when will it be available just as easy as the FDA makes drugs? Never. Stem cells will never be a main option when the pharmaceutical companies control the FDA. It is about money and politics. In order for me to go to California, first place in the US to offer stem cell treatment, is very expensive. I had to save up, and the FDA has strict rules on they can even offer it. Bunch of BS if you ask me.

I agree with you to a certain extent Vanessa.

One of the reasons I elected to have surgery was because I knew that even if a "cure" or promising drug came out it would be years before these new drugs passed FDA regulations and were made available to the public (sad but true).

With that said, in the back of my mind, I figured it was probably just as likely that organ regrowth could one day be the cure for colitis.

http://blogs.discovermagazine....we-ever-grow-organs/

Also I think there would be interest from medical/pharmaceutical companies in growing organs because of the high demand. As this article states "the more you age, the more organs fail"

They have already grown and implanted several human bladders with mostly successful results. That in and of itself gives me hope for the future.

What, essentially, is the bladder? A hollow sack. What, essentially, is the colon? A hollow tube. The techniques should translate fairly well, so it's mostly a question of nailing down the tissues and scaffolding.

Well actually a bladder is much easier than a colon because a bladder really has no purpose other than to hold and retain liquid waste.
A colon, however, absorbs massive amounts of water and electrolytes. But if it is possible to grow a colon cell by cell, i see no reason that it shouldn't function normally.

Another note- it is not true that the conditions for UC resonate in the colon. They are in the brain. This is why Crohn's patients are not recommended j pouches-the pre determined autoimmune disease causing crohn's just returns in the small intestine. Since UC seems to only attack the colon, there must be something about the colon that causes the body to attack it in UC patients and so i would think the risk of getting UC again would in fact be very high.

A bladder may have a more simple function than a colon, but I'm not talking about functionality, I'm talking about structure. They are both hollow organs, so they would both be grown using the same basic procedures.

As for that whole second paragraph there... I'm not even sure how to respond to that. J-pouches aren't recommended for Chron's patients because Chron's can affect the entire digestive system. Many Chron's suffers have no colonic involvement. Likewise, I'm sure there are cases of Chron's that only have colonic involvement. As for the problem being in the brain, the immune system really isn't controlled by the brain. When invaded by a foreign substance, your brain does not get a signal that says "hey, we've got a problem." Immune cells in your blood stream recognize that whatever it is that got in there isn't supposed to be there and that triggers the immune response. These immune cells originate in, of all places, the bone marrow. There is little, if any, involvement from the brain in the whole immune process. Whatever triggers UC, or any other autoimmune condition for that matter, either arises in the immune cells themselves (like a mutation that causes the production for self-targeting antibodies) or in the tissue that is being targeted. Now it could very well be that auto-immune diseases are in part predetermined as part of a person's genetic makeup but that, likewise, has nothing to do with the brain (unless you have an auto-immune condition that targets neural tissue).

There, science rant over.

My doc said my jpouch now has the appearance of a colon after 18 years. Wow, just did the math! Can't believe I've had my jpouch that long! Anyway, my colon made me a more nervous person. Anyone else feel that way? I had IBD also. I wouldn't want another colon, my pouch is fine. I just get dehydrated more easily. If the stem cells could help that, then I would be all for it.

Here's a thought I had with regards to tissue to use to make the new "colon". Since the pouch tissue eventually takes on colonic qualities, adult stem cells from the pouch itself could be harvested and grown on a colon scaffold. So basically, you'd have a colon shaped, colon sized pouch.

http://www.youtube.com/watch?v=tQnJAMsV1g8

Same here, J Pouches are nothing but a miserable bandage treatment, and far from a real cure! I'm sick and tired of living with this compromise, stem cells can't come soon enough!!!!!!!!!!!!!!!!![/

Dog Day STOP using your broad, negative, brush when speaking about a j-pouch. Mine is great and saved my life! It also treated me well during my long, arduous, treatment for breast cancer. I am grateful every day for it and absolutely DO NOT see it as a "miserable bandage treatment". For some it doesn't work and they seek other alternatives, however -- after 20+ years of having one, hating it and doing nothing to change, it's all about attitude and yours sucks.

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STOP using your large, negative, brush when speaking about a j-pouch. Mine is great and saved my life! It also treated me well during my long, arduous, treatment for breast cancer. I am grateful every day for it and absolutely DO NOT see it as a "miserable bandage treatment". After 20+ years, it's all about attitude and yours sucks.

Well it's not my fault that your J Pouch isn't mine. Everybody has their own opinions, and I can just as easily say "your attitude sucks" because you come here constantly, just for the sake of berating me. And you don't seem to understand that everybody has different outcomes with their pouch plus different opinions too. If anything it's time for you to become more understanding already.