Regenerative medicine

Regenerative medicine has already begun to produce complex skin, cartilage, and bone substitutes for clinical use in many countries, including the US, EU, Japan, China, and Australia. It may be the right time for Armenia to take advantage of its own resources and scientific potential to develop such a program by creating a national center on tissue engineering and regenerative medicine in order to establish itself as a regional leader in the field. No such centers exist regionally; currently, the closest tissue engineering labs are located in Moscow, Russia, and Ankara, Turkey. Large skin defects resulting from burns, trauma, diabetic ulcers, and congenital disease can lead to skin necrosis and can certainly represent a challenge to achieving skin coverage. Today, a number of tissue-engineered skin substitutes are available commercially in the US and Europe (but not in Armenia or in the region).Biological skin substitutes (such as allografts or xenografts) are similar to the skin, with an intact and native extracellular matrix, allowing the restoration of a more natural, new dermis. They also support re-epithelialization due to the presence of a basement membrane. The most widely used biological substitutes worldwide are porcine or cadaveric skin. Recently, it has been shown that excised excess skin from plastic surgery procedures can also serve as an effective source of biological skin substitutes or can be decellularized to serve as a scaffold to seed a patient’s own cells.

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According to the American Burn Association there are about 150.000 hospitalizations for burns in the US annually; in about a third of these cases the patients receive a skin graft, i.e. there are some 50.000 skin grafting procedures annually for burns in the US. The total incidence of skin grafting is much greater than the incidence of severe burns since it is also used for the treatment of chronic ulcers and skin replacement due to injury from other causes. Again, using very conservative estimates, one can assess the total expected number of skin graft procedures in Armenia to be around 1000 (including chronic ulcers, burns, trauma, etc). Assuming that the cost of the 10x10cm2 graft is about USD 300- USD 500, these procedures would bring in a revenue of about USD 300-500 thousand annually.

Zaruhi Karabekian, Head of the Laboratory of Tissue Engineering of L.Orbeli Institute of Physiology of NAS RA 
E-mail: zkarabekian {[ at ]} yahoo.com
Tel.: (+374 10) 272247 
(Co-author of the project: Dr., Prof. Narine Sarvazyan, GW Schools of Medicine and Engineering, USA)