THE CHALLENGES

Overall decline in regenerative capacity:

The capacity to regenerate our tissue hinges on multiple factors related to our genetic constitution and environmental factors. Individuals vary significantly in their capacity to regenerate different tissues. This will make certain individuals more prone to certain diseases than others.

As we age, our bodies experience a decline in the function of many organs and tissues, including the loss of regenerative capacity. One of the main causes of this decline is thought to be stem cell (and progenitor cell) exhaustion. These cells are specialized cells that can divide and differentiate into a variety of different cell types, and they play a crucial role in tissue regeneration and repair.

This age-related endogenous stem cell exhaustion or dysfunction will lead to a decline in tissue’s ability to regenerate and repair, as well as to an increased risk of age-related diseases such as cancer, cardiovascular, respiratory diseases, and neurodegenerative disorders, many of which are chronic debilitating and life-threatening diseases.

Introducing mechanisms for slowing down or reversing this decline in stem cell function, with the goal of improving health and healthspan in aging populations, is a major aim of the medical community.

Chronic diseases:

Approximately 47 percent of the U.S. population, 150 million Americans, suffered from at least one chronic disease as of 2014. Almost 30 million Americans are living with five or more chronic diseases. The risk and prevalence of chronic disease grow as individuals age. Approximately 27 percent of children in the United States suffer from a chronic condition, while about 6 percent have more than one chronic condition. In contrast, around 60 percent of adults suffer from at least one chronic condition, while 42 percent suffer from multiple conditions. Among those 60 or older, at least 80 percent have one chronic illness, and 50 percent have two. These ailments account for 70 percent of all deaths in America, killing more than 1.7 million people each year.

An estimated 84 percent of health care costs are attributed to the treatment of chronic disease. The rates are even higher for beneficiaries in public health insurance programs: 99 percent of Medicare and 80 percent of Medicaid spending went toward the treatment of chronic diseases as of 2010. Given the correlation between chronic disease and age, this health and cost burden is only expected to grow: It’s estimated that by 2060, the U.S. population aged 65 years and older will more than double, from 46 million today to 98 million.

When including indirect costs associated with lost economic productivity, the total cost of chronic disease in the United States reaches $3.7 trillion each year, approximately 19.6 percent of the country’s gross domestic product.

Chronic obstructive pulmonary disease COPD:

Affects 15 million in the USA, and 400 million worldwide, causing the death of 140000 in the USA and 3 Million worldwide. In most years, it is the third leading cause of death worldwide. Typically affecting individuals >40. It is caused by smoking; air pollution; inhaling dust, fumes, and chemicals, and rarely by the lack of a specific protein. Airways and air sacs in the lung lose their elastic quality, and the walls between many of the air sacs are destroyed. Airways become thick, inflamed, and clogged. Treatment can help, but the disease can’t be cured, and damage to the lungs can’t be reversed; in fact, it progressively worsens.

Chronic non-healing wound:

This “epidemic” was estimated in 2016 to affect 6.7 million patients. One-third of attended wound patients suffer from non-healing wounds resulting in amputation or death. up to 55% require amputation of the second leg within 2‐3 years. The average cost for each amputation is over $70,000. Nearly half of the amputees, due to vascular disease, die within 5 years. A rate higher than for breast cancer, colon cancer, and prostate cancer combined. Treatment costs range from $ 3.5K to $ 40K/year in non-healing wounds. The general cost of wound care currently exceeds $ 50 billion/year in the USA.

Control over blood vessel formation:

This is crucial for the cure of many persistent disease types such as cancer, obesity, diabetes, cardiovascular disease, and ocular disease. In the case of cancer, control of blood vessel formation could provide the opportunity to cure most types of cancers. Furthermore, establishing stable blood vessels is quintessential for engineering thick and viable artificially engineered tissues and organs for future human transplantations.