The following is a transcript of Press TV's interview with Mohammad Reza Razaghi, Mohammad Reza Masjedi, and Jalaladdin Ganavi, all of whom had collaborated in the development of the world's first in situ bio-artificial tracheal transplant.
Razaghi is the dean of Tehran's Shahid Beheshti University of Medical Sciences. Masjedi is the vice president of Masih Daneshvari Hospital and Ganavi is the head of the tissue-engineering team at the Lung and Tuberculosis Center at Shahid Beheshti University of Medical Sciences.
Press TV What is the effect of recent sanctions against Iran on the scientific advancements and the researches conducted in the country?
Dr Razaghi Based on the country's 20-year vision, Iran should rank first in the region in the field of science by the year 1404. Iranian scientists particularly those working in our center therefore are working hard to pave the way for the achievement of such goal in the near future.
The recent accomplishment of our team, similarly, is a novel national and international achievement celebrated for the first time in Iran, in an attempt to accomplish the abovementioned goal.
Press TV Have recent sanctions reduced the pace of researches or have they encouraged the scientists to make more attempts?
Dr Razaghi As the late Imam told many years ago, these sanctions would improve our country. The Leader of the Islamic Revolution, other officials and individuals of different social classes also believe that sanctions have not reduced the pace of scientific and industrial improvements in the country but have quickened their pace.
As you can see we are presenting a case that scientists in many European countries have failed to treat. The present case had undergone various surgeries for the treatment of tracheal stenosis in certain European countries, all of which failed to cure her. Today, however, the young Iranian scientists have succeeded to treat the patient, helping their compatriot to breathe easily. This is the result of the above mentioned sanctions.
Press TV So could you tell us more details about this bio-artificial organ?
Dr Masjedi Just as an introduction, our center is a referral center for pulmonary and respiratory diseases in the country and I can say it's the only center completely devoted for pulmonary diseases in Iran. So we receive difficult cases in pulmonary diseases and problems and the center is also unique in treating tracheal disease through surgery or by medical interventions.
On a daily basis we receive several patients with tracheal stenosis; bronchoscopy, laser therapy and balloon dilatation is used to treat many of them. Surgical repair for other cases is performed on a weekly basis, two or three times a week. Although tracheal stenosis is not a common disease, our center is one of the well known centers in the world to treat such patients.
Considering this case, she is a 29 year old female who had an accident two years ago and she got severe destruction and disruption of trachea and she was in coma for a long period of time. Aiming to treat her tracheal problems, she underwent several surgical therapies in some European countries. Apart from these operations, she underwent several sessions of tracheal dilatations in our center as she was still suffering from tracheal stenosis.
On the last session, she developed a very serious dyspnea and was admitted to the emergency ward; we hence decided to do something new for her. We discussed [the case] with our tissue engineering department, aiming to use the new modalities they were testing in the field of tracheal reconstruction and the use of bio artificial techniques.
While discussing the best management approach for the patient in the bronchoscopy room, a colleague from the engineering department proposed the use of bio artificial materials in the style of stem cells. He said we can inject these cells directly to the trachea to prevent the re-stenosis of the trachea and to establish a good architecture for the trachea. The ethical committee approved the project.
In the first session, almost 5 weeks ago, we decided to do the first part of the task on the lower half of trachea. So after cleaning the internal part of the trachea by laser and dilatation, we injected the matrix submucusally in a linear pattern from the lower portion to the middle part of the trachea in some 70 or 80 points.
Thereafter we followed the patient for two weeks. The bronchoscopy performed at this time was very surprising as the trachea was completely open with no signs of stenosis in its lower part. In the upper part, however, granulation tissues and stenosis was visible despite the fact that we had treated this part with laser.
It was very surprising so we decided to clean the upper part and to repeat the injection in this part too. Now after two weeks, the patient is doing well in the follow ups.
This is really a novel treatment and we hope we would be able to use it for cases with advanced and wide spread tracheal stenosis. There is a limited range of therapies for these patients. We use stents for them but it's very difficult to help these people have a regular and normal life. For us as a physician it [the achievement] is very surprising and we hope that we can use it for more patients in the future.
Press TV Do you think that you can teach this technology to other countries in the world as well?
Dr Masjedi Why not. It is an approach and we can teach it to our colleagues and other centers.
Press TV Are there any seminars coming up where you might be able to discuss your findings?
Dr Masjedi I think we have to wait and see what will happen to this patient in the coming six months. At the time being, we are intending to use this technique in other patients, aiming to build a collection of five, seven or ten patients and to follow them for a period of time to see what will happen. Despite all this, I think it [the achievement] is a very surprising and positive one.
Press TV In what way do you believe this technology to be ground breaking. What is so special about it and how is it different from stem cell research why are you so happy because I can see happiness in your eyes
Dr Masjedi I am doing this treatment for more than 25 years. I've lost many patients because of tracheal stenosis, as many patients get asphyxia and die when they develop severe stenosis. It's an emergency worse than shock because there is no way for the air to enter inside the body. In some cases, we do tracheostomy to save the patient. This approach, however, can save many lives without surgery or any other therapy only with injecting some biologic materials without any side effects. This is really surprising and a real breakthrough. We hope we can use it for more patients in the future.
Press TV Are you saying it is a non-invasive method and you don't need to cut the chest.
Dr Masjedi We use it only by bronchoscopy. There is no surgery. Its a complete endoscopic technique.
Press TV Can you tell us more about the new achievement?
Dr Ganavi This one step tissue engineering is the result of 12 years of efforts made to build an artificial trachea. First I should define tissue engineering, the term has two parts: engineering, involves all the engineering sciences and tissue, is a bed on which the cells are set. We made benefit of these two parts to design an artificial trachea.
Two years ago, we regenerated the world's first artificial trachea. Spanish researchers, however, reported their artificial trachea as the first such an organ regenerated in the world. The evidence however shows that Iranians are the first to regenerate such an organ in the world. Our recent accomplishment hence is so distinguished that no other country would reach us in this field, indicating that this technique is ours.
In this technique, we did not transplant the cells on the scaffolding; stem cells, on the other hand, are cultured and grown on scaffolding before being differentiated into an organ such as eye, liver and trachea. In this technique, we made use of dead scaffolding rather than stem cells.
In other words, we used the matrix as a scaffolding upon which the healthy stem cells, already circulating in the body, are located and differentiated into the requisite organ in the way it occurs in a normal body. For instance, there is no need to inject stem cells to the body each time it experiences an injury as the circulating stem cells, released from the bone marrow, can reach the injured site and differentiate into skin, conjunctiva or liver based on the injured underlying organ.
In this technique, we regenerated scaffolding which could only differentiate into cartilage. This scaffolding was not a sole network as it contained some capsular structures which permitted the release of specific compounds. Generally, the bone marrow cells circulating in the body would place on this scaffolding but are not directed toward the sought organ. The art of this technique, therefore, is to direct the scaffolding and the released compounds toward our target.
In this regard, we regenerated a scaffolding containing nano-capsules filled with growth hormones which were programmed to release significant amounts of the hormone on specific times and in precise concentrations. Some capsules were also programmed to release their content within 21 and 28 days aiming to differentiate our system into the wanted organ.
Considering the fact that our process was similar to that which occurred in a normal body, no fibrosis was seen during the whole course. It should be noted that during a normal differentiation process, no fibrosis or abnormal changes are noted. This is the advantage of our method over similar systems.
Press TV Dr Masjedi told us, previously, that the injection process was performed in two different steps. In the perspective of someone who works with computer, can we say that you intended to program the differentiation process of the cells through this act.
Dr Ganavi Exactly. I should stress that we have regenerated the world's first normal organ. Such a job had never been done using stem cells. In other words, stem cells were previously injected for example to regenerate a heart or other organs. In this technique, however, we regenerated an organ following the injection of a matrix.
The studied organ consisted of two main parts: the cartilage and the mucosa; as a result, we decided to produce the cartilage at the first step. In this regard, we injected the matrix of cartilage and made the circulating stem cells to differentiate into cartilage. After a considerable number of stem cells were transformed into cartilage, we intended to regenerate the mucosa. Thereafter, we continued the injection of cells on the superficial layers of mucosa until the epithelial cells were formed.
Press TV Do you believe scientists would be able to use similar techniques in treating the injuries of other parts of the body? What is the advantage of this technique over stem cells?
Dr Ganavi Stem cells are generally injected to a sick scaffolding such as an infracted heart or a necrosis tissue. In my perspective a fetus who is left in a wild wood would never grew to a healthy adult, whereas bringing up the same child in an appropriate house with parents would guarantee his/her sustainable development. This is the main difference between this technique and stem cells.
In response to your second question, I should mention that this center will announce surprising news upon our researches on trachea in the near future.
[Source: PressTV]
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