Imitate Nature or Wait for Nature? Two Approaches in Tissue Engineering That Shape the Medicine of Tomorrow

In 1971, then-U.S. President Richard Nixon announced the redirection of resources that had split the atom and brought people to the moon towards defeating disease, thus initiating the "war on cancer." This unprecedented investment at the time sought to conquer cancer as quickly as possible and ultimately propelled the field of biotechnology toward remarkable achievements in various areas.

Four decades after landing on the moon, scientific progress began to provide solutions for healing illnesses and addressing challenging conditions, not just managing them. For instance, engineering and growing living human tissues and organs in laboratories—once considered science fiction—is now a reality, with a market expected to generate over $31 billion a year by 2030.

Capital markets have shown great interest in biotechnological developments, particularly those related to curing diseases and tissue engineering. This interest sometimes surpasses that in conventional drug development, given the diminishing marginal utility of existing drugs, rising R&D costs, and decreasing ROI in the traditional pharmaceutical industry.

Tissue engineering is an applied research branch combining engineering, materials science, and life sciences principles. It aims to develop tissues and organs for transplantation to replace, renew, or preserve bodily functions. The demand for tissue engineering is driven by an aging population, increasing rates of organ failure due to illness or trauma, and an ongoing shortage of organs for transplantation.

Currently, most economic activity at the intersection of tissue engineering and regenerative medicine focuses on artificial organs, such as artificial joints or bone substitutes for treating minor bone deficiencies. These artificial organs are effective primarily because they restore a certain degree of shape and strength to tissues and provide relatively simple functions, like mechanical support. They can also serve as scaffolding for further tissue or organ regeneration.

However, scaffolding alone is insufficient for engineering large, complex tissues or those the body cannot regenerate independently. Engineering hearts and kidneys and repairing large bone deficiencies also require living cellular components and growth systems that provide the emerging tissue with a suitable environment before implantation in the patient's body. These conditions also influence the engineered tissue's functions after transplantation.?

Advanced tissue-engineering techniques, such as bioprinting and attempts to develop an artificial uterus to grow whole organisms, have progressed rapidly in recent years. While a functioning artificial uterus remains elusive, the core concept of providing optimal conditions and waiting for nature to take its course has already led to innovative products. For example, we developed BonoFill, a live human bone graft successfully implanted in dozens of patients, using this approach. BonoFill comprises cells grown in an environment that imbues them with various natural functions.

In contrast, bioprinting aims to construct the tissue's architecture fully. To achieve this, however, we must comprehend the natural processes of tissue construction that we seek to emulate on a level comparable to, or at least approaches, the understanding of the original architect—be it, Darwin or God.

The application of artificial intelligence models might pave the way for a better understanding of the natural construction processes of tissues, or at least one uterus, enabling nature to take its course. At Bonus Biogroup, we believe our role as tissue engineers is to learn from nature. Through this knowledge, we strive to leverage the body's natural healing mechanisms to provide better, safer, and more effective treatment options for patients suffering from severe diseases and conditions.

We are currently conducting two clinical trials to treat large bone deficiencies in limbs and craniomaxillofacial bones using BonoFill, a live human bone tissue graft engineered from cells extracted from the patient's adipose tissue. These cells are seeded on a natural scaffold and grown in the laboratory under conditions that enable them to support bone and blood vessel regeneration, reduce inflammation, and provide additional abilities needed for bone regeneration.

Products like BonoFill have saved patients from amputations and allowed them to regain activity after years of disability. Bonus Biogroup and other companies in the field are pioneering this medical revolution.

As we look to the future, it is crucial that investors, businesses, and governments recognize the enormous potential of tissue engineering and support innovation in this field. After all, the technological advances we make today will shape tomorrow's medicine.