Who Is the Father of Regenerative Medicine?
POSTED ON 3/31/2018 IN Regenerative Medicine Education BY Christopher Centeno
An avid blog reader this week sent a link to a press release where a plastic surgeon claimed to be considered "The Father of Regenerative Medicine." While I'll show that this is just another case of a doctor writing checks in a press release that his CV can't cash, it did bring up a great point. In the shower this morning, I ran through my head, who would really be widely considered to be the true father of regenerative medicine? It's a very tough question to answer.
How Can We Figure Out Who Should Be the Father of Regenerative Medicine?
This is a tough one. While I'll show you below why this plastic surgeon isn't even in the conversation, the more interesting question is, who should get this honor? In addition, much of that depends on what you consider to be "Regenerative Medicine." However, we can all learn a lot about regenerative medicine by unearthing its history. First, while I can lay claim to being the guy who performed many of today's common orthopedic stem cell injection procedures before anyone else on earth (intra-articular and structure-specific bone marrow concentrate and mesenchymal stem cells for knee, hip, and shoulder arthritis, etc...), I'm not the father of regenerative medicine. If you go back further along that line, Philippe Henigou in Paris has a legitimate claim as he began using bone marrow concentrate to regenerate bone diseases, like AVN and fracture nonunion, in the early '90s! If you only focus on bench scientists, Arnie Caplan, PhD, could be the father of the field. He first discovered mesenchymal stem cells in the late '80s and published the seminal paper in 1991. In fact, at various conferences, either Dr. Hernigou or Dr. Caplan are often introduced as the fathers of the field. However, the term "regenerative medicine" contemplates anything that will help regenerate tissue, so this conversation goes well beyond stem cells. In fact, we have to open this up next to platelet-rich plasma (PRP).
The Father of Regenerative Medicine Could be a PRP Pioneer
Since platelet-rich plasma can release growth factors that can prompt healing, the father of regenerative medicine may be found in the distant past of this technology. The early days of the clinical use of PRP saw a few physicians adopt the technology after a commercial bedside centrifuge kit became available in the early 2000s. However, the first use of PRP, before commercial kits were available, was in dentistry and other areas. A PubMed search turned up a reference in 1999 where an Estonian dentist suggested using PRP to enhance implant healing. About the same time, Gehring, in 1999, published a paper about using PRP in ophthalmology. However, since the phrase "Regenerative Medicine" encompasses anything that can be used to cause damaged tissue to heal, the story goes back even further to the early days of prolotherapy.
Why Hackett Is Likely the True Father of Regenerative Medicine
If we go back even further in time and look for physicians whose stated goal was to help damaged tissue heal by injecting something to prompt repair, then regenerative medicine publications can be traced back much further. Hackett published a paper in 1960 on the use of hypertonic dextrose injections to prompt an inflammatory healing response in the lax or damaged ligaments of patients with whiplash or low-back pain. Prior to that, Hackett published a paper in the '50s on treating ligaments with "sclerotherapy" to stabilize joints. Prior to those publications, the practice of injecting ligaments to treat things like chronic low-back pain was common in the '30s and '40s. You can trace the idea even further back in the treatment of animals. For example, pin firing (sticking a hot poker into a nonhealing wound to stimulate healing) is rumored to have begun in ancient Greece. Regrettably, we can't source a name here that we can call the father of the field.
So Who Can Claim the Title?
So is there one modern "father"? You could make arguments for Hernigou, Caplan, the early users of PRP, and so on. However, if you had to award the title to one person, that honor likely goes to George Hackett who figured out that you could help ligaments heal with injections. That's the best I can figure after running multiple searches through the US Library of Medicine.
Why C. Randall Harrell Isn't Close to Being the Father of Regenerative Medicine
The plastic surgeon who put out the press release has a clinic in Florida and also seems to have started yet another "me too" 361-registered birth-tissue vendor. I honestly can't keep up with the ever-expanding panoply of companies private labeling or processing birth tissues after a 45-minute, quickie FDA registration online and selling them for megabucks. There are literally one-to-three new companies every month, each claiming to magically process this stuff better than the last. Given that there are only a few things you can do to the same tissue and it still be "minimally manipulated," it's funny to see each company claim to reinvent the wheel to drive sales. This is the statement from the press release that the blog reader pointed out: "About Dr. Harrell: Dr. Harrell is considered the Father of Regenerative Medicine." Now, if Dr. Harrell was considered by anybody but Dr. Harrell as being the father of regenerative medicine, he would have extensive peer-reviewed publications going back decades on the subject. Hence, I ran a quick PubMed search. He has four publications that come up under the search "Harrell" and "stem cells." None of these were published before 2017. Three are review papers, so no original research. Only one is actually authored by him, and on the other two, he's buried as a contributing author. There is one research study, but that's a basic lab study and, again, his contribution based on his pecking order in the author list was likely minimal. He was apparently an early user of injectable collagen fillers in plastic surgery, which were later shown to have some regenerative properties, but the goal of these therapies was largely cosmetic.
Regenerative Medicine Is Filled with Wild Claims of Expertise
As I've pointed out in many prior blogs, physicians in the regen med space love to make claims about expertise that are creative at best and downright fraudulent at worst. I've seen doctors claim to have used stem cells for a decade or more when in reality they're referring to PRP. I had one doctor who took a weekend course and then went out and tried to sell himself to a major conference as an expert on stem cells. So not much surprises me these days. However, I find that PubMed is the great equalizer. If you're a true pioneer, you publish your findings and it's memorized in the US National Library of Medicine. The upshot? What began as a plastic surgeon claiming a title that he's not even in the conversation for ended up being a nice dive into the history of what we call regenerative medicine. We all owe a great debt of gratitude to the true pioneers who put their careers and necks on the line to try something new to help patients recover.
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