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The Italian Tissue
   Engineering(TE) and
Regenerative Medicine(RM)
        Network

              Claudio Zanon
    Director of the Piedmont Health
                 Agency
 Director of the National TE-RM Group
What is Tissue Engineering?




Tissue engineering is the development and manipulation of laboratory-grown
molecules, cells, tissues, or organs to replace or support the function of
defective or injured body parts.
 It is the field of study that requires input from many types of scientists,
including the problem solving expertise of engineers, hence the name: tissue
engineering
Rationale Design of Tissue
       Engineering
Regenerative Medicine
• Tissue engineering has emerged as a field
  to replace tissues and organs lost by
  disease, trauma, or congenital
  abnormalities.
• Attempts have been made to engineer
  many tissues including skin, cartilage,
  bone, nerve, cardiovascular valves and
  conduits, and liver. But the work is in
  progress……
And more….
•    We look forward to the development of effective
     therapies for:

1.    degenerative diseases, traumatic injuries, and
     disorders for which limited therapeutic options exist
     such as esophageal cancer or emphysema.
2.    The derivation of blood cells from stem cells, the
     creation of insulin-secreting, glucose-responsive cells
     for the treatment of diabetes, the constructive
     functional remodeling of the heart after a myocardial
     infarction, and the regeneration of nerves after spinal
     cord injury all represent realistic targets for
     regenerative medicine.
State of Art
•   The 1980s and 1990s were the “go-go years” of tissue engineering, but by
    the turn of the century commercial activity had encountered a variety of
    problems, including challenging regulatory hurdles and almost nonexistent
    third-party reimbursement mechanisms needed to sustain the
    commercialization effort.

•   In April 2008 U.E. and in Italy the Minister of Health introduced the concept
    of “Tissue Enginneered Products (TEPs) in the field of the”Advanced
    Therapy Medicinal Products (ATMPs) already regulated in the 2001, as a
    indipendent productal class(Tissue Engineered Products) different from
    somatic cellular therapeutic products and the genetic therapeutic products

•   Three different products are now described 1) Gene therapy products, 2)
    Somatic cell therapy products;3) Tissue Engineered Products.

•   In USA from 2000 is operating the M.A.T.E.S. (Multi-Agency Tissue
    Engineering Science) to coordinate the national activities in the field of
    Tissue Engineering e Regenerative medicine.
M.A.T.E.S.
•   The MultiAgency Tissue Engineering Scienee (MATES) Interagency Working
    Group (lWG), organized under the auspices.of the Subcommittee on
    Biotechnology of the National Science and Technology Council (NSTC), is the
    means by which Federal agencies involved in tissue engineering stay. informed
    of each other's activities and coordinate their efforts in a timely and efficient
    manner.

• The goals of theMATES IWG are:
1. • To facilitate communication across departments/agcncies by regular
   information exchanges and a common website

2. • To enhance cooperation through co-sponsorship of scientific meetings and
   workshops, and facilitation ofthe developrnent of standards

3. • To monitor technology by undertaking cooperative assessments of the status
   of the field

4. • To provide for support of tissue engineering research through interagency
   tissue engineering funding opportunity announcements
Tissue-Net
• Tissue –Net is the Italian M.A.T.E.S. born to reach
  the same goals

• The Tissue-Net task is:
1. To verify Tissue Engeenering(TE) and Regenerative
   Medicine (RM) centers operating in the field
2. To record the Italian TE-RM clinical trials
3. To avoid me too basic and translational researches
4. To focus the different centers on different activities
5. To distribute the national public funds as the agreed
   national program
6. To verify the skill and the technology of the TE-RM
   centers
7. To integrate our center in an international and/or
   European network
Italian TE-RM Centers
•   1. Tissue Net (10 Italian centers)

•   2. Centro di Ingegneria tessutale dell’Università di Pavia
•   http://cit.unipv.it/cit_it/

•   3. Il CENTRO di RICERCA INTERDIPARTIMENTALE sui BIOMATERIALI (CRIB)
•   http://www.crib.unina.it/

•   4. Centro di Nanomedicina e Ingegneria dei Tessuti dal 2008 Ospedale Riguarda Ca’ Granda Milano
•   http://www.ospedaleniguarda.it/

•   5. Struttura Semplice di Patologia Ortopedica e Rigenerazione Tissutale Osteoarticolare
    Istituto Ortopedico Rizzoli, Via di Barbiano 1/10 40136 Bologna
•   http://www.ior.it/curarsi-al-rizzoli/patologia-ortopedica-e-rigenerazione-tissutale-osteoarticolare

•   6. San Raffaele del Monte Tabor -Ingegneria Tissutale e Biomateriali
•   http://www.sanraffaele.org/home/ricerca/divisioni_centri_istituti_programmi/BoNetwork/ingegnaria_tissutale_biomateriali.html

•   7.Istituto Mario Negri Milano
•   http://www.marionegri.it/mn/it/sezioni/istituto/strutturaDipa.html

•   Banche dei tessuti:
•   Pagina del Ministero della salute
•   http://www.trapianti.salute.gov.it/cnt/cntDettaglioMenu.jsp?id=59&area=cnt-
    tessuti&menu=menuPrincipale&sotmenu=istituzioni&label=mti

•   Fondazione Banca dei tessuti di Treviso
•   http://www.fbtv-treviso.org/

•   Associazione Ingegneria dei tessuti ONLUS
•   http://www.ingegneriatissutale.it/chi-siamo.html
Conclusions
• Many centers are active in the TE-RM researches
  working as “somatic cell therapy products (SCTP)”
  centers and manufacturing TE product for clinical
  applications (up to now we don’t register any authorised
  national phase 1 clinical trials in the TE-RM field)

• We are recording the GMP laboratories comparing their
  activities and sites with the TE-RM or SCTP centers

• We are programming the activities of every center to
  avoid me too researches and the public funds dispersion
  incouraging national and european collaborations

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The Italian Tissue Engineering (TE) and Regenerative Medicine (RM) Network

  • 1. The Italian Tissue Engineering(TE) and Regenerative Medicine(RM) Network Claudio Zanon Director of the Piedmont Health Agency Director of the National TE-RM Group
  • 2. What is Tissue Engineering? Tissue engineering is the development and manipulation of laboratory-grown molecules, cells, tissues, or organs to replace or support the function of defective or injured body parts. It is the field of study that requires input from many types of scientists, including the problem solving expertise of engineers, hence the name: tissue engineering
  • 3. Rationale Design of Tissue Engineering
  • 4. Regenerative Medicine • Tissue engineering has emerged as a field to replace tissues and organs lost by disease, trauma, or congenital abnormalities. • Attempts have been made to engineer many tissues including skin, cartilage, bone, nerve, cardiovascular valves and conduits, and liver. But the work is in progress……
  • 5. And more…. • We look forward to the development of effective therapies for: 1. degenerative diseases, traumatic injuries, and disorders for which limited therapeutic options exist such as esophageal cancer or emphysema. 2. The derivation of blood cells from stem cells, the creation of insulin-secreting, glucose-responsive cells for the treatment of diabetes, the constructive functional remodeling of the heart after a myocardial infarction, and the regeneration of nerves after spinal cord injury all represent realistic targets for regenerative medicine.
  • 6. State of Art • The 1980s and 1990s were the “go-go years” of tissue engineering, but by the turn of the century commercial activity had encountered a variety of problems, including challenging regulatory hurdles and almost nonexistent third-party reimbursement mechanisms needed to sustain the commercialization effort. • In April 2008 U.E. and in Italy the Minister of Health introduced the concept of “Tissue Enginneered Products (TEPs) in the field of the”Advanced Therapy Medicinal Products (ATMPs) already regulated in the 2001, as a indipendent productal class(Tissue Engineered Products) different from somatic cellular therapeutic products and the genetic therapeutic products • Three different products are now described 1) Gene therapy products, 2) Somatic cell therapy products;3) Tissue Engineered Products. • In USA from 2000 is operating the M.A.T.E.S. (Multi-Agency Tissue Engineering Science) to coordinate the national activities in the field of Tissue Engineering e Regenerative medicine.
  • 7. M.A.T.E.S. • The MultiAgency Tissue Engineering Scienee (MATES) Interagency Working Group (lWG), organized under the auspices.of the Subcommittee on Biotechnology of the National Science and Technology Council (NSTC), is the means by which Federal agencies involved in tissue engineering stay. informed of each other's activities and coordinate their efforts in a timely and efficient manner. • The goals of theMATES IWG are: 1. • To facilitate communication across departments/agcncies by regular information exchanges and a common website 2. • To enhance cooperation through co-sponsorship of scientific meetings and workshops, and facilitation ofthe developrnent of standards 3. • To monitor technology by undertaking cooperative assessments of the status of the field 4. • To provide for support of tissue engineering research through interagency tissue engineering funding opportunity announcements
  • 8. Tissue-Net • Tissue –Net is the Italian M.A.T.E.S. born to reach the same goals • The Tissue-Net task is: 1. To verify Tissue Engeenering(TE) and Regenerative Medicine (RM) centers operating in the field 2. To record the Italian TE-RM clinical trials 3. To avoid me too basic and translational researches 4. To focus the different centers on different activities 5. To distribute the national public funds as the agreed national program 6. To verify the skill and the technology of the TE-RM centers 7. To integrate our center in an international and/or European network
  • 9. Italian TE-RM Centers • 1. Tissue Net (10 Italian centers) • 2. Centro di Ingegneria tessutale dell’Università di Pavia • http://cit.unipv.it/cit_it/ • 3. Il CENTRO di RICERCA INTERDIPARTIMENTALE sui BIOMATERIALI (CRIB) • http://www.crib.unina.it/ • 4. Centro di Nanomedicina e Ingegneria dei Tessuti dal 2008 Ospedale Riguarda Ca’ Granda Milano • http://www.ospedaleniguarda.it/ • 5. Struttura Semplice di Patologia Ortopedica e Rigenerazione Tissutale Osteoarticolare Istituto Ortopedico Rizzoli, Via di Barbiano 1/10 40136 Bologna • http://www.ior.it/curarsi-al-rizzoli/patologia-ortopedica-e-rigenerazione-tissutale-osteoarticolare • 6. San Raffaele del Monte Tabor -Ingegneria Tissutale e Biomateriali • http://www.sanraffaele.org/home/ricerca/divisioni_centri_istituti_programmi/BoNetwork/ingegnaria_tissutale_biomateriali.html • 7.Istituto Mario Negri Milano • http://www.marionegri.it/mn/it/sezioni/istituto/strutturaDipa.html • Banche dei tessuti: • Pagina del Ministero della salute • http://www.trapianti.salute.gov.it/cnt/cntDettaglioMenu.jsp?id=59&area=cnt- tessuti&menu=menuPrincipale&sotmenu=istituzioni&label=mti • Fondazione Banca dei tessuti di Treviso • http://www.fbtv-treviso.org/ • Associazione Ingegneria dei tessuti ONLUS • http://www.ingegneriatissutale.it/chi-siamo.html
  • 10. Conclusions • Many centers are active in the TE-RM researches working as “somatic cell therapy products (SCTP)” centers and manufacturing TE product for clinical applications (up to now we don’t register any authorised national phase 1 clinical trials in the TE-RM field) • We are recording the GMP laboratories comparing their activities and sites with the TE-RM or SCTP centers • We are programming the activities of every center to avoid me too researches and the public funds dispersion incouraging national and european collaborations