“How are we to prevent France from falling behind with regard to regenerative medicine?”

Publié le : 28 March 2013

 In a special section, the weekly Vateurs Actuelles looks into regenerative medicine, a practice which, according to André Choulika, president of France Biotech – an association that brings together around 150 biotechnology companies – "will completely change medicine, but also the health economy and all of society.

Unlike classic pharmaceutical products which are designed "to cure the affected organs with chemical substances that are more or less adapted to their objective and more or less productive of secondary effects," regenerative medicine consists of repairing the organs "more intimately, by simply replacing the affected cells by healthy cells" in the following way: "cells usually obtained from the patient or else from a compatible donor are selected and modified before being re-injected into the patient. They then get to work to produce tissues and transform themselves into a healthy organ that is renewed partly or totally." So regenerative medicine is a targeted medicine that "makes a complete break with the policy of mass medications developed up to now.
While "France has been a pioneer in cellular therapy […] the industrial development that would lead to true regenerative medicine has not taken place." André Choulika asks: “How are we to prevent France from falling behind with regard to regenerative medicine?" for, according to him, this risk is real. In order to develop regenerative medicine on a large sale, it is necessary to have access to a large quantity of stem cells capable of differentiating to become tissues and organs. In concrete terms, may diseases could benefit from regenerative medicine because they involve "the destruction or degeneration of tissues": myocardial infarction, heart failure and polyarthritis. Similarly, genetic diseases such as Parkinson’s, Alzheimer’s and diabetes could benefit from it.
Whereas, until the early 2000s, some researchers counted only on "embryonic stem cells [because they are] ‘multipotent’ and thus able to transform themselves into differentiated organs," other researchers have radically changed the therapeutic possibilities, notably because research on embryonic stem cells raises ethical problems. How? "By learning to extract stem cells from adults, the blood or the umbilical cord." Then, the genetic researchers John Gurdon and Shinya Yamanaka, both winners of the Nobel Prize for Medicine in 2012, showed that "adult cells, already differentiated, can recover their initial multipotency. This is the way to develop the equivalent or almost of embryonic cells." (Gènéthique press review from 8th to 12th of October 2012)
For example: "around 90 million blood transfusions are carried out each year around the world. This resource is insufficient, and unevenly distributed, while the pathologies requiring transfusions are on the increase," the journalist points out. Thus, "red blood cells produced in vitro could at least partially reduce this penury." In France, Prof. Douay, with the support of the French Blood Establishment (Etablissement Français du Sang), "massively produces red blood cells from adult stem cells for transfusion." And André Choulika explains that "in ten years’ time, nobody will want red blood cells taken from anonymous donors! They will prefer tissues produced in the laboratory which are safer and obtained under better control. Some emerging countries, which do not have the culture of blood donations, will move directly to the industrial production of cells." And "the market for cellular therapy was evaluated at $5 billion in 2015," adds the journalist. Hence, all that is needed is "its industrial development [because] the main players of the sector are SMEs, or start-ups, and hospitals." The representatives of France Biotech state that "the pharmaceutical industry needs to take up this production so that we can move from clinical trials to the medication stage. As long as we stay in this artisanal stage, we cannot properly demonstrate the effectiveness of cellular therapy. And so the pharmaceutical industry does not get involved, or not enough. It’s a vicious circle!
André Choulika adds: "what we are not doing is done elsewhere, quite simply. In Germany, in Great Britain, in Switzerland, etc. France will lose the benefit of its advance after opening the way with the sequencing of the human genome." Lastly, he points out, "we of course need strict bioethics regulations. But they must also be stable and not dissuasive: let us not put chains on our feet!"

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