Nip, Tuck, CRISPR: Gene Modification Could Help Plastic Surgery

Slot of the palace. Serious injury. Hands or faces lost. Everything could be repaired more completely than is currently possible if genetic editing became an integral part of plastic and reconstructive surgery. This possibility is being seriously considered now that gene editing CRISPR, a powerful research tool, is being developed for clinical applications. CRISPR could also improve cosmetic interventions by altering the genetic targets involved in hair loss and skin aging. In addition, the humanization of donor animals with CRISPR could lead to the production of new, less immunogenic and less expensive fillers.

These potential applications will, however, materialize only if plastic and reconstructive surgical professionals become "stakeholders in CRISPR gene editing and participate in future debates on the ethical use of CRISPR for the treatment of cancer". improvement of our patients, "write the authors of an article in the November issue of Plastic and Reconstructive Surgery. This article, "CRISPR Occupation: DNA Modification of the Reconstructive Scale," is the work of surgeons and clinical scientists based at Massachusetts General Hospital and Harvard Medical School.

"The potential impact of CRISPR on the treatment of human diseases includes several important areas for the plastic surgeon, such as oncology, wound healing, immunology and cranofacial malformations," comments Eric. Dog-Wei Liao, senior author of the article, associate. Professor of Surgery, Harvard Medical School. Dr. Liao is also Director of the Cleft and Craniofacial Center and Principal Investigator of the Center for Regenerative Medicine at the Harvard Stem Cell Institute.

In their article, Dr. Liao and his colleagues discuss some key areas in which CRSIPR has predictable implications for plastic surgery, including:

• Cranio-facial malformations. Basic scientific studies using CRISPR techniques have already led to a better understanding of cranofacial development pathways. CRISPR allows rapid identification of individual gene mutations and may eventually correct mutations and prevent the development of cleft lip, palate and other congenital malformations.
• Healing and repair of tissues. Gene therapy is a promising approach to improve the healing of wounds and tissues. In addition to accelerated healing of skin wounds, CRISPR can lead to new approaches for the repair and regeneration of bones, cartilage, nerves and muscles.
• Cell therapy and tissue engineering. Genetic techniques may allow the creation or modification of the patient's own (autologous) cells to graft or replace damaged tissue, stimulate cellular development, or modulate immune function. "[Techniques] creating skin grafts with therapeutic potential would have a widespread impact on reconstructive surgery, "write Dr. Liao and his coauthors.
• Flap Biology and Transplants. In addition to tissue flap modification, gene modification with CRISPR may allow reprogramming of vascularized composite allotransplantations, such as facial and / or hand grafts, to promote tolerance and prevent rejection by the recipient's immune system. . Similar approaches to immune modulation could also promote tolerance of animal donor tissues (xenotransplantation).

"CRISPR represents a major technological breakthrough that is revolutionizing vast areas of oncology, wound healing, immunology and cranio-facial genetics, so that plastic surgeons need to become familiar with this. breakthrough technology and become contributors and active leaders in the application of CRISPR to our respective areas of expertise "The current article authors maintain. "The new reconstruction scale bars could someday be modified to include the enhancement of tissue repair with CRISPR gene editing, the administration of CRISPR-modified cells with a improved survival, or even transplantation of humanized tissues from animals modified by CRISPR. "

Dr. Liao and his colleagues pointed out that there was still a lot of difficulty in making these changes and other clinical advances with CRISPR gene editing, including potential "off-target" effects, regulation of the FDA, the high costs and ethical issues associated with genetic editing of human cells and tissues.