Hearts & Bones
Gordana Vunjak-Novakovic is at the forefront of regenerative medicine. Can her laboratory-grown body parts really work?by Adam Piore Published Spring 2012
Jeffrey Ascherman had seen dozens of patients who looked like Marika, an eleven-year-old girl from Uniondale, New York. She had the drooping eyelids and sunken, formless cheeks of someone afflicted with Treachery Collins syndrome, a hereditary condition that causes people to be born without certain facial bones.
Her parents were hoping for a cosmetic fix. Marika, an honor-roll student, violinist, and aspiring actress whose name has been changed for this article, dreamed of looking more like her classmates.
But Ascherman, a plastic surgeon at the Columbia University Medical Center (CUMC) who specializes in treating children with cleft palate and other facial deformities, had no easy solution to offer. Implanting prosthetic bones was not an option for a still-growing child. The only way to fill out Marika’s face, Ascherman told her parents, would be to make an incision across the top of her head, remove a portion of her skull, and carve it into the shapes of two cheekbones. If Marika was lucky, the bones, once implanted, would grow along with the rest of her face.
But this solution was not ideal. The recovery would be long and painful as the skull bone grew back. Even then, there was no guarantee the procedure would work. Over time, the grafted bone might simply dissolve in her face, requiring reparative surgeries and more suffering.
Unpleasant as this was to contemplate, Ascherman knew that, to the girl and her parents, doing nothing seemed unthinkable.
“This is a condition that often leads to social withdrawal and ostracism,” he says. “When you see what these kids go through, it breaks your heart.”
Ascherman, who sees a handful of children with Treacher Collins every year, had resigned himself to the limited options available until he learned about the work of Gordana Vunjak-Novakovic, the Mikati Foundation Professor of Biomedical Engineering at Columbia’s Fu Foundation School of Engineering and Applied Science. Last July, he heard Vunjak-Novakovic deliver a lecture about her efforts to grow living human tissue. Afterward, he approached her and asked if she might grow facial bones for his young patients.
“She said anything was possible,” he recalls, “and that she was willing to try.”
Only a handful of biomedical engineers have ever succeeded in growing tissues that could be put into people — and these have been relatively simple tissues, like skin and blood vessels.
Last fall, a team of Columbia clinicians led by Sidney Eisig, a pediatric oral and maxillofacial surgeon, took a big step toward achieving this goal. They implanted in pigs — whose facial anatomy is similar to that of humans — jawbones that Vunjak-Novakovic had grown in her laboratory. Soon, Ascherman hopes to try the procedure with cheekbones. If the experiments prove successful, human trials could begin as early as next year.