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Regenerative Cell-Based Therapies: Cutting Edge, Bleeding Edge, and Off the Edge

Abstract

With the emergence of cell-based therapies as viable treatment options readily accessible to patients, the scientific community and public have raised concerns regarding consumer accessibility and regulation enforcement. Opposing viewpoints regarding regulation have emerged, and efforts to maintain the balance between promoting scientific innovation and ensuring public safety has proved challenging. To further complicate matters, there is contradictory information regarding the clinical safety and efficacy of cell-based treatments. Herein, we outline the FDA’s regulatory framework for cell-based therapies and describe what we term the cutting edge, bleeding edge, and off the edge interventions. We conclude with a new classification system for regenerative cell-based therapies intended to further aid in delineating between the clinically and scientifically sound therapies to those that compel further scientific investigation.

Lay Summary

There is controversy surrounding cell-based therapies. Patients have broad access to risky and unregulated stem cell therapies and this has raised concerns regarding regulation enforcement. Furthermore, there is contradictory evidence describing the clinical usefulness and safety of current therapies. Herein, we outline the FDA's regulatory framework for cellular therapies and describe what we define as the cutting edge, bleeding edge, and off the edge cell-based therapies. We describe a new classification system for regenerative cell-based therapies that stratifies interventions based on the supporting evidence and risk for harm. We intend to provide the scientific community with a systematic strategy to assess cell-based therapies and to further inform patients.

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Funding

Support from NIH DP1 AR068147 and the Raymond and Beverly Sackler Center for Biomedical, Biological, Physical, and Engineering Sciences is gratefully acknowledged.

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Correspondence to Cato T. Laurencin.

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Laurencin, C.T., McClinton, A. Regenerative Cell-Based Therapies: Cutting Edge, Bleeding Edge, and Off the Edge. Regen. Eng. Transl. Med. 6, 78–89 (2020). https://doi.org/10.1007/s40883-020-00147-1

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Keywords

  • Cell-based
  • Stem cells
  • Classification system
  • Regenerative engineering
  • Regulation