Stem cell applications in military medicine

Abstract

There are many similarities between health issues affecting military and civilian patient populations, with the exception of the relatively small but vital segment of active soldiers who experience high-energy blast injuries during combat. A rising incidence of major injuries from explosive devices in recent campaigns has further complicated treatment and recovery, highlighting the need for tissue regenerative options and intensifying interest in the possible role of stem cells for military medicine. In this review we outline the array of tissue-specific injuries typically seen in modern combat - as well as address a few complications unique to soldiers - and discuss the state of current stem cell research in addressing each area. Embryonic, induced-pluripotent and adult stem cell sources are defined, along with advantages and disadvantages unique to each cell type. More detailed stem cell sources are described in the context of each tissue of interest, including neural, cardiopulmonary, musculoskeletal and sensory tissues, with brief discussion of their potential role in regenerative medicine moving forward. Additional commentary is given to military stem cell applications aside from regenerative medicine, such as blood pharming, immunomodulation and drug screening, with an overview of stem cell banking and the unique opportunity provided by the military and civilian overlap of stem cell research.

Cell-Mediated Pathologies in Traumatic Orthopaedic Injuries

“…Orthopaedic injuries generally referred to blunt or penetrating trauma to the musculoskeletal system that results in a wide zone of injury crossing several different tissue planes and involving many different cell types 15 . After trauma, the affected cells are exposed to a series of necrotic, apoptotic, and inflammatory events.…”

“…Broadly speaking, there are three types of stem cells: adult stem cells, embryonic stem cells (ESCs), and induced pluripotent stem cells (iPSCs) 15 . Embryonic stem cells are not readily available and come with ethical concerns and will not be discussed here.…”

Toward Organs on Demand: Breakthroughs and Challenges in Models of Organogenesis

“…Indeed, the increase in Improvised Explosive Device (IED) in current conflicts has often resulted in massive wounds for warriors involving neural, cardiopulmonary, musculoskeletal and sensory tissues, opening a new branch of translational medicine, the military medical research (8). …”

Composite nature of fresh skin revealed during compression

“…8 Mammalian skin is a complex, biological material comprised of several layers including an outmost epidermis and a multilayered epithelium. 9 It functions as a protective barrier for underlying structures.…”