• 9/28/2004
  • University of Michigan
  • BY PATRICIA ANSTETT
  • Detroit Free Press

Kenji Izumi enters a small sterile room at the University of Michigan Medical Center, scrubbed and covered head to toe in white plastic disposable garments. A research scientist, he’s the caretaker for a collection of cells that will grow to millions in just two weeks. When he gets enough — he needs a supply the size of a quarter — the cells will be harvested as mouth grafts, for surgical treatment of oral cancers and periodontal disease.

Eventually, the product could be used for other skull and facial problems.

But oral surgeons found problems using such grafts in the mouth to repair wounds after surgery for oral and throat cancers and periodontal disease.
Kenji Izumi, a visiting assistant research scientist at U-M, is the caretaker of a group of cells that will grow to millions in two weeks. Skin grafts are rigid, don’t always last long and some — heaven forbid — grow hair like real skin does, says Dr. Stephen Feinberg, professor and associate chair of research at U-M’s section of Oral & Maxillofacial Surgery, in the Department of Surgery. The grafts the U-M team are working on do not grow hairbecause the cells come from inside a person’s mouth.

Last month, Feinberg’s U-M team began clinical studies with EVPOME, the oral mucosal tissue product for which the team has a pending patent application. The product is made from cells obtained from the oral mucosal tissue that covers most of the mouth. The team obtains the cells during a biopsy, then places them in a medium, or a substance, with nutrients that help them multiply. When the supply cells have grown enough, they are placed onto a synthetic base, a product called AlloDerm that is then used in surgery.

Current work centers on improving the culture in which the cells grow to make them hardier, longer-lasting and faster-growing, said Cynthia Marcelo, a research professor with the U-M medical and dental schools team.

The team, with the help of a $1.1 million federal grant, hopes to improve the procedure by putting the cells in a machine that sorts cells by size. The smallest ones are stems cells capable of becoming other types of cells, including mucosal cells. Other cell growth mediums use animal products or cholera toxins, Marcelo said. “We want to get rid of all that stuff,” Marcelo said. “It turns out the secret to growing epithelial cells — without giving away our work — is to remove a whole collection of factors . . . and to lower the amount of calcium.”

Last month, the first patient received the grafts in surgery. Four more await operations. If the grafts are successful, the U-M team will test them in more patients. If the federal Food and Drug Administration gives the team it’s approval, Feinberg says, “we plan to do 50 more patients who need major maxillofacial reconstruction of the mouth” for cancer, traumatic or developmental deformities.

“We hope this will be a treatment that not only will reconstruct your mouth after cancer surgery but also helps prevent recurrence,” Feinberg says.

The grafts eventually might be used for other types of cancers, diabetic foot ulcers, hemophilia, some autoimmune diseases. They also might help in reconstructive surgery for the eyelids, bladder, urethra and vagina. The team’s long-term goal, Feinberg says, is to combine growth factor products with the grafts to make the tissue smarter, so that it grows better and suits more uses. The work may prove to be “the foundation of advances in cell replacement therapy,” Feinberg says.