It all started when Mike Christensen used another fellow's log splitter.
The next thing he knew, the tip of his thumb, mangled and detached, sat inside his glove.
That's how the City of Bellevue employee in late February became a test case for a new powdery product from pigs that reputedly regrows tissue.
Christensen said he handed information about the product to a University of Nebraska Medical Center physician, who slid it back to him. Christensen could try it, but not with that doctor's help.
Christensen then thought of Dr. Theresa Hatcher, a friend and former Bellevue City Council member. They decided to order the powder, made by a Maryland-based company called ACell, and give it a shot.
Whether the powder helped regrow Christensen's thumb isn't clear. Mother Nature typically offers a bit of regrowth. Christensen and Hatcher are convinced the powder provided significant improvement -- perhaps three-fourths of the lost thumb tip has grown back.
Christensen's experience may serve as an example of what many scientists see as a brilliant future for regenerative medicine. It includes seeding wounded areas with proteins to aid in healing, using a patient's cells to grow bladders and other parts, and manipulating adult and embryonic stem cells to produce healthy cells to combat disease.
“The potential for regenerative medicine is very promising,” said Dr. Anthony Atala, director of the Wake Forest University Baptist Medical Center's Institute for Regenerative Medicine. “We're going to see a lot of technologies come out for patients in the next few years.”
Nevertheless, miraculous advances, such as the creation of hearts and livers, appear to be years away. The growth of a thumb tip may be a fitting symbol for how far regenerative medicine has advanced.
“I think we're all at risk of overselling,” said Dr. James Turpen, interim director of UNMC's regenerative medicine program. “There's a very large gap between regenerating the tip of a thumb and finger and regenerating the whole joint or regenerating the whole finger.”
Atala's lab is among those that have successfully created human bladders from patients' own cells and placed those organs back inside patients.
Atala said last week he is working to grow more than 20 different tissues and organs in the laboratory. Skin, blood vessels and cartilage already have been made, he said, and kidneys, livers and pancreases are in experimental stages.
How long will it take before scientists create hearts, livers and other organs? “That's going to be a while,” Atala said.
The pig-bladder powder, which consists of proteins and other material, treats large wounds, diabetic ulcers, burns and other conditions.
Scientists have insights into how the powder works, said Dr. Thomas Gilbert, a faculty member at the University of Pittsburgh's McGowan Institute for Regenerative Medicine. But as with most regenerative medicine, Gilbert said, “we have outcomes before we have full understanding.”
Proteins in that powder evidently recruit the patient's own stem cells to the wounded area and help it heal, he said. Atala, a physician, and Gilbert, whose doctorate is in bioengineering, are on ACell's scientific advisory board.
Scientists are experimenting with the powder for other uses, such as tendon repair and production of heart and windpipe tissue.
The pig product works well, some say, because it's plentiful and fairly similar to human tissue.
Christensen's wife had heard about the Food and Drug Administration-approved product.
Two days after his ER visit, Christensen went to Dr. A.J. Lauder, a UNMC faculty member in orthopedic surgery. Armed with information about the powder, Christensen suggested Lauder treat the wound with it.
Lauder said hand surgeons across the country aren't using it, and it's certain that thumbs and fingers aren't magically growing back.
Typically, Lauder said, surgeons use skin grafts or let nature do its work, adding a bit of length to an amputated thumb tip. Maybe, Lauder said, surgeons will use the powder in the future.
“To be quite honest, I don't know what to think of it,” Lauder said last week.
Because a doctor must order the product for a patient, Hatcher went to work on it for Christensen. Hatcher, an ER doctor, studied the product on the ACell website and called the company. Soon, she and Christensen had 15 doses in sterile capsules from ACell, at more than $900.
Christensen, 51, would kneel at Hatcher's kitchen counter, then place his thumb over the edge of a coffee cup. Hatcher covered the wound in saline solution and placed the powder onto it with a sterile tongue depressor. They did this every other day.
This was a simple project, but much of regenerative medicine hinges on complex and sometimes controversial stem cell technology.
Scientists view stem cells as crucial to regenerative strategies because those cells have almost limitless ability to divide and renew themselves, Turpen said.
Scientists have used adult stem cells for years at UNMC, the University of Iowa and many other institutions to supply healthy blood cells to bone marrow and the bloodstream in certain leukemias, lymphomas and other blood diseases.
Many scientists also value controversial embryonic stem cells, produced in early-stage embryos, because those cells have the potential to become any kind of cell in the body. Opponents say it's unethical to use embryos for the sake of research.
Scientists ultimately are striving to manipulate other cells, such as adult skin cells, with genes or chemicals so they will mimic embryonic stem cells. This would enable scientists to avoid the controversy that goes with using embryonic stem cells.
Dr. Dana Levasseur, who conducts research on stem cells at the University of Iowa, said he hopes that in 10 to 20 years it will be possible to swab the inside of a person's cheek to gain the skin cells that scientists will convert into healthy heart and brain cells.
UNMC's Turpen said quackery continues to concern him and other scientists. Turpen cited a Chinese claim that fingers could be regenerated through aromatherapy, and a Californian's claim that he could cure Lou Gehrig's disease right now with stem cells.
Turpen said the ACell powder, however, isn't quackery. The company has legitimate scientists on its scientific board, he said, and the product relies on biological principles.
Christensen lost about 16 millimeters more than a half inch from the base of his thumbnail up. He and Hatcher applied 15 doses of the powder. Then he ordered one more box of five applications for about $300 to complete the treatment.
Two months after the Feb. 20 accident, Hatcher checked on Christensen. Gauze covered the wound.
“That's not blood, is it?” Hatcher said of a red stain on the gauze.
“It's barbecue sauce from last night,” Christensen said as he unwrapped the gauze and showed the doctor the wound.
“It looks beautiful,” she said.
Replied Christensen: “Best thousand bucks I ever spent in my life.”
Contact the writer:
444-1123, rick.ruggles@owh.com
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