Skin Grafting from 9-Gene Genetically Engineered Pigs in the Treatment of Burns: An Experimental Study in Monkeys
Abstract
Objectives and Rationale: The treatment of severe burns frequently requires grafting using skin from the patient him/herself (autologous skin), or skin from a human donor, or pig. Pig skin grafts are sometimes used, but are rejected more quickly than human skin grafts. We now have available pigs with 9 genetic manipulations, all aimed at protecting the pig cells from the human immune response (rejection). We believe skin grafts from these pigs will survive as long as, if not longer than, skin grafts from other humans, and will therefore provide a new source of skin for the treatment of patients with severe burns. Multi-Domain Lifesaving Trauma Innovations Award Sub-Areas: The proposal is fully aligned with Focus Area 1 (novel burn stabilization and coverage capabilities, and optimizing sustained resuscitation for burn injuries). The experimental plan compares the survival of grafts in monkeys using skin (i) from the same monkey (autologous skin), (ii) from another monkey, or (iii) from a genetically engineered pig. The autologous skin will not be rejected, but the other monkey and pig skin grafts are anticipated to be rejected within about 2 weeks. The reasons for their rejection will be identified, which might allow even better genetically engineered pigs to be produced in the future. Potential Clinical Applications, Benefits, and Risks: In a severely burnt patient, it is frequently necessary to cover the burnt area with temporary skin grafts to prevent loss of fluid and infection, and allow time for some healing to take place. If rejection of pig skin grafts could be prevented for at least 2 weeks (in the absence of any immunosuppressive drug treatment, which increases the risk of infection), this would be invaluable. There are few associated risks. For example, it is already known that, even when a pig skin graft is rejected, this does not prevent a subsequent human skin graft (if one can be obtained) from being successful. Projected Timeline: If this experimental study is successful, there would be no reason why, once Food and Drug Administration (FDA) approval is obtained, a clinical trial should not be initiated immediately in patients with severe burns. Pigs bred and housed under FDA-approved “clean” conditions will be available later this year. Benefit to Service Members and Public: The ready availability of stored pig skin would be of immense benefit to the treatment of both military and civilian patients with severe burns, greatly facilitating their recovery. Pig skin will be more readily available than human skin, and may indeed survive longer than a human skin graft. The experience gained will allow the breeding of even more advanced genetically engineered pigs.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010559
Entities
People
- David K.C. Cooper
Organizations
- United States Army
- University of Alabama at Birmingham