National Benefits
Social Benefit.
Australians are living longer, and expect to maintain
an active and healthy lifestyle well into old age. By the year 2050,
25% of Australia’s population will be over 65. Currently,
12% of our population is in this age group. An aging population
places an increased burden on the healthcare system. For example,
the costs of managing age related musculoskeletal diseases (including
osteoarthritis) costs the Australian community close to $1 billion
annually in direct costs and $2.5 billion in indirect costs, representing
0.35% of the Gross National Product (Australian Bureau of Statistics
data from 1995 National Health Survey). It has been estimated that
80% of people over the age of 65 suffer from the effects of osteoarthritis
and cartilage degeneration. This long-term breakdown is compounded
by the impaired healing capacity found in this group of individuals.
An effective cartilage tissue replacement, made of cells seeded
in appropriate scaffolds, would benefit many people in this group
making them able to walk, hold objects and live a normal life without
the need for constant care and free from pain. As well as the aging
process itself, conditions such as osteoporosis severely limit the
healing capacity of and treatment options available to the elderly.
In addition, there are over 100,000 Australians with type I diabetes
that would benefit from an alternative transplantation therapy of
insulin producing cells in an appropriate scaffold. Current insulin
replacement therapies for diabetes involve considerable reductions
in quality of life and result in serious long-term health complications.
Up to 5% of the people suffering from diabetes will experience foot
ulcers, which significantly compromise the quality of life for the
patient and often result in the amputation of the limb. The generation
of tissue-engineered skin, which can be used to cover the ulcerated
area and promote healing, is a focus area of some of the researchers
in ARNTE.
In all situations, novel therapies aimed at replacing tissues damaged
by disease, degeneration, and/or trauma, or removed as a consequence
of therapy, would dramatically improve the lives of thousands of
Australians every year. This would be of enormous benefit to the
economy. ARNTE is a network that will bring together researchers
from diverse disciplines that are focused on collaborative studies,
which will address the current challenges that prevent tissue engineering
from achieving these goals. For example, a major goal of the group
is to replace damaged tissue by providing cells in a suitable scaffold
that controls the behaviour of those cells. Another major goal is
to understand how cells and their products (proteins and glycoproteins)
interact with the surfaces of materials.
Top
Economic Benefit.
Longer-term economic benefits derive from the development
of novel therapies, which reduce the medical expenses and infrastructure
costs associated with prolonged hospitalisation, as well as increasing
productivity due to a rapid return to work. Total health care
expenditure in Australia is currently approximately A$51 billion
per year, representing 8.3% of the gross domestic product. This
has risen 3.6% per person per year since 1960 with by far the
major proportion of this being due to the cost of publicly-funded
institutional care. Consequently, cell-based therapies aimed at
reducing these costs represent an expanding market. The engineering
of skin replacement tissue has the economic benefit of reducing
time in hospital for many patients with diabetic foot ulcers.
Many of these patients are often in hospital for weeks to months
for particularly recalcitrant cases (costing $500/day approx).
The biomaterials market alone has a compound annual growth rate
of 13.6%. The orthobiological component is the most rapidly growing
portion of the orthopaedic market, in 2000 increasing by 44% over
the 1999 level. The global market for tissue engineered devices
is predicted to be worth US$ 20 billion by 2020, and Australia
can play a significant role in this market, underpinned by strategic
research typified in this proposal.
In the "Promoting and Maintaining Good Health" initiative,
Biomaterials Science and Engineering play a key role in providing
the essential materials for development of new strategies for
the treatment, repair and regeneration of various diseased and
damaged tissues. Many technologies, particularly tissue engineering,
seek to control and prevent further deterioration of diseased
tissue. Some of the focus of the ARNTE will be within 'Advanced
Materials' for medical applications, and will include biomaterial
applications of ceramics (eg: for orthopaedics), polymers (eg.
resorbable polymers), fabrics (eg for cardiovascular devices)
and composites (eg. for tissue engineering applications). Nano-engineering
is another area of interest for ARNTE that addresses the promotion
and maintenance of good health. A recent spillover benefit from
the work of ARNTE researchers is an array for detecting and discriminating
the various forms of leukemia. This technology is now in clinical
trials and promises to revolutionise the early detection and diagnosis
of this disease. By accurate and rapid discrimination of the type
of leukemia present, treatments will be more effective and survival
rates improved. Such developments require the combined skills
of the physical science, materials engineering, protein biochemistry
and medical science communities, all represented in ARNTE. This
aspect of advanced materials and devices will benefit from the
fundamental studies on interactions between surfaces and biological
systems being carried out by ARNTE researchers and drawing on
the skill base of materials physicists, protein biochemists and
biologists.
Australia has a good track record in biomaterials development,
which falls under Priority Goal 3 (Advanced Materials) of National
Research Priority 3. Researchers in ARNTE have been involved in
the production of a number of successful biomaterials, including
the Elasteon® polymers licensed to Aortech and the Focus®
contact lenses developed in partnership with CIBA Vision. By providing
fundamental information for the rational design of three-dimensional
scaffolds, ARNTE will build on this existing expertise in an area
designated as a national research priority. The research team
are well-placed to maximise the benefit of this work by providing
research outcomes to Australian SMEs involved in tissue engineering
activities. Polymers in particular are ideally suited to implantable
scaffold applications because of their adaptable surface properties,
tissue equivalent density and ease of forming.
ARNTE will bring direct benefit to Australia through
providing better awareness of international scientific developments,
and better awareness of the key competitors on the international
stage. ARNTE will also provide excellent opportunities for industry,
universities and research institutes to promote their science
and technologies and to form commercial linkages and partnerships
with international players in the field of tissue engineering,
which would normally be expected to lead to overseas investment
in Australian science and technology.
Knowledge Benefit.
ARNTE is open to and inclusive of researchers with an interest
in Tissue Engineering from all States/Territories and will be
unique in Australia. Our national focus will be integral to our
success in ensuring an internationally competitive edge to the
cross-disciplinary projects.
ARNTE will give Australian researchers, active in the disciplines
involved in tissue engineering, outstanding opportunities to build
and extend their networks and alliances, bringing opportunities
for involvement in new product and process developments and in
accessing new research knowledge. The generation of novel knowledge
in the cutting-edge field of tissue engineering will enhance the
status of Australia as a serious generator of intellectual property
and make it a key player on the global stage. This is critical
to its future as a viable member of the group of countries that
can commercialise high-technology discoveries. ARNTE will also
assist in the development of well-trained scientists capable of
performing curiosity-driven research, which has both intrinsic
and applied value. Working across several scientific boundaries,
the network will foster a more meaningful and productive level
of communication between institutions and disciplines essential
for Australia to compete effectively in the global research environment.
ARNTE will be involved in training postdoctoral staff in an expanding
interdisciplinary area at the interface between physical and life
sciences. There are currently a number of graduates planning careers
in the tissue engineering area, but because the career progression
pathway at the postdoctoral level is weak in Australia, these
graduates need to continue their career overseas, unless multidisciplinary
networks such as this become available. The activities of ARNTE
will lead to the promotion of interdisciplinary areas of science
involving chemistry, biochemistry, physics, materials science
and biology – all combinatorial skills which are proving
to be in high demand in this post-genomic era. The benefits of
new health promoting technologies in the community can only occur
if there are sufficient highly-skilled individuals. The knowledge
dissemination aspect of ARNTE will be of benefit here.
Other knowledge benefits include the education and awareness of
secondary school students on the topic of Tissue Engineering and
the many disciplines that work together to generate an outcome.
This will be via visits to classes and open days that will be
organised by ARNTE. Many of the ARNTE participants have been involved
in similar outreach programs in the past and have successfully
set up and completed many public demonstrations of their research
activities.
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