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Wilhelm Aicher is committed to regenerative medicine research

Laboratory-based regeneration of human cartilage and muscle tissue is his strong suit: Prof. Dr. Wilhelm K. Aicher brings his expertise in cellular and molecular biology to research focusing on the development of innovative therapies for the treatment of tissue damage. Successes such as a knee cartilage made from autologous (patients’ own) cells show that Aicher is on the right track.

Prof. Dr. Wilhelm Aicher from the University of Tübingen focuses on cell-based therapies for the regeneration of cartilage © private

Scientists working at the boundaries of classical disciplines inevitably end up in an interdisciplinary field such as regenerative medicine. Prof. Dr. Wilhelm K. Aicher from the University of Tübingen is a highly competent practitioner in this field. Aicher originally studied biochemistry, moving towards immunology during his doctoral work at the Tübingen-based Max Planck Institute for Developmental Biology. He received his doctoral degree in the mid-1980s for research into the cellular and molecular characterisation of receptors located on immune system cells. The move to the MPI required Aicher to make a far-reaching decision relating to his human medicine studies which he had been doing alongside his biochemistry studies. “I had already obtained all the qualifications necessary to do the preliminary medical examination. However, I decided not to enrol for the exam. My work at the MPI meant that I did not have any spare time for medical studies,” said Aicher.

Aicher has no real regrets about this decision, probably because it was never really his lifetime’s ambition to practice medicine. “At no time did I intend to become a general practitioner. I was more interested in medical research,” said Aicher. While he was doing his doctoral thesis at the MPI for Developmental Biology in Tübingen, Aicher also spent some time in the USA. “My work at the MPI required me to develop new specific antibodies and our cooperation partners at the Institute of Microbiology at the University of Alabama (UAB) in Birmingham had better conditions than us for developing the antibodies. And as I did my doctoral thesis at the MPI, I was able to spend some time as a guest of the Institute of Microbiology,” said Aicher who then went on to write his doctoral thesis in English, which was far from being standard practice in Germany in the 1990s. He returned to Germany to do his doctoral examination and then went back to the UAB to do his post-doctoral studies in the field of rheumatology, for which he received a German Rheumatism Research Centre grant.

From immunological research to rheumatology and on to regenerative medicine

Aicher returned to Germany in 1992 and continued his work in the field of rheumatology for around four years. He was project leader of the “Rheumatic Diseases” research group led by Prof. Dr. Hans Hartmut Peter from the University of Freiburg and Prof. Dr. Klaus Eichmann from the Max Planck Institute of Immunbiology. This was the first clinical research group established by the German Research Foundation (DFG) that involved both medical doctors and natural scientists. Aicher moved on to Tübingen in 1996 where he was appointed head of the “Cell Biology Research Laboratory” in the Department of Orthopaedics at Tübingen University Hospital. While working in Tübingen, Aicher came into contact with two scientists who were the catalysts for a further move into a different area of research.

“My work on rheumatological joint degeneration brought me into contact with Dr. Christoph Gaissmaier and Dr. Jürgen Fritz from the BG Trauma Hospital in Tübingen who were working on chondrocyte and osteoblast cultures.” The two researchers were focusing on different issues related to the potential use of patients’ own cells for the treatment of cartilage and bone damage. Amongst other things, the two were working on the analysis of the vitality of cells in culture and whether these cells expressed the right genes. As I had a great deal of experience in the field of molecular genetics, I was able to assist them in their analyses,” said Aicher. This work, which also involved researchers from the NMI Natural and Medical Sciences Institute at the University of Tübingen in Reutlingen, provided the basis for the establishment of a company called TETEC AG, amongst other things. TETEC AG is a specialist in the production of autologous cartilage tissue for use in regenerative medicine and is now one of the leading companies in this field.

Considerable optimisation of knee cartilage replacements

Representation of a human placenta vessel: red: endothelial cells, green: mesenchymal stem cells. The cell nuclei are stained blue (DAPI). The stem cells surround the vessels of the placenta. © Manuel Ruh

Aicher regards his contributions to the development of autologous cartilage tissue for use in regenerative medicine as a particular highlight in his professional career. Over time, his own research focus has also shifted towards regenerative medicine. However, he has remained in the Department of Orthopaedics at the University Hospital of Tübingen. In 1999, he qualified as professor in the Faculty of Medicine at the University of Tübingen (German: habilitation) and was promoted to associate professor of molecular medicine in 2005. Since 2006, Aicher has been the vice director of the Centre for Regenerative Biology and Medicine (ZRM), which was jointly founded by the Medical Faculty of the University of Tübingen and the Tübingen University Hospital.

Initially, Aicher’s research focused on the regeneration of joint cartilage, in particular in the knee. “Since joint cartilage is not supplied with blood, it is relatively easy to produce replacement tissue from the patients’ own cells. However, the cartilage used for transplants needs to be stable and needs to be adapted to the spatial conditions of the knee. We have developed and patented specific biomaterials for the cultivation of cartilage and achieved a breakthrough with the development of a scaffold material that had the structure of an accordion. This scaffold material enables us to turn the width shrinkage of the cartilage substitute into a height shrinkage, which is far easier to deal with when it comes to treating knee joint cartilage defects,” said Aicher.

In addition to the biotechnological improvement of cartilage engineering, the researchers also improved the surgical method. These two improvements led to a groundbreaking therapy known as scaffold augmented autologous chondrocyte transplantation (ACT). Prior to this, a chondrocyte suspension had to be injected into a piece of periosteum, which was carefully sown together in order to prevent blood leaking. Standard treatment now involves the use of a piece of cartilage tissue punched out from the scaffold material and fixed to the site of operation with only a few stitches. Patients now have cartilage substitutes produced from their own cells. Although the cartilage substitute is not an exact copy of the original tissue, it is nevertheless very similar. The work on ACT has recently been complemented by new projects concentrating on the regeneration of intervertebral disc damage. These projects are funded by the BMBF as part of the REGiNA – Health Region for Regenerative Medicine concept.

Successful therapy to be expanded to the regeneration of muscles

Adult stem cells from different tissues of the human body are tested for their suitability for regenerative therapies. The photo shows stem cells surrounding the vessels of a placenta (red: endothelial cells, green: mesenchymal cells; the cell nuclei are stained blue (DAPI)). © Manuel Ruh
Cartilage is not the only type of tissue that Prof. Aicher is interested in. In cooperation with experts from the Department of Urology at the University Hospital of Tübingen, the Fraunhofer IPA in Stuttgart, the NMI in Reutlingen and the Institute of Systems Dynamics at the University of Stuttgart, Prof. Dr. Arnulf Stenzl (Department of Urology, University Hospital Tübingen) and Prof. Aicher plan to establish a research group that will exclusively focus on the regeneration of muscle tissue. “Our goal is to assess the prospect of stem cell-based therapies for the treatment of incontinence in women,” said Aicher highlighting that this involves more than just cell biology. Major focus is also put on cell labelling and imaging. This is because whenever cells are used for human treatment, care must be taken to monitor what happens to them and what effect they have in the body. Such monitoring must be reliable and carried out over extended periods of time. “We are also planning to develop a needle-free application of the cells in order to prevent the injection-related impairment of the target tissue, i.e. muscle, right from the beginning,” said Aicher. In order to achieve these ambitious goals, the group of around 20 medical doctors, natural scientists and engineers submitted an application to the DFG and subsequently received the go-ahead to submit a full proposal. The project is also expected to have positive effects on an administrative level as it reinforces the cooperation between the Universities of Tübingen and Stuttgart that was initiated in 2007 with the establishment of the Tübingen-Stuttgart Interuniversity Centre for Medical Technology (IZST).

Education at two sites

Another of the IZST’s products is the medical technology bachelor’s programme that started in autumn 2010. Aicher lectures in this programme as well as in the molecular medicine course that is offered by the University of Tübingen. “I have also been offering a course on modern regenerative medicine concepts for medical students for some years now,” said Aicher explaining that this course provides insights into transfusion, transplantation and tissue engineering. “I also feel it is very important to train medical students in key aspects of basic research,” said Aicher. Aicher thus neatly completes his circle of activities aimed at driving regenerative medicine forward and making it into one of the region’s unique selling points.

Further information:
Prof. Dr. Wilhelm K. Aicher
Centre for Regenerative Biology and Medicine (ZRM)
Department of Orthopaedics
University Hospital Tübingen
Waldhörnlestr. 22
72072 Tübingen
E-mail: RFiT(at)uni-tuebingen.de

Website address: https://www.gesundheitsindustrie-bw.de/en/article/news/wilhelm-aicher-is-committed-to-regenerative-medicine-research