Page last updated at 16:03 GMT, Wednesday, 30 April 2008 17:03 UK
The man who grew a finger
By Matthew Price
BBC News, Ohio
In every town in every part of this sprawling country you can find a faceless sprawling strip mall in which to do the shopping.
Rarely though do would you expect to find a medical miracle working behind the counter of the mall’s hobby shop.
That however is what Lee Spievak considers himself to be.
“I put my finger in,” Mr Spievak says, pointing towards the propeller of a model airplane, “and that’s when I sliced my finger off.”
It took the end right off, down to the bone, about half an inch.
“We don’t know where the piece went.”
The photos of his severed finger tip are pretty graphic. You can understand why doctors said he’d lost it for good.
Today though, you wouldn’t know it. Mr Spievak, who is 69 years old, shows off his finger, and it’s all there, tissue, nerves, nail, skin, even his finger print.
How? Well that’s the truly remarkable part. It wasn’t a transplant. Mr Spievak re-grew his finger tip. He used a powder – or pixie dust as he sometimes refers to it while telling his story.
Mr Speivak’s brother Alan – who was working in the field of regenerative medicine – sent him the powder.
For ten days Mr Spievak put a little on his finger.
“The second time I put it on I already could see growth. Each day it was up further. Finally it closed up and was a finger.
“It took about four weeks before it was sealed.”
Now he says he has “complete feeling, complete movement.”
The “pixie dust” comes from the University of Pittsburgh, though in the lab Dr Stephen Badylak prefers to call it extra cellular matrix.
The process he has been pioneering over the last few years involves scraping the cells from the lining of a pig’s bladder.
The remaining tissue is then placed into acid, “cleaned” of all cells, and dried out.
It can be turned into sheets, or a powder.
It looks like a simple process, but of course the science is complex.
“There are all sorts of signals in the body,” explains Dr Badylak.
“We have got signals that are good for forming scar, and others that are good for regenerating tissues.
“One way to think about these matrices is that we have taken out many of the stimuli for scar tissue formation and left those signals that were always there anyway for constructive remodelling.”
In other words when the extra cellular matrix is put on a wound, scientists believe it stimulates cells in the tissue to grow rather than scar.
If they can perfect the technique, it might mean one day they could repair not just a severed finger, but severely burnt skin, or even damaged organs.
They hope soon to start a clinical trial in Buenos Aires on a woman who has cancer of the oesophagus.
The normal procedure in such cases is often deadly. Doctors remove the cancerous portion and try to stretch the stomach lining up to meet the shortened oesophagus.
In the trial they will place the extra cellular matrix inside the body from where the portion of oesophagus has been removed, and hope to stimulate the cells around it to re-grow the missing portion.
So could limbs be re-grown? Dr Badylak is cautious, but believes the technology is potentially revolutionary.
“I think that within ten years that we will have strategies that will re-grow the bones, and promote the growth of functional tissue around those bones. And that is a major step towards eventually doing the entire limb.”
That kind of talk has got the US military interested.
They are just about to start trials to re-grow parts of the fingers of injured soldiers.
They also hope the matrix might help veterans like Robert Henline re-grow burnt skin.
He was almost killed in an explosion while serving in Iraq. His four colleagues travelling with him in the army Humvee were all killed.
He suffered 35% burns to his head and upper body. His ears are almost totally gone, the skin on his head has been burnt to the bone, his face is a swollen raw mess.
So far he has undergone surgery 25 times. He reckons he has got another 30 to go.
Anything that could be done in terms of regeneration would be great he says.
“Life changing! I think I’m more scared of hospitals than I am of going back to Iraq again.”
Like any developing technology there are many unknowns. There are worries about encouraging cancerous growths by using the matrix.
Doctors though believe that within the so called pixie dust lies an amazing medical discovery.
Regrown finger is ‘junk science’
A leading plastic surgeon today dismissed claims that a powder made from a pig’s bladder caused the regrowth of a man’s fingertip.
Professor Simon Kay, professor of hand surgery at the University of Leeds, said the claims by the US company that developed the powder were “junk science”.
Lee Spievack, a hobby store salesman in Cincinnati, Ohio, has claimed the treatment stimulated the regrowth of his right hand middle fingertip, which was severed in 2005 by the propeller of a model plane.
Spievack, 69, described the powder as “pixie dust”. It was developed by ACell – a company co-founded by his brother Alan, a former Harvard surgeon.
Within four weeks of using the preparation, he said his finger had regained its original length, and four months later “it looked like my normal finger”.
But Kay, consultant plastic and hand surgeon at St James’ University Hospital, Leeds, said Spievack’s injury did not look to have been serious from studying before and after photos.
“It’s a ridiculous story – absurd and over-egged in the extreme,” Kay said. “It looked to have been an ordinary fingertip injury with quite unremarkable healing. All wounds go through a repair process.”
ACell, the company behind the claim, said it had already used the extract of pig bladder to treat ulcers and other wounds, and to help regrow cartilage.
The powder was mostly collagen and a variety of substances, without any pig cells, said Dr Stephen Badylak, a regeneration researcher at the University of Pittsburgh and scientific adviser to ACell.
He said it formed microscopic scaffolding for human cells to occupy, and emitted chemical signals to encourage those cells to regenerate tissue. The signals did not specifically say “make a finger” but cells picked up that message from their surroundings, Badylak said.
“We’re not smart enough to figure out how to regrow a finger,” Badylak said. “Maybe what we can do is bring all the pieces of the puzzle to the right place and then let mother nature take its course.
“But we are very uninformed about how all of this works. There’s a lot more that we don’t know than we do know.”
Kay said there was “no evidence” that ACell had manipulated the regenerative capabilities of the human body.
“There’s no clinical evidence to support the claims,” he said. “It really is junk science.
“If you could regenerate body parts like this, your first port of call would be a serious science journal like Nature because it would be a Nobel prize winning revolution.”
British scientists have led the way in research into genetic treatments that could enable humans to regrow limbs damaged by accidents or surgery and allow patients to recover from wounds without scarring.
A charity, the Healing Foundation, which funds research into pioneering scientific techniques, set up a 25-year project in 2005 with the University of Manchester to advance the understanding of wound healing and tissue regeneration.
The Healing Foundation Centre aims to unravel the genetic quirks that allow certain amphibians, such as frogs and salamanders, to recover from severe injuries by generating fresh body tissue. By identifying the genetic mechanisms involved, the researchers hope to develop medical treatments that do the same in humans.
Professor Enrique Amaya, a tissue engineer at Manchester University and leader of the project, is investigating the regenerative capabilities of frogs. Frog embryos share the human embryo’s ability to heal wounds without scars in a matter of hours. Frogs can also regrow appendages.