To engineer is to create: the link between engineering and regeneration

Tissue engineering is a radically different approach to reconstruction of the body following degenerative diseases, trauma or chronic debilitating conditions. Although there have been some successes, tissue engineering is not yet delivering significant progress in terms of clinical outcomes and commercialization. Part of the problem is that we have failed to understand what tissue engineering really means and to appreciate that engineering is synonymous with creation. These processes involve many different phases and there has been minimal integration of these phases within tissue-engineering paradigms. The conventional concept, based upon a temporal sequence from sourcing cells through to the incorporation of generated tissue into a host, has to be transformed by a systems engineering approach in which all biological and technological phases, and the inter-relationships between them, are fully integrated. It might be that real success will not be achieved until systems biology is superimposed onto this systems engineering paradigm.