25 Tissue engineering: the multidisciplinary epitome of hope and despair

During any of the years of the last decade, a contribution to the multidisciplinary approach to the theory of regenerative medicine, a subject that we shall see subsumes tissue engineering, could well have been written with immensely different perspectives, emphases, and prognoses depending on the precise time of writing. This may not sound too surprising, since many emerging sciences, including medical sciences, flow through troubled times, often with alarming perturbations, before they emerge with hypotheses which are intact or refined, and practical applications ensured. Neither the pharmaceutical and biotechnology industries experienced smooth passage towards billion-dollar revenues, nor did the theories of anatomical or functional imaging emerge unchanged on their way to clinical reality. The question arises as to whether regenerative medicine is any different. Will each of the depths of despair to which the subject has descended at times, prove to be a nadir out of which only success can emerge? Or is it a subject so fatally flawed by a misappropriation of medical principles and commercial hype that it can only serve to deceive and ultimately fail? At the time of writing, there is no clear answer to this, and the possibility of abject failure is there for all to see. This chapter attempts to provide different perspectives on this subject and place the well-founded hopes and despairs of clinical and commercial reality on a balanced scientific foundation. The practice of medicine is built on progress, and often that is technological progress. It is rare for technology not to be synonymous with progress, and even rarer for technological progress to go into reverse,