Exploring how diversity, context and complexity are transforming regenerative medicine to create equitable treatments for all populations.
As a Black woman training in regenerative medicine, Erika noticed something troubling. Growing up, she had witnessed people in her community struggle disproportionately with lupus, high blood pressure, and stroke recovery. Now, reading scientific articles that validated these lived experiences, she discovered a painful paradox: people of African ancestry are more likely to suffer from certain diseases, yet were largely absent from the cell lines and models used to study these conditions 1 .
This pattern isn't unique. Idalis, a Latina researcher, observed similar gaps when trying to understand health patterns in her own family, which spanned multiple ethnic backgrounds and genetic histories. She wondered: "If modeling diseases to universal baselines removes the complexity that ancestry, genetic make-up, and patterns of disease carry, are we developing treatments that work for everyone?" 1
Their experiences highlight a critical blind spot in regenerative medicine—the field that aims to repair or replace damaged tissues and organs. While revolutionary treatments emerge, the question remains: who will they actually work for? This article explores how scientists are working to weave diversity, context, and complexity into the very fabric of regenerative medicine, ensuring its revolutionary treatments can heal everyone, not just some.
People of African ancestry are more likely to suffer from certain diseases but are underrepresented in research models.
Regenerative medicine focuses on regenerating, repairing, and replacing cells, tissues, and organs to restore function 2 . But emerging research reveals that ancestral background significantly influences how our cells function at the most fundamental level:
This means that the biological context matters—a lot. Just as medications work differently in different populations, cellular therapies may need to account for genetic diversity to be effective for all patients.
The challenges extend beyond the laboratory into clinical practice:
These interconnected challenges create a perfect storm where both the development of therapies and access to existing treatments are hampered by a lack of diversity and contextual understanding.
"If modeling diseases to universal baselines removes the complexity that ancestry, genetic make-up, and patterns of disease carry, are we developing treatments that work for everyone?"
To understand the scope of the diversity problem in regenerative medicine, let's examine a crucial meta-analysis that quantified representation in research materials.
A research group led by Ryan conducted a systematic analysis of scholarly papers in regenerative medicine 1 :
They focused on studies published from July 1, 2019, to December 31, 2019, specifically selecting a pre-COVID period to avoid pandemic-related research distortions.
The team profiled 202 scientific articles from prominent journals, examining both the use of primary cells and commercially available cell lines.
For each cell source used, they documented whether and how researchers reported the ancestral background of donors.
They calculated percentages of cell lines by reported ancestry and compared their findings with existing literature on cell line diversity.
The findings revealed significant disparities in whose cells are used to advance regenerative science:
| Ancestral Background | Percentage of Cell Lines |
|---|---|
| White/European | 54.8% |
| Other/Unknown | 45.2% |
Source: Ryan et al. analysis of 202 scientific articles in regenerative medicine 1
Even more concerning was the reporting gap for primary cells:
| Reporting Category | Percentage |
|---|---|
| Unknown/Not Reported | 94.2% |
| Documented Ancestry | 5.8% |
Source: Ryan et al. analysis of primary cell usage in regenerative medicine studies 1
This "HUGE gap in understanding and acknowledgement of who we are considering in our regenerative medicine design" raises critical questions 1 . If we don't know the ancestral background of the cells we're studying, how can we ensure the resulting therapies will work across diverse populations? The problem extends beyond regenerative medicine—similar studies on prostate cancer cell lines and induced pluripotent stem cells have also demonstrated significant lack of diversity in disease modeling and stem cell biology 1 .
To address these diversity gaps, scientists are developing and refining a set of specialized tools and approaches that enable more nuanced, representative research.
| Tool/Reagent | Function | Diversity Application |
|---|---|---|
| Induced Pluripotent Stem Cells (iPSCs) | Patient-specific pluripotent cells | Create disease models from diverse genetic backgrounds without embryos 6 |
| CRISPR-Cas9 | Precision gene editing | Correct genetic mutations in stem cells from diverse populations 6 |
| Decellularized Scaffolds | Natural ECM for cell growth | Provide structural templates that can be customized for different physiological needs 5 |
| Mesenchymal Stem Cells (MSCs) | Multipotent cells with immunomodulatory properties | Study how ancestral background influences stem cell function and therapeutic potential 3 |
| OmicsTweezer | AI-powered cell mapping in bulk tissues | Identify subtle cellular differences across diverse populations that might be missed in traditional analysis 5 |
| Extracellular Vesicles (EVs) | Intercellular communication and drug delivery | Explore how vesicles from different cell types might have varying effects across genetic backgrounds 3 |
New technologies enable more precise analysis of cellular differences across populations.
Tools like iPSCs allow for patient-specific models that account for genetic diversity.
Machine learning helps identify patterns that might be missed in traditional analysis.
These tools enable researchers to ask more nuanced questions about how diseases manifest and progress differently across ancestral backgrounds, and to develop treatments that account for this complexity rather than ignoring it.
Progressive research teams are implementing several key strategies to better capture biological complexity:
Several promising developments could help close the diversity gap in regenerative medicine:
The integration of diversity considerations into regenerative medicine requires a multifaceted approach that spans from basic research to clinical implementation. By intentionally designing studies that account for genetic and ancestral diversity, researchers can develop therapies that are effective across populations rather than optimized for a narrow subset.
This shift requires not only technological innovation but also changes in research culture, funding priorities, and regulatory frameworks to ensure that the benefits of regenerative medicine reach all communities equitably.
The journey toward truly inclusive regenerative medicine is just beginning, but the path is becoming clearer. As the field advances, we must ensure that dignity and choice can be offered in ways that can change the lives of all impacted by the diseases we seek to cure 1 .
Required at multiple levels—from laboratory benchtop to clinical bedside to policy decisions.
The goal is not just scientific excellence, but ensuring treatments work for all populations.
Revolutionary treatments must become a right available to everyone, not a privilege for some.
The promise of regenerative medicine is too profound—the ability to repair damaged hearts, regenerate nervous tissue, reverse genetic diseases, and potentially grow new organs—to allow it to become a privilege available only to some. By embracing diversity, context, and complexity, we can work toward a future where these revolutionary treatments can truly heal everyone.