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Help with burnt skin

Our body is covered with around 1.7 square metres of skin. If this protection is missing, for example due to extensive burns, reserve skin is needed for skin grafts within a short period of time. Zurich-based start-up Cutiss has developed a new process to bio-engineer the required skin.

Text: Janine Radlingmayr; photo: Marco Rosasco

“There was a moment that changed everything. As a researcher at the Zurich Children’s Hospital, I witnessed the seven-hour operation of a boy with burns. His life hung by a thread. It really brought it home to me that we had to make our research results available to patients as quickly as possible," recalls Dr Daniela Marino, CEO of the Zurich start-up Cutiss. Today, she is responsible for generating millions of Swiss francs in the form of grants to drive forward their dream of providing people suffering from burns with new skin. Cutiss specialises in the development of personalised skin grafts. Marino estimates that some 50 million people around the world each year suffer severe skin damage from burns, illness or operations. And 30% of patients are children. Today’s treatment methods often lead to scars that are permanent, painful, disfiguring and debilitating. They can impair mobility and growth, resulting in further surgery, intensive home care and psycho-social rehabilitation.

“When I first read about this project, I knew I wanted to be part of it.”

Biotechnologist Daniela Marino and biologist and chief clinical officer Fabienne Hartmann-Fritsch have witnessed this suffering close up. “For our research and first study, we observed patients over a long period of time. Seeing the injuries first-hand was all the motivation we needed to drive our project forward,” says Marino. The two women met in 2009 when they worked on the research project headed by professors Ernst Reichmann and Martin Meuli at the Zurich Children’s Hospital. “When I first read about this project, I knew I wanted to be part of it. At the time, I would never have dreamt that one day I would be CEO of a company specialising in growing human skin in the lab for patients around the world,” adds Marino.

After more than 15 years of research, Cutiss is now in a position to bio-engineer customised large-area skin grafts. The idea behind denovoSkin is simple: “Skin the size of a stamp is removed from the patient and within a month is enlarged up to seventy times the original size,” says Hartmann-Fritsch. The wound caused by the biopsy heals like a graze. “In the laboratory, we divide the piece of skin into individual layers and then multiply the different cell types separately. Once we’ve got enough, we bring them back together in a larger piece of skin,” explains Hartmann-Fritsch. The research group was constantly faced with new questions to ensure that the cultivated, personalised skin was ready for transplantation, that it was not rejected by the patient and that minimal scarring occurred: Which cell types should be used? Which matrix should be used so that the surgeon gets the right piece of skin at the end? Which wound dressing can be used on the skin? The first clinical study on the safety of denovoSkin has been completed and was published recently, and follow-up studies on its efficacy are now underway. “Seeing the product in action is a major milestone. For us, the good initial results after years of research are a dream come true,” says Marino.

From the laboratory for the world

At Cutiss, it’s not just skin that is growing from a cell to a transplant, but the whole company. The 2017 founding members Hartmann-Fritsch and Marino have since been joined by a further 16 members of staff. “In the beginning, we all came from an academic research background. It was only when we had investors on board that we were able to hire people for the other tasks, such as business development, accounting and HR,” says Hartmann-Fritsch.

The two founders never switch off their smartphones. “It’s getting increasing difficult to keep the same pace and yet still maintain a good work/life balance,” says Marino. What else does a start-up need? “Speed”, says Hartmann-Fritsch. The next big steps for the developing start-up company are already clearly defined: First, research is underway into the cultivation of pigmented skin. This is more a question of appearance than the function of the skin. And second, we’re working on a machine for skin cultivation. “We must be able to produce the best possible skin in the shortest possible time. An average body has 1.7 square metres of skin. That’s a lot. Manual production is no longer an option. It’s too complicated, too expensive for manual work,” says Marino. This technological development would have another advantage in addition to reducing manufacturing costs. If the skin could be produced in this way in Zurich, then the same process could be introduced in Hong Kong, for example. Founder Hartmann-Fritsch says: “We’re proud that the research that started at the University of Zurich and the Zurich Children’s Hospital will probably soon be able to help injured people worldwide.”