Fish Skin Bandages: The Latest Product of Medical Desperation

In a world driven by technological progress, many impoverished communities are bucking the trend by successfully turning to "low-tech" and unorthodox treatments.

A closeup of fish scales.
A closeup of fish scales. ERNESTO BENAVIDES/AFP/Getty Images.

Tucked away in northeast Brazil's seaside city of Fortaleza, an unusual medical advancement has been discovered. As reported by STAT, researchers and physicians based out of the region's burn center, the José Frota Institute, have begun testing the use of fish skin as dressings for patients suffering from second- and third-degree burns.


Throughout history, we've seen that windows of acute desperation have produced some of the most remarkable medical breakthroughs. The physically grievous casualties generated during World War II forced advancements in the purification, stabilization, and mass production of penicillin. During the height of the AIDS crisis in the 1980s, researchers turned to a former cancer drug, AZT, to successfully treat the decade's most fearsome disease.

Today, Brazil's medical community faces a uniquely desperate situation. The country's three operational skin banks are only able to meet approximately one percent of the nation's needs. Moreover, alternatives to human skin, such as pig skin and synthetic skin substitutes—materials commonly available in the United States—are virtually unobtainable.

Unlike their American counterparts, material and supply shortages have forced some Brazilian burn centers to deviate from the standard medical practice which advocates for early skin grafts, instead being relegated to using traditional gauze-and-silver sulfadiazine cream dressings. While such a method of treatment is time-tested and effective in preventing infection in burn wounds, the dressings necessitate daily and excruciatingly painful changes, which can delay recovery.   

Enter fish skin—namely that of tilapia. What was once simply thrown in the trash after harvesting has now become a critical therapeutic agent. After undergoing a thorough cleaning process, the sterilized tilapia skins are applied directly to the wound. For superficial second-degree burns, the skins are left in place until the burn naturally scars over, more severe burns with deeper wound cavities require a few changes over the course of several weeks. While the testing of this technique has been somewhat limited, the consensus amongst attending physicians is that the use of tilapia skin bandages reduces healing time and significantly decreases pain levels in patients.

The project's lead plastic surgeon, Dr. Edmar Maciel, commented on the unexpected superior healing properties of tilapia skin, stating, “We got a great surprise when we saw that the amount of collagen proteins, types 1 and 3, which are very important for scarring, exist in large quantities in tilapia skin, even more than in human skin and other skins. Another factor we discovered is that the amount of tension, of resistance in tilapia skin is much greater than in human skin. Also the amount of moisture.”


Video produced by Nadia Sussman for STAT.

While experts argue that we're unlikely to see such fish skin bandages in American hospitals, they may very well revolutionize burn care in the medical resource-depleted developing world, where desperation warmly embraces unorthodoxy.

This trend doesn't end with tilapia skin. In recent years, resource-barren medical professionals have reached back centuries and even millennia in order to find solutions to the mounting challenges posed by the modern age.

Researchers in Nottingham have replicated a Medieval eye salve that has proven capable of destroying 90 percent of antibiotic-resistant MRSA bacteria. Honey, whose medicinal value was held in high regard in antiquity, has recently been heralded by contemporary scientists for its now-proven antimicrobial properties.

Most of us would laugh off notions of leech therapy providing any true medical benefit, yet leech therapy has been firmly incorporated into cosmetic and microsurgery practices for some time now, with the FDA approving its medicinal use in 2004. Moreover, scientists are working diligently to harness the anticoagulant properties of leech saliva for use in the treatment of cardiovascular disease. In another surprising throwback to an ancient era, maggot debridement therapy has been found to be effective in the treatment of diabetes-associated wounds, those often prone to the development of gangrene.

The past has always been an inspiration for the future. We may not see fish skin bandages in US hospitals, but we've already—even if quietly—increasingly incorporated the use of other "low-tech" medical treatments in desperate situations. Striding forward with cutting-edge medical advancements has been one of our era's crowning glories, but making technologies equally accessible throughout the world is the step that's been missed—hopefully that changes. Until then, necessity will breed invention.

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CRISPR therapy cures first genetic disorder inside the body

It marks a breakthrough in using gene editing to treat diseases.

Credit: National Cancer Institute via Unsplash
Technology & Innovation

This article was originally published by our sister site, Freethink.

For the first time, researchers appear to have effectively treated a genetic disorder by directly injecting a CRISPR therapy into patients' bloodstreams — overcoming one of the biggest hurdles to curing diseases with the gene editing technology.

The therapy appears to be astonishingly effective, editing nearly every cell in the liver to stop a disease-causing mutation.

The challenge: CRISPR gives us the ability to correct genetic mutations, and given that such mutations are responsible for more than 6,000 human diseases, the tech has the potential to dramatically improve human health.

One way to use CRISPR to treat diseases is to remove affected cells from a patient, edit out the mutation in the lab, and place the cells back in the body to replicate — that's how one team functionally cured people with the blood disorder sickle cell anemia, editing and then infusing bone marrow cells.

Bone marrow is a special case, though, and many mutations cause disease in organs that are harder to fix.

Another option is to insert the CRISPR system itself into the body so that it can make edits directly in the affected organs (that's only been attempted once, in an ongoing study in which people had a CRISPR therapy injected into their eyes to treat a rare vision disorder).

Injecting a CRISPR therapy right into the bloodstream has been a problem, though, because the therapy has to find the right cells to edit. An inherited mutation will be in the DNA of every cell of your body, but if it only causes disease in the liver, you don't want your therapy being used up in the pancreas or kidneys.

A new CRISPR therapy: Now, researchers from Intellia Therapeutics and Regeneron Pharmaceuticals have demonstrated for the first time that a CRISPR therapy delivered into the bloodstream can travel to desired tissues to make edits.

We can overcome one of the biggest challenges with applying CRISPR clinically.

—JENNIFER DOUDNA

"This is a major milestone for patients," Jennifer Doudna, co-developer of CRISPR, who wasn't involved in the trial, told NPR.

"While these are early data, they show us that we can overcome one of the biggest challenges with applying CRISPR clinically so far, which is being able to deliver it systemically and get it to the right place," she continued.

What they did: During a phase 1 clinical trial, Intellia researchers injected a CRISPR therapy dubbed NTLA-2001 into the bloodstreams of six people with a rare, potentially fatal genetic disorder called transthyretin amyloidosis.

The livers of people with transthyretin amyloidosis produce a destructive protein, and the CRISPR therapy was designed to target the gene that makes the protein and halt its production. After just one injection of NTLA-2001, the three patients given a higher dose saw their levels of the protein drop by 80% to 96%.

A better option: The CRISPR therapy produced only mild adverse effects and did lower the protein levels, but we don't know yet if the effect will be permanent. It'll also be a few months before we know if the therapy can alleviate the symptoms of transthyretin amyloidosis.

This is a wonderful day for the future of gene-editing as a medicine.

—FYODOR URNOV

If everything goes as hoped, though, NTLA-2001 could one day offer a better treatment option for transthyretin amyloidosis than a currently approved medication, patisiran, which only reduces toxic protein levels by 81% and must be injected regularly.

Looking ahead: Even more exciting than NTLA-2001's potential impact on transthyretin amyloidosis, though, is the knowledge that we may be able to use CRISPR injections to treat other genetic disorders that are difficult to target directly, such as heart or brain diseases.

"This is a wonderful day for the future of gene-editing as a medicine," Fyodor Urnov, a UC Berkeley professor of genetics, who wasn't involved in the trial, told NPR. "We as a species are watching this remarkable new show called: our gene-edited future."

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