Saturday, December 17, 2011

The Future of Medicine



According to the statistical abstract of the U.S. Census bureau for 2009, about 110,000 patients were waiting to receive one or more organs including: hearts, lungs, livers, kidneys, and pancreas. These organs were vital to each patient’s survival, and yet each person waited in a seemingly endless queue. “Every day nearly twenty Americans die waiting for donor organs” (Nova). Less than a quarter of the needed organs were transplanted into the lucky patients. The survival rate for patients receiving these organs was only 86 percent. The remainder lost the battle because their bodies refused to accept the new organs—they were rejected.
Whenever a foreign substance, like a transplanted organ, enters the body, the immune system immediately reacts by attacking these substances until they are destroyed. The common treatment that helps inhibit this immune response is anti-rejection medication. This medication works by weakening the immune system of the body and thereby eases the body’s adjustment to the new organ. But by suppressing the immune system, a patient may encounter further complications. The immune system is a natural function of the human body and helps in ridding the body of any infection or disease. Weakening this system inhibits the body’s natural defense against various blights. Therefore, a patient taking medication to help accept an organ inadvertently places himself at a higher risk of a serious infection. These infections can sometimes be fatal. All in all, receiving an organ transplant is a very complicated and unpleasant experience—even if one is lucky enough to reach the top of the list.
On the other hand, cars are much easier to fix. Sometimes a part, like a carburetor, may break or stop working. In any case, one must simply take the car to the mechanic, remove the dysfunctional part and replace it with a brand-new one. This new part would be virtually identical to the original and would function just as well—if not better. Wouldn’t it be much easier if we humans could be more like our cars? Yes, of course! But how can such a thing be possible? Although it may sound like science-fiction, recent breakthroughs and new technologies may soon provide humanity with brand-new, custom-made body parts to replace our old, rusty ones.

In 2006, a drunk driver collided with Pierpaolo Petruzziello’s car. The terrible accident resulted in the loss of Pier’s left hand and forearm. He was faced with two difficult choices: should he live with a missing limb or should he be fitted with a prosthetic? Prosthetics, as most people know them, are simply plastic replicas of body parts that are attached in the same spot as the missing limbs. Usually, these artificial limbs have little to no functionality—especially when one compares them to the living ones.
With the help of his father, Pier discovered one type of research that may provide a better alternative. In Rome, they found that the Biomedics University and Hospital was developing a bionic hand. Soon after, Pier was enrolled in the Life Hand Project. First, the scientists sent various stimuli into his arm including needles and electrical signals. Tiny little electrodes were surgically implanted into his arm to produce these signals. The purpose of these stimuli was to teach Pier to recognize them as they would pertain to his missing hand and fingers. He said, “Like a lot of amputees, I still perceive my lost hand… I closed my eyes and tried to think that my hand [still] did exist.” Then, the scientists connected a bio-mechanical prosthetic to the electrodes in Pier’s arm. Through intense concentration and much time in silence, Pier was able to move the fingers of the mechanical hand (Discovery Networks).
Although experiments similar to this one were done in the past, the researchers in the life hand project said that this was the first time a patient was able to make such complicated movements in a biomechanical hand using only his mind. This project was funded by the European Union and took five years to complete. The next goal is to connect a patient’s nervous system and prosthetic limb for years rather than just months. Pier was guaranteed to receive one of these new prosthetics. His participation in this research project helped move the science forward, and he was happy to have participated (Discovery Networks). Although Pier lost a hand, there are many people who do not need mechanical parts, but real, living body parts.
Scientists are saying that it is possible to harness nature’s ability to form organs, and in turn, build our own. Scientists have been growing cells, the basic building-blocks of life, in laboratories for many years now. But how do you take cells and turn them into organs? These cells are also the basic building-blocks for any organ, similar to how bricks are used to construct buildings. Both organs and buildings are a collection of parts that must come together and work together. Alone, bricks and cinder blocks are not enough to construct a building. A building needs an internal framework or scaffolding to give it structure. Similarly, to build an organ, cells also need to have a framework to guide their growth (Nova).
Creating a structure for cells to grow on is the first step to creating an organ, but it is challenging because living tissue cannot grow on just any material. This is because many of the materials can be toxic to a cell, or the cell simply cannot grow in the environments provided by some materials. Robert Langer, a chemical engineer says, “Cells are picky and some are more picky than others.” He and Jay Focanti, a transplant surgeon, developed a material called bio-rubber and it was perfect for the cells (Nova). Next, this bio-rubber is built and shaped to match the structure of a body part like an ear. The bio-rubber ear is then seeded with living cells. The cells living on this structure are then placed into an incubator. An incubator is a device that facilitates cell growth and multiplies the cells. These cells spread across the surface of the bio-ear until it’s thoroughly covered (Nova).
Furthermore, in various experiments scientists implanted these “grown” ears onto the backs of mice. Robert Langer stated, “This is an important step in the science,” and the implants on these mice are “[there] for a greater purpose” (Nova). Using the mouse as a medium, the scientists grew perfectly shaped cartilage that looked identical to a human ear. In addition, these parts are completely connected in an intricate network of blood vessels. Thus the lab-grown parts are not only look-alikes, but they have the same functionality as their real, human counterparts. Jay Focanti said, “We’re going to start with the patient’s own cells, it’ll make his own tissue, and therefore the body will accept it” (Nova). There is no chance for this body part to trigger rejection by the immune system because it recognizes its own cells.
Just like in mice, the same steps were followed to implant body parts on humans. Parts like these ears have already been implanted on injured soldiers that served in the Middle East. “The defense department has been funding research into a broad range of tissue engineering for wounded soldiers from: bone, muscle, and skin to vital organs including the heart. Engineering tissues could save a lot of lives” (Tissue Engineering). Soldiers are not the only ones who have received these transplants. Other patients have received blood vessels, skin, muscles and even bladders built the same way (Nova).
Vital organs like kidneys, livers, and hearts are the more complex organs needed to save lives. Scientists creating these organs are mainly challenged by the intricate “plumbing” involved in the structures of these organs. The plumbing in an organ is similar to the plumbing in a building. In a building, pipes carry water and other resources to all corners of the building. In an organ, blood vessels carry oxygen to all the tiny corners in a cell to keep it alive. Major organs like the heart require a “blood vessel per cell” (Nova). For example, the blood vessels in the heart are like a tree and “the challenge is not to build that big limb, but to build those little tiny branches that come off” (Nova).
These scientists had to discover another new technology to overcome the difficulty in building these more complex organs. Harald Ott used a chemical to wash away the cells of a rat heart in an attempt to isolate the structure. He had to find the perfect chemical that would clear away the living cells, but leave the protein structure undamaged at the same time. First, Ott tried using enzymes, but these dissolved everything on the heart. Other chemicals disfigured the hearts and made them swell. Finally, by means of trial and error, Ott discovered a soap commonly found in shampoo that was perfectly ideal for this procedure. Using this soap, a rat heart was washed of all cells and all that remained was the scaffold or structure. This scaffold was checked for damage and Ott found that it was intact. Afterwards, the heart was seeded with cells from a rat. But simply putting cells on the structure of a complex organ like a heart is not enough to make it viable. The heart was placed in an artificial environment and given an electrical signal. Soon, this heart became the first lab grown heart to beat independently of a body. Later on, a lung was manufactured the same way. This lung was successfully transplanted into a rat (Nova).
These same techniques have already been used on humans in need of various body parts. Organs, like bronchial tubes, are harvested from human cadavers. These parts are then similarly washed clean of all cells. Furthermore, the organs are seeded with cells taken from the to-be recipient’s body. Then the new organ is transplanted into the same person. For many years following the transplant, the patients’ bodies do not show any signs of rejection (Nova).
Harvesting organs from human cadavers can create a moral dilemma for some people. After all, those cadavers used to be people too. Similar techniques have been used with pig kidneys. These organs have the same size, complexity, and shape as their human counterparts—all the piping and blood vessels intact. Animal organs like these have been successfully transplanted into humans (Nova). Still, some animal rights activists may be opposed to these procedures. If that is the case, there is an alternative technology that circumvents the harvesting of organs from any kind of creature—whether they are human or animal. Where else would one acquire the structures needed to build new organs? As crazy as it may sound, some scientists have developed a technique to literally print organs from a printer. Researchers at Wake Forest University took a regular printer and gave it the capability to print organs. They took an empty ink cartridge and filled it with living cells. Then they placed the cartridge into a modified printer. Using this machine, the researchers printed out a two chambered mouse heart. This heart wasn’t just a clump of cells, but it actually beat (Nova).
These new breakthroughs in organ-transplant techniques and new technologies may someday lead to a new era of medicine. Imagine a world in which all the parts of your body are replaceable. A person may get into a car accident and lose a limb or damage a vital organ. But that person and his family will feel secure because they will know that those parts will be replaced with brand-new ones as soon as the ambulance arrives at the hospital. How distant is this sci-fi-like reality? Most researchers believe that we are only decades away. Some are more enthusiastic and say that organs and body parts will be available in unlimited supply within only a few years. There will be a day when one can stroll into a manufacturing facility, and discover that lining the shelves are: jars of kidneys, jars of livers, jars of lungs and whatever else is needed (Nova).





Nova Science Now Replacing Body Parts Video


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