Alan Russell – Regrowing by Thinking Small

The morning’s session is entitled “Small Miracle” and promises a series of talks about innovation on microscale. We lead off with Ethel, an innovative string quartet, who sound something like Bartok leading a jug band of super-hip Brooklynites… and I mean that in a good way.

Leading off is Dr. Alan Russell, director of the McGowan Institute for Regenerative Medicine. Bionic humans – hip replacement, for instance – is the complete opposite of regenerative medicine – instead of trying to figure out how to ameliorate functions with medicine or devices, we figure out how to regenerate organs so you were the same as before your disease.

The richer we are, the longer we live. And the longer we live, the longer we need to deal with complicated diseases. And demographics are against us: In 1930, there were 41 workers per retire. Today, that ratio is three to one. In 2010, that will be 2 to 1. Cost of healthcare spikes when an individual is 45; there’s another spike about 7 years before you die.

How do we deal with this situation? You can ration healthcare, a terrible option. You can work on prevention, which works on some diseases. Or you can start treating diseases very early, and start treating it very early on.

We look at diabetes – we wait until there are symptoms, then treat them, and can treat them for 10-40 years… but eventually, it’s a catastrophic disease. Why can’t we detect the disease before it’s symptomatic, inject something into the pancreas and regenerate the damage? He shows us a video of a newt regrowing a leg and invites us to imagine diabetics (like me!) regrowing a pancreas.

We need to have a conversation with the body and learn to speak the body’s language. We have to switch on processes we knew how to do as a fetus. A mamalian fetus, if it loses a limb in the first trimester, will regrow it. A one year old can regrow a fingertip.How do we take advantage of these strategies as adults?

There’s three ways we might do this – cell regeneration therapies, new materials that can heal, and smart devices that offload work of the body. We begin with materials. Alan tells us about a scientist who discovered that the small intestine of a pig could, treated a certain way, regenerate other types of cells. He shows us a brutally ulcerated foot (a diabetic ulcer) – after 11 weeks treatment with the small intenstine, the open wounds are healed and the skin has regrown… the previous option was amputation. 400,000 patients have used this treatment – the most amazing example is the regeneration of a diseased fingertip of a 78 year old man – the finger has regrown entirely.

The other two techniques are a bit harder to understand. Alan shows us a fascinating strategy for stem cell production – grabbing stem cells from liposuction fluid… which we have a lot of in the US. In the future, stem cell treatments might be done using stem cells from one’s own fat.

To show off devices that offload work, we talk about burn treatment. We see a burn treatment strategy that works on “seeding” the skin, allowing new cell growth, rather than “sodding” burn areas with skin grafts.

Japan, China and the EU are all leaders in this field, investing billions each. We’re more than a little behind – in a meeting with the NIH, Alan tells us the NIH director said, “Your vision is larger than our appetite.” The solution – we need to change those appetites, our willingness to dream big.