Building a Better You

 

Better You Graphic

We can rebuild him. We have the technology. We can make him better than he was…”

So begins the 1970s American TV sci-fi classic, The Six Million Dollar Man, about an astronaut who scientists reconstruct into a cyborg superman—part human, part “bionic”—after an accident causes devastating injuries.

Although we haven’t begun producing super-humans, the concept of rebuilding grievously damaged bodies to be better than before has moved from the science fiction shelf to one marked simply, science. Today’s doctors are replacing lost limbs with robotic prosthetics, swapping failed hearts, livers, kidneys and other organs with functioning ones, restoring some hearing to the deaf and limited sight to the blind.

Tomorrow’s doctors may be able to end blindness altogether, make paralysis a thing of the past—and if an organ wears out? No problem. They’ll grow you a new one from scratch in a lab.

On the next few pages, we’ll show you some of the amazing advances changing lives   for the better right now… and what else might be coming in the not very distant future.

I, Robot?

Prosthetic legs have been with us since ancient times, and at their simplest, merely fill the void left by the loss of a natural leg. But today’s specialized prosthetic legs are anything but simple, allowing users who can afford their hefty price-tags to hike, swim, ski, climb mountains, and more.

Magnus Oddson, an engineer with Ossur of Iceland, which developed the carbon fibre “Cheetah” legs used by Paralympic athletes, says the next phase in lower limb prosthetics is bio-electronics—bionics, for short—robotic prosthetics with built-in sensors and microprocessors.

That phase is already well on its way in upper limb prosthetics. Trauma surgeon Albert Chi, MD, medical director of the Targeted Muscle Reinnervation Program at Johns Hopkins in Baltimore, Maryland, believes that sometime in a not very far-off  future, robotic limbs will be indistinguishable in every way from natural ones. His focus is on giving amputees greater function by surgically re-routing nerves that once were attached to amputees’ missing hands into new areas of muscle where these nerves can communicate, via tiny electrodes on the surface of the skin, to robotic prosthetics. When this is done, the result is a thought-controlled bionic arm. It uses the same brain signals that once led to the missing hand and arm to flex, grasp, and rotate, and the user feels almost like the prosthetic is his own limb.

Our nerves do more than transmit the brain signals that allow us to move, though.

“Remember that scene from Star Wars where Luke Skywalker has his hand cut off?” asks Dr. Chi.  “After they’re replaced his hand, they’re stimulating Luke Skywalker’s [bionic] hand with a needle. And he’s reacting to it.”

Could a real bionic limb do what Luke Skywalker’s did? Could it feel?

Dr. Chi’s patient, Johnny Matheny, lost his much of his left arm to cancer. But when using the thought-controlled bionic arm, developed in Johns Hopkins’ Applied Physics lab, Matheny can sense touches to each individual bionic finger. He can feel whether he’s grasping hard or soft objects. It’s even possible for his bionic hand to distinguish hot from cold. For Matheny, perhaps the most wondrous moment was when his wife reached out and held his bionic hand. Her touch felt almost as it had when his natural hand last held hers, five years before.

It’s not just those who have lost limbs who are benefiting from robotics. People who are paralyzed or weakened by spinal cord injuries or neurological disorders can be fitted with wearable robots, known as exoskeletons, that are like “an Iron Man suit, which you strap on,” explains Arun Jayaraman, who studies these devices at the Rehabilitation Institute of Chicago. And much like the Iron Man suit of superhero fame, the robotic exoskeleton gives the body greater strength as—absent the weaponry and armor, of course—it propels the wearer along.

Several models of exoskeletons are already commercially available in certain countries. They use different mechanisms to get you where you want to go, but all have multiple sensors meant to detect the user’s intended movement. So, for example, leaning forward on your left might trigger the left exoskeleton leg to move you a step forward. A computer and battery in a backpack provide the brains and power for many models but a newer, lighter exoskeleton developed by Honda can be controlled by an app from your smartphone or tablet.

Restoring Sight to the Blind

As a young man, Mark Humayun, MD, Ph.D, could do little to help as his grandmother lost her sight and struggled with the simple things most of us take for granted: recognizing a loved one from across the room… finding the doorway in an unfamiliar building…reaching for a glass of water. Since then, the professor of ophthalmology and biomedical engineering at the University of Southern California has devoted much of his career to developing an artificial retina, a.k.a. “bionic eye. ”

But what exactly is a bionic eye and how does it work?

A small camera, mounted on wrap-around eyeglasses, captures a scene, which is then wirelessly communicated to a minuscule device that is surgically implanted on the retina. The implant “takes the information from the camera, and converts it into tiny electrical impulses that jumpstart the otherwise blind eye,” explains Dr. Humayun.

The resulting images resemble blurry, low-resolution video.

Initially, the bionic eye was able to transmit only gray-scale visuals, but a tweak to the software has allowed those with the implant to distinguish up to nine colors. “We don’t know the limit of this technology,” says Dr. Humayun. “Every time we’ve pushed it, patients continue to see better and better.”

Approved for use in Europe in 2011, the bionic eye only works for those whose blindness is due to a loss of the cells that process light, which happens in retinitis pigmentosa, macular degeneration, and some other diseases. But it might be possible one day to connect such a device directly to the part of the brain that processes vision, so that people with other types of blindness might again be able to see.

Tomorrow’s Organ “Donor”: A 3-D Printer

There simply aren’t enough organ donors to save the lives of all 56,000 people on transplant waiting lists throughout Europe. This year alone, about four thousand will die before suitable donors are found.

But what if those awaiting transplants could be saved despite the scarcity of donors?

“What if?” may be a reality sooner than we imagine, thanks to a novel technique for bio-engineering new body parts using 3-D printing technology.

“We started with your typical desktop ink jet printer,” says Anthony Atala, MD, director at the Wake Forest Institute for Regenerative Medicine in Winston-Salem, North Carolina. “We modified printers so they’d print one layer at a time, layer after layer after layer.”

The “inks” used by 3-D printers in bio-engineering can be cells or other organic materials, minerals, synthetics, or a combination, depending on the body part being manufactured.

For example, using collagen as “ink,” Dr. Atala’s team has produced hollow objects the shape and size of human bladders. These form the scaffolds onto which patients’ own cells are seeded.

To get the cells, “We take a very small piece of [healthy bladder] tissue from the patient, about half the size of a postage stamp,” says Dr. Atala. Those cells are cultured until there are enough to coat the scaffold. The whole bio-engineered bladder is then incubated in a device that mirrors the temperature and other conditions of the human body. The cells proliferate for six to eight weeks, until the scientists have a fully functioning transplantable organ.

Several young people whose bladders failed are now living with Dr. Atala’s lab-grown organs, and his team has successfully transplanted other 3-D printed hollow, flat and cylindrical body parts.

Solid organs, printed in the lab, are years away from being viable due to their complexity. But sometime in the future, should you need a heart, kidney, lung, liver, or pancreas, your new organ might be generated this way from your own cells. As a side benefit, because the cells come from your body, your immune system is less likely to attempt to reject the new organ, as it would one from a donor, eliminating perhaps the greatest challenge facing recipients of donated body parts.

Bio-electronics and bio-engineering are still in their infancy. But as medicine becomes more and more intermingled with technology, it resembles what, only recently, we might have dismissed as science fiction.

And tomorrow? Somewhere, a scientist is dreaming of a breakthrough solution to one of medicine’s most intractable problems. And, sooner than we think, that dream will be part of our everyday reality.

 

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A longer version of this article originally appeared in Reader’s Digest international editions.

 

 

 

3-D Printing

Doctors have already transplanted synthetic substitutes of skulls and bone grafts, 3-D printed to fit, to replace damaged skull and other bone. In the future they could replace lost bone by 3-D printing with cells cultured from your body.

Burn victims could be positioned under a 3-D printer, which will then “print” new skin cells, previously cultured from them, directly over the injury.

Instead of off-the-shelf replacement joints, tomorrow’s surgeons will use a scan to produce a 3-D printed model of your natural hip. From this a customized joint replacement is manufactured, greatly increasing the chances of long-term success.

One day, scientists hope to 3-D print an ear that incorporates everything you need for hearing, without requiring external processors. Some believe such a device could make it possible to hear well beyond current human capabilities.

Grow-your-own

In a small study, heart failure patients had their own healthy heart stem cells extracted during coro- nary bypass, cultured and infused back into their hearts. These multi- plied, and in most patients, dam- aged heart muscle healed. Such infusions might become an alternative to heart transplants.

New organs from old

Many organs are unsuitable for transplant but their structure might in the future form the “scaffold” for generating new, transplantable organs. Doctors are already experimenting with discarded livers.