Nina Tandon: Could tissue engineering mean personalized medicine?

Translator: Joseph Geni Reviewer: Morton Bast

Translator: Tania Cid Reviewer: Serv. de Norm. Lingüística U. de Santiago de Compostela

Gustaríame amosarlles un vídeo dalgúns modelos

cos que traballo.

I'd like to show you a video of some of the models

Teñen un tamaño perfecto e nin un ápice de graxa.

I work with.

They're all the perfect size, and they don't have an ounce of fat.

Mencionei que son fermosos?

E que son modelos científicos? (Risas)

Did I mention they're gorgeous?

And they're scientific models? (Laughs)

Como imaxinan, son enxeñeira de tecidos

e este é un vídeo dos corazóns con latexo

As you might have guessed, I'm a tissue engineer,

que deseñei no laboratorio.

and this is a video of some of the beating heart

Esperamos que no futuro estes tecidos

that I've engineered in the lab.

poidan substituír partes do corpo humano.

And one day we hope that these tissues

can serve as replacement parts for the human body.

Pero hoxe vou falar

do bos que son estes tecidos como modelo.

But what I'm going to tell you about today

is how these tissues make awesome models.

Pensemos no proceso de aprobación dun fármaco.

Formulación, probas de laboratorio, probas en animais,

Well, let's think about the drug screening process for a moment.

ensaios clínicos, que chamaríamos probas en humanos,

You go from drug formulation, lab testing, animal testing,

antes de que o fármaco chegue ó mercado.

and then clinical trials, which you might call human testing,

Isto custa moitos cartos e tempo,

before the drugs get to market.

It costs a lot of money, a lot of time,

e cando se pon á venda

pode provocar efectos secundarios e danar á xente.

and sometimes, even when a drug hits the market,

it acts in an unpredictable way and actually hurts people.

E canto máis tarde falle, peores serán as consecuencias.

And the later it fails, the worse the consequences.

Resúmese todo en dous temas: Un: os humanos non somos ratas,

It all boils down to two issues. One, humans are not rats,

e dous: malia as nosas incribles semellanzas,

and two, despite our incredible similarities to one another,

as pequenas diferenzas entre nós

teñen un forte impacto no xeito en que metabolizamos fármacos

actually those tiny differences between you and I

have huge impacts with how we metabolize drugs

e en como nos afectan os fármacos.

Pero, e se tivésemos mellores modelos

and how those drugs affect us.

que nos imitasen mellor cás ratas

So what if we had better models in the lab

that could not only mimic us better than rats

e ademais reflectisen a nosa diversidade?

but also reflect our diversity?

Vexamos como facelo coa enxeñería de tecidos.

Let's see how we can do it with tissue engineering.

Unha das tecnoloxías clave son

One of the key technologies that's really important

as células nai pluripotentes inducidas.

is what's called induced pluripotent stem cells.

Desenvolvéronse no Xapón hai pouco.

Estas células parécense moito

They were developed in Japan pretty recently.

ás células nai embrionarias

Okay, induced pluripotent stem cells.

pero non xeran polémica.

They're a lot like embryonic stem cells

Por exemplo, inducimos células da pel

except without the controversy.

engadíndolles algúns xenes, cultivámolas

We induce cells, okay, say, skin cells,

e recollémolas.

by adding a few genes to them, culturing them,

Estas células pódense levar

and then harvesting them.

a un estado de amnesia celular, un estado embrionario.

So they're skin cells that can be tricked,

kind of like cellular amnesia, into an embryonic state.

É xenial que non xeren polémica

e que se poida obter todo tipo de tecidos con elas:

So without the controversy, that's cool thing number one.

Cool thing number two, you can grow any type of tissue

cerebro, corazón, fígado... xa se fan unha idea

out of them: brain, heart, liver, you get the picture,

pero a partir de células propias.

Así que podemos facer un modelo do corazón ou do cerebro propios

but out of your cells.

So we can make a model of your heart, your brain

nun chip.

Xerar tecidos de densidade e comportamento predicible é o segundo elemento

on a chip.

Generating tissues of predictable density and behavior

e será clave

is the second piece, and will be really key towards

para que o descubrimento de fármacos adopte estes modelos.

getting these models to be adopted for drug discovery.

Este é un esquema dun biorreactor que estamos a desenvolver

And this is a schematic of a bioreactor we're developing in our lab

para deseñar tecidos dunha maneira modular e escalable.

to help engineer tissues in a more modular, scalable way.

Imaxinemos unha versión a grande escala

Going forward, imagine a massively parallel version of this

con miles de fragmentos de tecido humano.

Sería como facer un ensaio clínico nun chip.

with thousands of pieces of human tissue.

It would be like having a clinical trial on a chip.

Outra cousa sobre estas células nai pluripotentes inducidas

But another thing about these induced pluripotent stem cells

é que, se collemos células da pel,

de xente cunha enfermidade xenética

is that if we take some skin cells, let's say,

e xeramos un tecido a partir delas,

from people with a genetic disease

poderiamos usar técnicas de enxeñería de tecidos

and we engineer tissues out of them,

para xerar modelos desa enfermidade.

we can actually use tissue-engineering techniques

to generate models of those diseases in the lab.

Este é un exemplo do laboratorio de Kevin Eggan en Harvard.

Here's an example from Kevin Eggan's lab at Harvard.

El xerou neuronas

a partir destas células nai

He generated neurons

from these induced pluripotent stem cells

de pacientes con esclerose lateral amiotrófica,

e diferenciounas a neuronas,

from patients who have Lou Gehrig's Disease,

a sorpresa é que as neuronas amosaban síntomas da enfermidade.

and he differentiated them into neurons, and what's amazing

is that these neurons also show symptoms of the disease.

Con modelos coma este, podemos loitar máis rápido

So with disease models like these, we can fight back

e entender mellor a enfermidade

faster than ever before and understand the disease better

e quizais, atopar fármacos máis axiña.

than ever before, and maybe discover drugs even faster.

Este é outro exemplo de células nai dun paciente

This is another example of patient-specific stem cells

que se deseñaron a partir de alguén con retinose pigmentaria.

that were engineered from someone with retinitis pigmentosa.

É unha dexeneración da retina.

Unha enfermidade presente na miña familia

This is a degeneration of the retina.

e esperamos que células coma estas nos axuden a atopar unha cura.

It's a disease that runs in my family, and we really hope

Algúns pensan que estes modelos apuntan posibilidades,

that cells like these will help us find a cure.

pero preguntan, "son tan bos como a rata?"

So some people think that these models sound well and good,

but ask, "Well, are these really as good as the rat?"

A rata é un organismo completo,

The rat is an entire organism, after all,

con redes interactivas de órganos.

Un fármaco para o corazón pode metabolizarse no fígado

with interacting networks of organs.

A drug for the heart can get metabolized in the liver,

e algúns dos bioprodutos poden almacenarse na graxa.

and some of the byproducts may be stored in the fat.

Non botas en falta todo iso nos modelos de enxeñería de tecidos?

Don't you miss all that with these tissue-engineered models?

Isto é outra tendencia nesta área.

Combinando a enxeñería de tecidos coa microfluídica,

Well, this is another trend in the field.

By combining tissue engineering techniques with microfluidics,

o campo evoluciona

a un modelo completo do corpo,

the field is actually evolving towards just that,

con múltiples sistemas de órganos, onde comprobar

a model of the entire ecosystem of the body,

como un fármaco para a presión sanguínea

complete with multiple organ systems to be able to test

lle afecta ó fígado, ou un antidepresivo ó corazón.

how a drug you might take for your blood pressure

might affect your liver or an antidepressant might affect your heart.

Estes sistemas son difíciles de construír,

pero estamos comezando a facelo, así que estean atentos.

These systems are really hard to build, but we're just starting to be able to get there,

and so, watch out.

Isto non é todo, xa que unha vez aprobado un fármaco,

a enxeñería de tecidos pode axudarnos a xerar tratamentos personalizados.

But that's not even all of it, because once a drug is approved,

tissue engineering techniques can actually help us develop more personalized treatments.

Este exemplo podería interesarlles algún día,

This is an example that you might care about someday,

aínda que espero que non,

xa que, imaxinen que un día reciben unha chamada,

and I hope you never do,

que lles dá a mala noticia de que teñen cancro.

because imagine if you ever get that call

that gives you that bad news that you might have cancer.

Non probarían primeiro se os fármacos que van tomar

Wouldn't you rather test to see if those cancer drugs

funcionan contra o seu cancro?

Este é un exemplo do laboratorio de Karen Burg,

you're going to take are going to work on your cancer?

onde empregan células de cancro de mama impresas

This is an example from Karen Burg's lab, where they're

using inkjet technologies to print breast cancer cells

para estudar a súa progresión e tratamento.

Algúns dos nosos compañeiros en Tufts mesturan modelos coma este

and study its progressions and treatments.

con ósos creados por enxeñería de tecidos para ver como o cancro

And some of our colleagues at Tufts are mixing models

like these with tissue-engineered bone to see how cancer

podería estenderse polo corpo,

might spread from one part of the body to the next,

e poden imaxinar este tipo de chips multitecido

como a próxima xeración deste tipo de estudos.

and you can imagine those kinds of multi-tissue chips

to be the next generation of these kinds of studies.

Pensando nos modelos que acabamos de comentar,

nun futuro, a enxeñería de tecidos

And so thinking about the models that we've just discussed,

pode revolucionar o descubrimento de fármacos

you can see, going forward, that tissue engineering

en cada paso do proceso:

is actually poised to help revolutionize drug screening

modelos de enfermidades que melloren a formulación,

at every single step of the path:

modelos de tecido humano que revolucionen as probas de laboratorio,

disease models making for better drug formulations,

massively parallel human tissue models helping to revolutionize lab testing,

reducir as probas en animais e humanos en ensaios clínicos

reduce animal testing and human testing in clinical trials,

e terapias individualizadas

que revolucionarán o mercado.

and individualized therapies that disrupt

what we even consider to be a market at all.

En esencia, estamos a acelerar a retroalimentación

entre a xeración dunha molécula

Essentially, we're dramatically speeding up that feedback

e a aprendizaxe de como actúa no corpo humano.

between developing a molecule and learning about

O proceso para facer isto é transformar a biotecnoloxía

how it acts in the human body.

Our process for doing this is essentially transforming

e a farmacoloxía nunha tecnoloxía da información,

biotechnology and pharmacology into an information technology,

axudándonos a achar e avaliar fármacos de maneira máis rápida,

helping us discover and evaluate drugs faster,

barata e efectiva.

more cheaply and more effectively.

Dálle un novo significado ós modelos contra a experimentación animal, non é?

It gives new meaning to models against animal testing, doesn't it?

Grazas. (Aplausos)

Thank you. (Applause)