(heart beating)
The human body is an amazing biological machine
composed of a myriad of complex components
medical science is just now beginning to understand.
New technologies provide incredible images and new insights
into how everything works,
and in many ways, at the heart of it all is,
well, the heart.
(pulsing music)
But heart disease is the number one
cause of death worldwide.
killing more than eight million people each year.
Cardiac infarction, more commonly known as a heart attack,
can happen without warning,
killing heart muscle cells immediately.
Even if the patient recovers,
the damage to their heart may not.
And so we want to somehow improve the function
of that heart tissue.
So all around the world,
researchers are determined to learn
how to fix a broken heart.
Exploring multiple paths of inquiry,
to innovate new bio-engineering methods,
even developing the technology to print a new heart.
Dr. Warren Grayson is a professor
of biomedical engineering at Johns Hopkins University.
His own work focuses on utilizing 3D printing techniques
to aid facial bone regeneration.
He also studies pioneering new research
in regenerative medicine from around the world.
Could we build something that's biological replacement
that can either augment the normal function of the heart
and in the most extreme conditions,
I think the dream is could we actually build a new heart?
An imbiological heart to replace that organ.
This is a reconstruction
of our circulatory system.
Based on actual medical data.
Blood vessels extend a total length
of about 100,000 kilometers,
or, about two and a half times around the globe.
They deliver oxygen and nutrients to every corner,
and take waste products away.
They also serve as an organ-to-organ communication system.
Transporting messaging molecules
vital to our health and wellbeing.
Including instructions, directing repair and regeneration.
The heart is the engine of this circulatory network,
pumping blood throughout our bodies,
so any disruption can have dire consequences.
But the heart is difficult to treat,
due to a rather unique and troublesome characteristic.
Many organs continue working
as old cells are replaced by new ones.
However, that process occurs very slowly in the heart.
It's believed that only 30% of its cells
are replaced over 50 years.
So once the heart is damaged,
it takes a long time for recovery to take place.
How can new heart cells be generated?
It appears, tiny extracellular bubbles, called exosomes,
some hidden within the heart, play a key role.
They contain a message that can rebuild the heart.
Let's make more and more cells.
So if a damaged heart receives an infusion
of artificially created messaging molecules,
this could speed up the process.
(beating)
Renown researcher, Dr. Eduardo Marban,
tested this theory by giving with mice,
that had experienced cardiac infarction.
The results were dramatic.
This is the wall of the heart after cardiac infarction.
The cells on the right side have died.
And the wall has become thin.
But, in mice that received these additional
messaging molecules, the number of cells had increased,
and the wall had become thicker.
Exosomes and their biology
have sparked a revolution in our understanding,
of how things work inside our bodies.
If it can take the right ones
from a defined therapeutic source
they might be very powerful agents
in the treatment of disease,
in a way that defies all their connections.
While Marban and his team
continue their work to address cardiac disease,
elsewhere, researchers investigate other approaches.
Including the development of lab culture tissues and organs.
This is Kenneth Chien, a world leading expert
in the field of regenerative medicine.
At Chien's lab, he uses embryonic stem cells
to observe the formation of one organ almost everyday.
Here, the researcher adds a certain signaling molecule
to an ES cell,
it's called WNT.
WNT molecules are present in large quantities
in dividing eggs.
After one week, part of the cell is starting to pulse.
Two days later, large ripples move across the flatten cell.
This is the very beginning of a human heart.
You can take an embryonic stem cell,
that can become any cell.
And then instruct it to specifically, almost entirely,
become human beating ventricular muscle.
This is an exciting event.
Building on this excitement
and enabling growth in biomedical research,
is the development of a new type of material
with which to work.
Essentially reprogramming common human cells,
such as skin cells.
Scientists can now create
induced pluripotent stem cells, or IPS for short.
With the same transformative properties
of embryonic stem cells,
researchers in Israel are using IPS cells
to develop startling new innovations.
Even printing a miniature heart.
This is the first time that the whole
cellular heart, with blood vessel is printed.
How did they do it?
Tal Dvir and a team of research scientists
at Tel Aviv University, harvested patients fatty tissue,
to produce a personalized biological hydrogel.
As well as IPS cells,
manipulated to become cardiac invascular cells.
Together, these form what Dvir calls bioinks.
We have bioinks for the heart,
and bioinks for the blood vessels,
and then we use a 3D printer to print whole hearts
with the major blood vessels.
The next stage is to mature these hearts, in the lab,
to help the cells, or teach them how to interact
with each other and how to provide electrical signal
into every contraption or pumping ability of the heart.
In a year or two we hope to take these hearts
and transplant them in smaller animal, models and rats
or whatever, rabbits.
Astounding, no doubt, and while much more work
must be done to scale up the study,
from printing rabbit sized organs to a truly
human sized heart, its impact, may be more immediate.
By being able to create something like that, inside a lab,
you can start testing (music drowns out speaker)
It's definitely a positive, it definitely moves
the field forward in terms of understanding basic biology,
basic cell biology, and understanding conduct biology.
And, yet, another element of Nor's study
could result in medical applications more quickly.
Using these same bioprinting techniques,
the researchers developed a vascularized cardiac patch,
leading to potentially new ways to repair the damaged
done by heart attacks.
And so the idea there is that
you can't remove that scar tissue entirely,
but if you can plant a patch over it
so you think of it as, you know,
a cardiac band-aid in the sense, and you place over it,
then that has contractability
then it kind of augments that thinning wall.
It makes it thicker and it also provides
certain strength through that wall.
So the cells campaign with that matrix
is all entirely biological
and it's all entirely back compatible,
it can integrate with anybody, there's not gonna be any
immune injection as a response to that,
because the cells come from that particular patient.
I believe that in 10 years that there will be printers
in every hospital that will print tissues and organs
that will then be transplanted in new patients.
Doctor Grayson believes
that's an optimistic timeline.
But given the remarkable advances of biomedical engineering,
doctors may soon truly learn how to fix a broken heart.
Within science there's always promise
and there's always hope.
And so each of these breakthroughs takes us, you know,
that step further and maintains that hope in getting there.