1 00:00:05,110 --> 00:00:06,810 The latest science has revealed 2 00:00:06,810 --> 00:00:10,150 paradigm breaking insights into the workings 3 00:00:10,150 --> 00:00:11,193 of the human body. 4 00:00:15,430 --> 00:00:17,700 It is now thought that there is a vast web 5 00:00:17,700 --> 00:00:19,714 of information networks, 6 00:00:19,714 --> 00:00:23,803 just like the internet within our bodies. 7 00:00:27,580 --> 00:00:30,088 The established view on the human body 8 00:00:30,088 --> 00:00:32,980 was that the brain ruled the entire system 9 00:00:34,340 --> 00:00:37,593 and all the other organs obeyed what the brain commanded. 10 00:00:41,160 --> 00:00:44,733 But now this idea has been completely overturned. 11 00:00:46,750 --> 00:00:49,600 It's now been shown that our various organs in the body 12 00:00:50,910 --> 00:00:53,310 are directly talking to one another, 13 00:00:57,960 --> 00:01:02,803 bypassing the brain using their own unique networks. 14 00:01:04,360 --> 00:01:08,150 And it's these networks that could hold the key 15 00:01:08,150 --> 00:01:10,663 to our health and longevity. 16 00:01:13,590 --> 00:01:16,646 Organs need to speak to each other 17 00:01:16,646 --> 00:01:20,020 and there is more to understand physiology 18 00:01:20,020 --> 00:01:22,853 than single cell or single organs. 19 00:01:24,260 --> 00:01:27,520 An entirely new perspective on the human body 20 00:01:27,520 --> 00:01:30,233 has been revealed through cutting edge microscopy. 21 00:01:33,220 --> 00:01:37,883 Have a look here, this is an image from inside our body. 22 00:01:41,070 --> 00:01:43,270 Access into this microscopic world 23 00:01:43,270 --> 00:01:45,660 are now letting us catch the very moments 24 00:01:45,660 --> 00:01:49,093 where our internal organs are exchanging messages. 25 00:02:02,790 --> 00:02:05,260 The latest science about our organs' networks 26 00:02:05,260 --> 00:02:08,709 is also revealing, that most illnesses 27 00:02:08,709 --> 00:02:11,240 are signs of disruptions occurring 28 00:02:11,240 --> 00:02:13,563 in the dialogue between organs. 29 00:02:14,720 --> 00:02:17,402 By intervening in the organs' dialogue 30 00:02:17,402 --> 00:02:20,640 modern medicine may now be able to overcome 31 00:02:20,640 --> 00:02:23,080 many diseases that had previously been thought 32 00:02:23,080 --> 00:02:24,073 as untreatable. 33 00:02:30,743 --> 00:02:31,757 Yes. 34 00:02:31,757 --> 00:02:33,488 (laughing) 35 00:02:33,488 --> 00:02:36,800 We have a better chance of living a longer, healthy life. 36 00:02:36,800 --> 00:02:39,870 The point where we now sit is that evolution 37 00:02:39,870 --> 00:02:43,453 of the human species is happening in real time. 38 00:02:58,550 --> 00:02:59,470 So what do we mean 39 00:02:59,470 --> 00:03:01,393 by the body's internal network? 40 00:03:03,860 --> 00:03:05,640 First let's seek some assistance 41 00:03:05,640 --> 00:03:08,400 from the very latest, cutting edge microscopy 42 00:03:08,400 --> 00:03:09,687 for some answers. 43 00:03:09,687 --> 00:03:11,337 Good morning. 44 00:03:11,337 --> 00:03:12,250 Very lovely to meet you. 45 00:03:12,250 --> 00:03:13,550 Good to meet you too. 46 00:03:13,550 --> 00:03:15,463 This is Dr. Eric Betzig. 47 00:03:17,960 --> 00:03:21,390 He jointly won the Nobel Prize in 2014 48 00:03:21,390 --> 00:03:23,540 for developing innovative microscopy 49 00:03:23,540 --> 00:03:25,563 that widely pushed boundaries. 50 00:03:28,150 --> 00:03:31,180 So the purpose of this microscope 51 00:03:31,180 --> 00:03:33,700 is to be able to watch the dynamics 52 00:03:33,700 --> 00:03:35,753 of living cells in three dimensions. 53 00:03:38,220 --> 00:03:39,770 This complicated device 54 00:03:39,770 --> 00:03:42,923 looks nothing like a traditional optical microscope. 55 00:03:46,770 --> 00:03:48,430 It can scan a tiny cell 56 00:03:49,410 --> 00:03:51,890 and when rendered by a computer 57 00:03:51,890 --> 00:03:53,813 produce a 3D image. 58 00:03:57,980 --> 00:04:00,383 Here's an image from a conventional microscope. 59 00:04:01,620 --> 00:04:03,880 The round particles are immune cells 60 00:04:03,880 --> 00:04:06,073 that protect our bodies from infection. 61 00:04:08,680 --> 00:04:11,730 And through Dr. Betzig's microscope 62 00:04:11,730 --> 00:04:13,080 here's what they look like. 63 00:04:15,800 --> 00:04:20,800 These immune cells are not even 0.01 millimeters across 64 00:04:21,270 --> 00:04:24,253 yet their dynamic motion has been clearly captured. 65 00:04:28,270 --> 00:04:30,110 And at a higher magnification 66 00:04:31,860 --> 00:04:34,330 these spiny microstructures emerging 67 00:04:34,330 --> 00:04:37,263 from the surface of the cell can be seen in 3D. 68 00:04:43,600 --> 00:04:46,710 Astonishingly this microscope can even peer 69 00:04:46,710 --> 00:04:50,023 into the cell's interior from any angle. 70 00:04:55,240 --> 00:04:58,470 This is the moment when an immune cell in green 71 00:04:58,470 --> 00:05:00,803 devours a cancer cell in blue. 72 00:05:04,830 --> 00:05:07,400 The red particles inside the immune cell 73 00:05:07,400 --> 00:05:09,613 are fired off into the cancer cell. 74 00:05:10,570 --> 00:05:13,123 These are chemical weapons of destruction. 75 00:05:14,770 --> 00:05:17,650 This historic clip shows for the first time 76 00:05:17,650 --> 00:05:21,750 an immune cell at work fighting off the body's enemies. 77 00:05:28,980 --> 00:05:32,790 And this image has been captured on an 8K microscope, 78 00:05:32,790 --> 00:05:34,053 it's a world first. 79 00:05:36,030 --> 00:05:38,690 What you can see in red is blood flowing 80 00:05:38,690 --> 00:05:39,990 through our blood vessels. 81 00:05:43,720 --> 00:05:46,720 The green spheres traveling along with the flow 82 00:05:46,720 --> 00:05:47,753 are immune cells. 83 00:05:50,030 --> 00:05:54,010 Immune cells on patrol seeking intruders in our blood 84 00:05:54,010 --> 00:05:56,083 have been captured in vivid detail. 85 00:05:58,600 --> 00:06:01,380 Up until recently microscopes were only able 86 00:06:01,380 --> 00:06:04,823 to observe a very limited area within the human body. 87 00:06:08,940 --> 00:06:12,954 However by using an 8K microscope it becomes possible 88 00:06:12,954 --> 00:06:17,030 to capture a much wider area in more detail, 89 00:06:17,030 --> 00:06:20,313 as much as 16 times wider in one go. 90 00:06:22,160 --> 00:06:25,800 This is a process of clot forming in a blood vessel. 91 00:06:25,800 --> 00:06:28,280 We've managed to catch this mechanism in action 92 00:06:28,280 --> 00:06:31,243 over an extended area for the very first time. 93 00:06:32,760 --> 00:06:35,636 Should this clot be allowed to travel to the brain 94 00:06:35,636 --> 00:06:37,433 it could cause a stroke. 95 00:06:42,650 --> 00:06:45,420 Such innovative technologies have allowed scientists 96 00:06:45,420 --> 00:06:48,210 to observe living cells at a resolution 97 00:06:48,210 --> 00:06:50,100 that can capture images as small 98 00:06:50,100 --> 00:06:52,883 as a hundred thousandth of a grain of sand. 99 00:06:55,690 --> 00:06:56,570 And at last 100 00:06:57,460 --> 00:06:59,660 the crucial moment when a cell releases 101 00:06:59,660 --> 00:07:03,043 a signaling molecule has now been captured. 102 00:07:10,690 --> 00:07:13,543 This critical event was filmed in the intestine. 103 00:07:15,810 --> 00:07:18,543 The organ that absorbs nutrients in our bodies. 104 00:07:20,660 --> 00:07:23,560 If you look in further detail into the wall of the gut 105 00:07:28,580 --> 00:07:30,340 clearly visible are a carpet 106 00:07:30,340 --> 00:07:33,570 of these tiny protrusions called villi, 107 00:07:33,570 --> 00:07:35,953 which are about a millimeter each in length. 108 00:07:40,240 --> 00:07:43,193 A special light is used to observe these in detail. 109 00:07:47,340 --> 00:07:50,810 What you can see in between the mesh of these villi 110 00:07:50,810 --> 00:07:51,883 are capillaries. 111 00:07:54,290 --> 00:07:57,370 Nutrients from food are absorbed by these villi 112 00:07:58,430 --> 00:08:01,413 and are carried throughout the entire body by our blood. 113 00:08:08,720 --> 00:08:11,620 Cells near the surface of the villi have been captured 114 00:08:13,140 --> 00:08:14,233 using a microscope. 115 00:08:15,600 --> 00:08:18,110 The area indicated by the line 116 00:08:18,110 --> 00:08:21,023 is a single cell that forms a part of the intestine. 117 00:08:24,780 --> 00:08:27,683 The interior of this cell is shimmering away. 118 00:08:29,520 --> 00:08:31,363 Now watch as it changes. 119 00:08:32,230 --> 00:08:33,680 Something is about to happen. 120 00:08:45,220 --> 00:08:48,370 Glistening clouds of molecules burst out 121 00:08:48,370 --> 00:08:49,883 from the intestine cell. 122 00:08:51,900 --> 00:08:54,160 At a further magnification 123 00:08:54,160 --> 00:08:55,510 here's what they look like. 124 00:08:57,030 --> 00:09:00,200 These are the signaling molecules. 125 00:09:00,200 --> 00:09:02,340 They are only a hundred thousandth 126 00:09:02,340 --> 00:09:04,453 of a grain of sand in size. 127 00:09:07,570 --> 00:09:11,683 The message they deliver for example could be food's here. 128 00:09:14,350 --> 00:09:16,640 These messages are telling the entire body 129 00:09:16,640 --> 00:09:18,473 that food has been consumed. 130 00:09:22,780 --> 00:09:24,180 Carried in the blood stream, 131 00:09:25,760 --> 00:09:27,853 the message flows throughout the body. 132 00:09:32,600 --> 00:09:35,620 Other organs respond to this message in their own way 133 00:09:36,760 --> 00:09:38,340 such as in controlling appetite 134 00:09:39,720 --> 00:09:41,543 and promoting nutrient absorption. 135 00:09:46,650 --> 00:09:48,790 Recent research has so far discovered 136 00:09:48,790 --> 00:09:50,550 hundreds of different molecules 137 00:09:50,550 --> 00:09:51,843 carrying such messages. 138 00:09:58,110 --> 00:10:01,430 Our internal organs are likely to be using these molecules 139 00:10:01,430 --> 00:10:03,143 to communicate with one another. 140 00:10:11,900 --> 00:10:13,880 To find out more about this community 141 00:10:13,880 --> 00:10:16,500 of organs inside our bodies, 142 00:10:16,500 --> 00:10:18,430 today we will be focusing on 143 00:10:21,130 --> 00:10:22,023 the kidneys. 144 00:10:25,280 --> 00:10:28,010 The kidney is the size of our fist 145 00:10:28,010 --> 00:10:30,263 and are located just above our hips. 146 00:10:32,578 --> 00:10:33,900 Perhaps you may have thought of them 147 00:10:33,900 --> 00:10:37,333 as rather dull organs that just produce urine, 148 00:10:39,300 --> 00:10:42,050 but you couldn't be further from the truth. 149 00:10:42,050 --> 00:10:45,500 They are in fact starting to draw a great deal of attention 150 00:10:45,500 --> 00:10:47,680 from scientists the world over, 151 00:10:47,680 --> 00:10:49,113 more than any other organ. 152 00:10:51,780 --> 00:10:54,840 By sending out signals all throughout our body 153 00:10:54,840 --> 00:10:58,113 they hold a commanding position in the body's networks. 154 00:11:03,300 --> 00:11:07,073 The kidneys may even hold a key to our lifespan. 155 00:11:14,240 --> 00:11:17,410 To reveal more about our incredible kidneys 156 00:11:17,410 --> 00:11:19,993 we've brought you to a very special location. 157 00:11:23,930 --> 00:11:27,560 The elevation of this plateau is over two thousand meters 158 00:11:27,560 --> 00:11:28,593 above sea level. 159 00:11:34,740 --> 00:11:36,913 These people are not here to sight see. 160 00:11:41,070 --> 00:11:43,533 They've come here to train their kidneys. 161 00:11:52,240 --> 00:11:55,280 For many years swimmers preparing for the Olympics 162 00:11:55,280 --> 00:11:57,833 have been coming here for high altitude training. 163 00:12:09,498 --> 00:12:11,890 Straight after finishing a session the athlete's 164 00:12:11,890 --> 00:12:13,713 blood oxygen levels are measured. 165 00:12:15,350 --> 00:12:17,660 At sea level this number never dips 166 00:12:17,660 --> 00:12:20,373 below 96 percent, but here. 167 00:12:25,264 --> 00:12:26,180 (laughing) 168 00:12:26,180 --> 00:12:28,740 Even this swimmer is shocked to see a reading 169 00:12:28,740 --> 00:12:32,163 in the eighties, that is far below normal. 170 00:12:37,403 --> 00:12:38,800 (breathing heavily) 171 00:12:38,800 --> 00:12:40,740 This means that their bodies are suffering 172 00:12:40,740 --> 00:12:42,313 from oxygen deficiency. 173 00:12:45,580 --> 00:12:47,130 But after two weeks of training 174 00:12:55,825 --> 00:12:59,075 now their bodies have plenty of oxygen. 175 00:13:00,480 --> 00:13:03,003 This is altitude acclimatization. 176 00:13:06,200 --> 00:13:08,130 What kind of physiological changes 177 00:13:08,130 --> 00:13:10,743 have taken place in just two short weeks? 178 00:13:13,863 --> 00:13:16,567 Is it in the lungs which take in oxygen? 179 00:13:17,970 --> 00:13:20,763 Or the heart which pumps it throughout the body? 180 00:13:23,300 --> 00:13:25,630 The answer is neither. 181 00:13:25,630 --> 00:13:27,820 The athletes are actually temporarily 182 00:13:27,820 --> 00:13:30,683 training their kidneys even without realizing it. 183 00:13:34,990 --> 00:13:37,513 This body is suffering oxygen deprivation. 184 00:13:39,620 --> 00:13:42,713 The kidneys are releasing a large amount of some molecule. 185 00:13:48,040 --> 00:13:51,303 This tiny molecule is called EPO. 186 00:13:52,390 --> 00:13:54,270 It sends a message to other organs 187 00:13:54,270 --> 00:13:56,143 saying we need more oxygen. 188 00:13:59,770 --> 00:14:02,620 It's carried by the blood stream all throughout the body. 189 00:14:06,820 --> 00:14:08,720 So which parts of the body respond 190 00:14:08,720 --> 00:14:10,363 to this signaling molecule? 191 00:14:15,200 --> 00:14:16,353 The bones for one. 192 00:14:19,210 --> 00:14:22,570 Bones have holes that allow blood vessels in 193 00:14:22,570 --> 00:14:25,460 and are laced with voids filled with bone marrow 194 00:14:25,460 --> 00:14:26,753 where blood is produced. 195 00:14:30,920 --> 00:14:33,520 The messaging molecule flows into the spaces 196 00:14:33,520 --> 00:14:34,413 within the bone. 197 00:14:36,030 --> 00:14:40,180 In response red blood cells, the transporters of oxygen 198 00:14:40,180 --> 00:14:41,303 start multiplying. 199 00:14:48,090 --> 00:14:50,720 With an increased number of red blood cells 200 00:14:50,720 --> 00:14:53,470 more oxygen is now delivered to the muscles 201 00:14:53,470 --> 00:14:56,573 and this improves physical endurance of the athlete's body. 202 00:14:59,700 --> 00:15:01,720 These are the red blood cell data 203 00:15:01,720 --> 00:15:05,523 for the Japanese Olympic gold medalist Rita Koneto. 204 00:15:07,830 --> 00:15:10,670 When she won gold her red blood cell levels 205 00:15:10,670 --> 00:15:11,983 recorded the highest. 206 00:15:13,970 --> 00:15:17,000 The central figure behind this achievement 207 00:15:17,000 --> 00:15:18,013 were her kidneys. 208 00:15:20,526 --> 00:15:22,890 During this course of high altitude training 209 00:15:22,890 --> 00:15:24,890 the proportion of her red blood cells 210 00:15:24,890 --> 00:15:26,663 had also shown an increase. 211 00:15:31,280 --> 00:15:34,300 In every one of us the kidneys are constantly 212 00:15:34,300 --> 00:15:36,370 sending out signals to our bones 213 00:15:38,370 --> 00:15:40,783 to keep our blood oxygen levels at an optimum. 214 00:15:51,240 --> 00:15:54,210 But the messages from our kidneys don't stop there. 215 00:15:54,210 --> 00:15:56,140 Many more have been discovered 216 00:15:56,140 --> 00:15:59,783 and they all play a crucial role in maintaining our health. 217 00:16:05,240 --> 00:16:06,760 And one of them 218 00:16:06,760 --> 00:16:08,493 is regulating blood pressure. 219 00:16:09,340 --> 00:16:10,403 We can see that here. 220 00:16:14,350 --> 00:16:16,900 This hospital has started cutting edge treatments 221 00:16:16,900 --> 00:16:17,893 on their patients. 222 00:16:19,950 --> 00:16:21,533 This is Jurgen Middendorf. 223 00:16:22,520 --> 00:16:24,870 He suffers from serious hypertension 224 00:16:24,870 --> 00:16:27,030 and doctors at another clinic had told him 225 00:16:27,030 --> 00:16:28,630 that nothing more could be done. 226 00:16:35,133 --> 00:16:38,800 (speaking foreign language) 227 00:16:39,640 --> 00:16:41,830 He used to take many different types of drugs 228 00:16:41,830 --> 00:16:45,373 to lower his blood pressure, but they didn't work. 229 00:16:50,326 --> 00:16:53,140 I was anxious as my blood pressure quickly went 230 00:16:53,140 --> 00:16:54,653 from 200 to 110. 231 00:16:55,570 --> 00:16:58,400 Sometimes 215 to 100. 232 00:16:58,400 --> 00:17:00,993 For a very short time, but that's not normal. 233 00:17:03,820 --> 00:17:05,880 Such cases are not unusual 234 00:17:05,880 --> 00:17:09,463 and conventional medicine is unable to help. 235 00:17:13,150 --> 00:17:15,620 Persistent hypertension can lead to strokes 236 00:17:15,620 --> 00:17:17,420 and heart attacks. 237 00:17:17,420 --> 00:17:20,213 Globally it affects over one billion people. 238 00:17:28,160 --> 00:17:30,190 But a revolutionary treatment can now 239 00:17:30,190 --> 00:17:32,473 remove this condition overnight. 240 00:17:34,900 --> 00:17:36,443 It is a surgical procedure. 241 00:17:39,960 --> 00:17:41,920 The doctor who performs the surgery 242 00:17:41,920 --> 00:17:44,683 is a cardiologist, a heart specialist. 243 00:17:46,290 --> 00:17:49,333 But the organs he operates on are the kidneys. 244 00:17:55,300 --> 00:17:56,960 The surgeon threads this device 245 00:17:56,960 --> 00:17:58,630 from an artery in the thigh 246 00:17:58,630 --> 00:17:59,730 through to the kidney. 247 00:18:03,670 --> 00:18:06,400 By applying heat from inside the blood vessel 248 00:18:06,400 --> 00:18:09,110 it decreases the overactivity of the nerves 249 00:18:09,110 --> 00:18:10,210 leading to the kidney. 250 00:18:13,270 --> 00:18:14,930 But how can operating on a kidney 251 00:18:14,930 --> 00:18:16,813 possibly lower blood pressure? 252 00:18:24,350 --> 00:18:26,900 Our kidneys release yet another kind of signaling 253 00:18:26,900 --> 00:18:29,143 molecule to regulate our blood pressure. 254 00:18:36,450 --> 00:18:39,283 The molecule used for this task is called renin. 255 00:18:41,070 --> 00:18:44,060 Renin triggers the contraction of our blood vessels 256 00:18:44,060 --> 00:18:45,853 thereby boosting blood pressure. 257 00:18:50,400 --> 00:18:53,190 So our kidneys are fine tuning renin levels 258 00:18:53,190 --> 00:18:54,610 to control our blood pressure 259 00:18:54,610 --> 00:18:56,293 in a very precise manner. 260 00:19:00,310 --> 00:19:03,200 But it's been found that in many hypertensive patients 261 00:19:04,210 --> 00:19:06,463 the kidneys are releasing too much renin. 262 00:19:09,990 --> 00:19:12,580 Many drugs have already been developed 263 00:19:12,580 --> 00:19:15,203 but their effects are not enough in some cases. 264 00:19:17,470 --> 00:19:19,780 But it's becoming clearer that with surgery 265 00:19:19,780 --> 00:19:23,068 if the neural activity of the kidneys can be suppressed 266 00:19:23,068 --> 00:19:25,720 renin levels can decrease, 267 00:19:25,720 --> 00:19:28,083 which can then result in lower blood pressure. 268 00:19:31,000 --> 00:19:33,110 How did Jurgen's high blood pressure respond 269 00:19:33,110 --> 00:19:34,303 after his procedure? 270 00:19:35,470 --> 00:19:36,623 It was a success. 271 00:19:37,852 --> 00:19:40,019 (dinging) 272 00:19:41,570 --> 00:19:43,470 His blood pressure returned to normal. 273 00:19:46,170 --> 00:19:48,210 Yes I am very happy for my husband 274 00:19:48,210 --> 00:19:49,820 now that he's all better. 275 00:19:49,820 --> 00:19:51,863 We can still experience a lot together. 276 00:19:52,700 --> 00:19:54,810 Yes we want to experience a lot more 277 00:19:54,810 --> 00:19:57,230 in good health together. 278 00:19:57,230 --> 00:20:01,880 Kidneys are very important organ in body. 279 00:20:01,880 --> 00:20:05,437 Cross talk they are connected to all other organs 280 00:20:05,437 --> 00:20:09,970 and they are responsible for our fluid balance 281 00:20:09,970 --> 00:20:13,100 and the fluid control and certainly 282 00:20:13,100 --> 00:20:17,963 one of the main control organs for our blood pressure. 283 00:20:19,710 --> 00:20:22,550 Increasing our red blood cell count with EPO 284 00:20:28,490 --> 00:20:31,110 as well as regulating our blood pressure with renin 285 00:20:32,911 --> 00:20:36,260 why do our kidneys, the organs that also produce urine, 286 00:20:36,260 --> 00:20:37,853 take on so much work? 287 00:20:42,480 --> 00:20:45,773 That's because the fundamental job of the kidneys is this, 288 00:20:48,770 --> 00:20:50,673 they are the managers of our blood. 289 00:20:53,760 --> 00:20:57,460 This is a reconstruction of our circulatory system 290 00:20:57,460 --> 00:20:59,333 based on actual medical data. 291 00:21:03,430 --> 00:21:05,740 Blood vessels extend across our body. 292 00:21:05,740 --> 00:21:09,450 Their total length comes to about 100,000 kilometers, 293 00:21:09,450 --> 00:21:12,883 a distance of about two and a half times around the globe. 294 00:21:15,130 --> 00:21:17,550 They are the body's transportation roots 295 00:21:17,550 --> 00:21:20,890 that deliver oxygen and nutrients to every corner 296 00:21:20,890 --> 00:21:23,100 and take waste products away. 297 00:21:23,100 --> 00:21:25,810 They're also used as information circuits 298 00:21:25,810 --> 00:21:27,743 to carry signaling molecules. 299 00:21:32,170 --> 00:21:34,360 A closer look shows that blood vessels 300 00:21:34,360 --> 00:21:36,580 are particularly concentrated around 301 00:21:38,090 --> 00:21:42,350 the kidneys, astonishingly about one quarter 302 00:21:42,350 --> 00:21:45,933 of the blood pumped by the heart goes to the kidneys. 303 00:21:47,540 --> 00:21:50,370 As our kidneys monitor the amounts of red blood cells 304 00:21:50,370 --> 00:21:53,030 in our body as well as our blood pressure 305 00:21:54,063 --> 00:21:57,553 they are tasked with sending commands all across the body. 306 00:22:03,330 --> 00:22:06,690 But our kidneys are actually doing even more. 307 00:22:06,690 --> 00:22:09,603 They have to manage various components in our blood too. 308 00:22:13,560 --> 00:22:15,100 When we eat food 309 00:22:15,100 --> 00:22:17,750 nutrients are absorbed in the stomach and intestines. 310 00:22:19,031 --> 00:22:21,581 The various chemicals filter into the blood stream. 311 00:22:26,260 --> 00:22:30,853 They include sugar, salt, minerals like calcium and so on. 312 00:22:33,490 --> 00:22:35,920 But if these components in our blood stray 313 00:22:35,920 --> 00:22:37,290 from acceptable levels 314 00:22:38,270 --> 00:22:39,943 alarming things can happen. 315 00:22:41,840 --> 00:22:43,603 Take for example potassium. 316 00:22:46,510 --> 00:22:48,710 Bananas are rich in potassium, 317 00:22:48,710 --> 00:22:50,883 a mineral known to be good for our health. 318 00:22:51,840 --> 00:22:53,850 However, if there is too much of it 319 00:22:54,870 --> 00:22:57,620 it can cause an irregular heartbeat 320 00:22:57,620 --> 00:23:00,413 and could be potentially harmful to life. 321 00:23:05,040 --> 00:23:08,400 But if a healthy person eats bananas potassium 322 00:23:08,400 --> 00:23:11,223 in the blood stream will not rise to critical levels. 323 00:23:14,150 --> 00:23:16,070 And it's our kidneys that are responsible 324 00:23:16,070 --> 00:23:18,543 for regulating these blood chemical levels. 325 00:23:19,840 --> 00:23:23,950 They work away constantly simultaneously fine tuning 326 00:23:23,950 --> 00:23:26,163 the many types of chemicals in our blood. 327 00:23:30,390 --> 00:23:33,493 So our kidneys are the overall managers of our blood, 328 00:23:34,340 --> 00:23:36,280 but how do they get that adjustment job 329 00:23:36,280 --> 00:23:38,053 accomplished so efficiently? 330 00:23:42,400 --> 00:23:45,090 To lift the veil on the inner workings of the kidneys 331 00:23:47,020 --> 00:23:49,910 NHK pioneered a project by enlisting the aid 332 00:23:49,910 --> 00:23:52,600 of imaging specialists and leading experts 333 00:23:52,600 --> 00:23:53,823 in various fields. 334 00:23:59,540 --> 00:24:01,300 If you have a look at the cross section 335 00:24:01,300 --> 00:24:02,840 of a kidney with a microscope 336 00:24:12,330 --> 00:24:14,580 it's tightly packed with tubes 337 00:24:14,580 --> 00:24:17,223 scattered with mysterious spherical structures. 338 00:24:23,490 --> 00:24:25,143 What are these spheres? 339 00:24:29,180 --> 00:24:32,610 By magnifying even further many different images 340 00:24:32,610 --> 00:24:34,623 from multiple angles have been captured. 341 00:24:39,024 --> 00:24:41,900 And by combining hundreds of images 342 00:24:41,900 --> 00:24:44,860 this microscopic world within our kidneys 343 00:24:44,860 --> 00:24:46,983 has been reconstructed in 3D. 344 00:24:55,540 --> 00:24:58,963 They are each about 0.2 millimeters across. 345 00:25:00,890 --> 00:25:04,123 It's a tightly wound bundle of small blood vessels. 346 00:25:05,930 --> 00:25:08,060 It's called the glomerulus, 347 00:25:08,060 --> 00:25:11,323 the very object that filters urine from the blood. 348 00:25:12,460 --> 00:25:16,263 It's 3D structure has been captured in remarkable detail. 349 00:25:18,790 --> 00:25:21,960 The surface is wrapped in strange looking cells 350 00:25:21,960 --> 00:25:24,240 with protrusions like tentacles. 351 00:25:24,240 --> 00:25:26,370 They stretch out their long arms 352 00:25:26,370 --> 00:25:27,970 that intertwine with each other. 353 00:25:32,030 --> 00:25:35,343 These are working together in order to filter out urine. 354 00:25:40,850 --> 00:25:44,020 One single kidney contains about one million 355 00:25:44,020 --> 00:25:45,353 of these glomeruli. 356 00:25:50,490 --> 00:25:53,360 The kidney is said to have the most intricate structure 357 00:25:53,360 --> 00:25:55,363 of any organ in the human body. 358 00:26:02,060 --> 00:26:03,990 These new images have been integral 359 00:26:03,990 --> 00:26:06,960 to reconstructing the configuration of blood vessels 360 00:26:06,960 --> 00:26:08,093 within our kidneys. 361 00:26:11,360 --> 00:26:14,490 In order to observe the dramatic world up close 362 00:26:14,490 --> 00:26:17,183 let's go on a journey inside a kidney. 363 00:26:29,590 --> 00:26:30,473 Take a good look. 364 00:26:31,490 --> 00:26:33,920 This is a glomerulus, 365 00:26:33,920 --> 00:26:36,833 just 0.2 millimeters across. 366 00:26:38,250 --> 00:26:39,920 Blood flows in and out of it 367 00:26:39,920 --> 00:26:42,500 through these two blood vessels on the left. 368 00:26:45,607 --> 00:26:49,073 In the glomerulus blood is filtered to make urine. 369 00:26:52,250 --> 00:26:53,783 Let's go deeper inside. 370 00:26:56,760 --> 00:26:59,630 The blood here contains both waste products 371 00:26:59,630 --> 00:27:02,610 and various kinds of essential chemicals. 372 00:27:02,610 --> 00:27:05,560 Now we're at a section of a blood vessel that's perforated. 373 00:27:08,490 --> 00:27:10,893 We're inside a glomerulus. 374 00:27:12,120 --> 00:27:16,063 These holes are about a ten thousandth of a grain of sand, 375 00:27:17,750 --> 00:27:20,623 too small for red blood cells to pass, 376 00:27:22,720 --> 00:27:25,303 but large enough to pass through waste products. 377 00:27:31,490 --> 00:27:33,310 On closer inspection 378 00:27:33,310 --> 00:27:35,330 you can see the stream of fluid heading out 379 00:27:35,330 --> 00:27:36,540 of the blood vessels. 380 00:27:40,502 --> 00:27:43,753 Let's go along with this, see where it leads. 381 00:27:46,120 --> 00:27:47,870 We've been filtered out from blood. 382 00:27:52,760 --> 00:27:55,440 This fluid, called primitive urine, 383 00:27:55,440 --> 00:27:57,593 is only partway to becoming urine. 384 00:28:00,630 --> 00:28:03,380 Besides waste products it still contains 385 00:28:03,380 --> 00:28:05,503 large amounts of essential chemicals. 386 00:28:08,530 --> 00:28:11,403 Here is where the kidney's main work begins. 387 00:28:13,570 --> 00:28:16,900 While producing urine the kidneys are simultaneously 388 00:28:16,900 --> 00:28:18,963 adjusting the blood content too. 389 00:28:25,580 --> 00:28:26,653 How is this done? 390 00:28:27,660 --> 00:28:30,713 We're inside a duct where primitive urine is flowing. 391 00:28:32,070 --> 00:28:33,773 It resembles a long cave. 392 00:28:37,290 --> 00:28:39,800 The walls of the ducts are thickly lined 393 00:28:39,800 --> 00:28:44,033 with thin, rod like cells called microvilli. 394 00:28:50,280 --> 00:28:52,720 This is where the essential chemicals are selected 395 00:28:52,720 --> 00:28:54,263 to return to the blood stream. 396 00:29:02,247 --> 00:29:06,390 This is a rare clip of a cross section of a renal tubule 397 00:29:06,390 --> 00:29:07,913 where primitive urine flows. 398 00:29:19,050 --> 00:29:21,263 You can see the dense lining of microvilli. 399 00:29:27,270 --> 00:29:29,710 Each strand has ion exchange pumps 400 00:29:29,710 --> 00:29:32,463 that work to reabsorb the essential chemicals. 401 00:29:40,170 --> 00:29:42,260 Tiny molecular pumps are scattered 402 00:29:42,260 --> 00:29:44,333 across the surface of each strand. 403 00:29:45,970 --> 00:29:49,343 Each type of pump absorbs only a specific kind of chemical. 404 00:29:52,600 --> 00:29:54,983 For example here is a salt pump. 405 00:29:56,850 --> 00:29:59,533 It ramps up absorption when the body needs salt. 406 00:30:02,710 --> 00:30:04,810 The amount of chemicals returned to the blood 407 00:30:04,810 --> 00:30:07,763 are fine tuned by countless pumps like these. 408 00:30:18,750 --> 00:30:20,470 Chemicals that have been reabsorbed 409 00:30:20,470 --> 00:30:23,030 by the microvilli are being carried away 410 00:30:23,030 --> 00:30:24,430 and they are going back into 411 00:30:28,610 --> 00:30:30,550 the blood stream again. 412 00:30:30,550 --> 00:30:34,280 Now the fresh blood contains adjusted amounts of chemicals 413 00:30:34,280 --> 00:30:35,463 and no waste products. 414 00:30:42,480 --> 00:30:44,780 The amounts of chemicals that get reabsorbed 415 00:30:44,780 --> 00:30:47,023 aren't just simply decided by the kidneys. 416 00:30:50,460 --> 00:30:52,320 Our kidneys keep closely watching 417 00:30:52,320 --> 00:30:55,700 the messages sent out from various other internal organs 418 00:30:57,440 --> 00:30:59,960 and swiftly responding to the messages 419 00:30:59,960 --> 00:31:01,790 they decide how much of chemicals 420 00:31:01,790 --> 00:31:04,203 should be reabsorbed back into the system. 421 00:31:06,800 --> 00:31:10,120 So for example when it receives a message from the heart 422 00:31:10,120 --> 00:31:11,870 that it's being pushed to the limit 423 00:31:17,140 --> 00:31:20,260 the kidneys decrease the amount of salt that is reabsorbed 424 00:31:24,283 --> 00:31:26,553 and the excess is expelled as urine. 425 00:31:31,670 --> 00:31:33,740 When the salt levels are decreased 426 00:31:33,740 --> 00:31:35,093 blood pressure goes down. 427 00:31:36,270 --> 00:31:39,193 And this in turn lessens the strain on the heart. 428 00:31:46,300 --> 00:31:49,840 Everyday around 180 liters of primitive urine 429 00:31:49,840 --> 00:31:51,893 gets filtered through these glomeruli, 430 00:31:53,490 --> 00:31:56,163 but we only produce about two liters of urine. 431 00:31:59,630 --> 00:32:03,430 This is because 99 percent of it is reabsorbed 432 00:32:03,430 --> 00:32:05,233 and gets turned in to fresh blood. 433 00:32:11,000 --> 00:32:12,183 While producing urine, 434 00:32:13,280 --> 00:32:15,940 the kidneys are thus regulating the components 435 00:32:15,940 --> 00:32:18,290 of our blood through this remarkable mechanism. 436 00:32:31,130 --> 00:32:34,280 Along with this incredibly exquisite mechanism 437 00:32:34,280 --> 00:32:37,303 another discovery has been made about our kidneys recently. 438 00:32:40,090 --> 00:32:43,343 The kidneys are deeply involved with our lifespan. 439 00:32:47,030 --> 00:32:49,973 Each species of animal has an approximate lifespan. 440 00:32:52,680 --> 00:32:55,183 Mice live about three years. 441 00:32:56,670 --> 00:32:58,033 Sheep about 20. 442 00:33:01,245 --> 00:33:02,883 And elephants 70 years. 443 00:33:04,780 --> 00:33:06,703 Body size seems to matter. 444 00:33:09,816 --> 00:33:13,823 The bigger the animal the longer its lifespan. 445 00:33:15,440 --> 00:33:18,190 But there are certain animals that don't fit the trend. 446 00:33:22,120 --> 00:33:24,540 There are naked mole rats, 447 00:33:24,540 --> 00:33:27,203 bats and humans. 448 00:33:29,720 --> 00:33:31,760 Why do these species live longer 449 00:33:31,760 --> 00:33:33,660 than one would expect from their size? 450 00:33:36,500 --> 00:33:39,150 Scientists seeking an answer to this riddle 451 00:33:39,150 --> 00:33:41,343 honed in on a particular chemical. 452 00:33:46,490 --> 00:33:50,120 It is phosphorus, one of the chemicals 453 00:33:50,120 --> 00:33:51,673 that the kidneys regulate. 454 00:33:55,260 --> 00:33:57,390 Let's reformat our graph based on 455 00:33:57,390 --> 00:33:59,143 phosphorus levels in the blood. 456 00:34:01,000 --> 00:34:03,550 Now the line fits perfectly. 457 00:34:03,550 --> 00:34:05,744 The less phosphorus in the blood 458 00:34:05,744 --> 00:34:08,093 the longer the animal's lifespan. 459 00:34:10,870 --> 00:34:12,980 Phosphorus is an important nutrient 460 00:34:12,980 --> 00:34:15,493 found in foods such as meats and lentils. 461 00:34:18,320 --> 00:34:20,200 But a lack of sufficient phosphorus 462 00:34:20,200 --> 00:34:24,543 can cause various diseases and even be fatal. 463 00:34:28,010 --> 00:34:31,300 However, too much phosphorus is now known 464 00:34:31,300 --> 00:34:32,623 to accelerate aging. 465 00:34:38,690 --> 00:34:41,520 This discovery was made while a Japanese scientist 466 00:34:41,520 --> 00:34:43,823 was investigating a unique mouse. 467 00:34:47,290 --> 00:34:49,450 What's special about these mice? 468 00:34:49,450 --> 00:34:52,150 These two mice were born on the same day. 469 00:34:52,150 --> 00:34:53,313 They're the same age. 470 00:34:54,530 --> 00:34:56,150 This one is an ordinary mouse 471 00:34:57,400 --> 00:34:59,833 and this one suffers from accelerated aging. 472 00:35:05,910 --> 00:35:09,300 A mouse will usually live about two and a half years. 473 00:35:09,300 --> 00:35:11,190 This mouse with accelerated aging 474 00:35:11,190 --> 00:35:13,253 will not live past two and a half months. 475 00:35:18,670 --> 00:35:20,710 The mouse was an accidental result 476 00:35:20,710 --> 00:35:22,103 of genetic engineering. 477 00:35:25,863 --> 00:35:27,520 It has a defective gene related 478 00:35:27,520 --> 00:35:29,993 to the regulation of phosphorus by the kidney. 479 00:35:37,850 --> 00:35:41,140 The resulting abnormally high phosphorus level in the blood 480 00:35:41,140 --> 00:35:44,063 accelerates the aging process. 481 00:35:47,650 --> 00:35:50,370 Exactly how this happens is still under study 482 00:35:54,120 --> 00:35:57,510 but calcification may be one cause. 483 00:35:57,510 --> 00:36:00,670 More phosphorus causes vascular calcification 484 00:36:00,670 --> 00:36:02,423 and hardening of the blood vessels. 485 00:36:09,600 --> 00:36:12,053 Impaired kidney function accelerates aging. 486 00:36:13,080 --> 00:36:15,080 That's true of humans and other animals. 487 00:36:21,730 --> 00:36:24,410 So if proper kidney function can be maintained 488 00:36:24,410 --> 00:36:25,963 lifespan can be extended. 489 00:36:27,010 --> 00:36:28,520 There is a very close relationship 490 00:36:28,520 --> 00:36:31,053 between our kidney function and our longevity. 491 00:36:34,410 --> 00:36:36,360 Our kidneys are very precisely 492 00:36:36,360 --> 00:36:38,833 controlling the amount of phosphorus in our body. 493 00:36:43,210 --> 00:36:45,670 To carry out this job they are listening in 494 00:36:45,670 --> 00:36:47,503 to the voices from our bones. 495 00:36:51,440 --> 00:36:55,470 The bones store phosphorus in the form of calcium phosphate 496 00:36:55,470 --> 00:36:57,873 and constantly monitor how much they have. 497 00:37:00,760 --> 00:37:02,560 They send messages to the kidneys 498 00:37:02,560 --> 00:37:05,060 that a sufficient amount of phosphorus is present. 499 00:37:06,540 --> 00:37:09,870 In turn the kidneys stop the phosphorus pumps 500 00:37:09,870 --> 00:37:12,383 to maintain adequate blood phosphorus levels. 501 00:37:15,440 --> 00:37:18,480 And it is this elaborate mechanism by the kidneys 502 00:37:20,310 --> 00:37:21,983 that affects our longevity. 503 00:37:45,540 --> 00:37:49,620 Each one of us has internal organs information networks 504 00:37:49,620 --> 00:37:52,363 that stretch out throughout the entire body. 505 00:37:53,730 --> 00:37:56,700 On these networks, not only the kidneys, 506 00:37:56,700 --> 00:37:59,140 but also many other organs 507 00:37:59,140 --> 00:38:01,240 are vigorously releasing messages 508 00:38:01,240 --> 00:38:02,823 to interact with each other. 509 00:38:04,300 --> 00:38:07,140 And research is now showing that such organs include 510 00:38:07,140 --> 00:38:10,270 even some unexpected parts of our bodies, 511 00:38:10,270 --> 00:38:12,590 they're all playing very important roles 512 00:38:12,590 --> 00:38:14,870 in maintaining our health and well being 513 00:38:14,870 --> 00:38:16,063 through their messages. 514 00:38:18,270 --> 00:38:22,293 For instance our bones also send out messaging substances. 515 00:38:24,840 --> 00:38:28,700 Our bones in fact function as a monitoring sensor 516 00:38:28,700 --> 00:38:31,660 that detects shocks received by the body 517 00:38:31,660 --> 00:38:33,103 when walking and running. 518 00:38:36,829 --> 00:38:39,070 When shocks pass through the bone 519 00:38:45,650 --> 00:38:49,533 our bone cells start sending out various kinds of molecules. 520 00:38:58,017 --> 00:38:59,740 And it's becoming clearer that these can act 521 00:38:59,740 --> 00:39:03,470 to boost virility, muscular power, 522 00:39:03,470 --> 00:39:06,113 memory and even immunity. 523 00:39:10,300 --> 00:39:13,610 Body fat also sends out messages. 524 00:39:13,610 --> 00:39:16,653 It used to be considered nothing more than oily deposits, 525 00:39:17,920 --> 00:39:20,993 but the signals from fat can even work on the brain. 526 00:39:28,680 --> 00:39:30,490 When we take in enough food 527 00:39:30,490 --> 00:39:32,380 and as the amount of sugar and liquid 528 00:39:32,380 --> 00:39:34,350 stored in our body increases 529 00:39:45,230 --> 00:39:47,140 fats start to release the message 530 00:39:47,140 --> 00:39:50,733 that enough energy has now been stored so stop eating. 531 00:39:58,100 --> 00:40:00,410 And when this message is received by the brain 532 00:40:03,760 --> 00:40:07,180 it stimulates the brain to suppress appetite, 533 00:40:07,180 --> 00:40:09,240 which helps us avoid overeating. 534 00:40:18,510 --> 00:40:21,300 Attempts have now begun to build a better picture 535 00:40:21,300 --> 00:40:23,940 of the mechanisms of the body's internal networks 536 00:40:24,820 --> 00:40:27,403 so that new remedies for diseases can be found. 537 00:40:30,960 --> 00:40:34,000 At the forethought of such work is DARPA, 538 00:40:34,000 --> 00:40:37,610 a research institute in the US Department of Defense 539 00:40:37,610 --> 00:40:39,480 who are known to have helped pave the way 540 00:40:39,480 --> 00:40:41,713 to create the internet we know today. 541 00:40:43,780 --> 00:40:46,290 Together with the world's top universities 542 00:40:46,290 --> 00:40:49,620 the institute has been working on a large scale project, 543 00:40:49,620 --> 00:40:52,060 working to reveal a complete picture 544 00:40:52,060 --> 00:40:54,143 of the body's inner networks. 545 00:40:57,760 --> 00:40:59,250 In this special device 546 00:41:00,240 --> 00:41:03,633 cells of various human body organs are being cultured. 547 00:41:07,480 --> 00:41:08,863 It's the human liver. 548 00:41:12,250 --> 00:41:14,050 When the cultured cells are connected 549 00:41:14,050 --> 00:41:16,230 with the canals acting as blood vessels 550 00:41:20,540 --> 00:41:22,400 they form a miniature version 551 00:41:22,400 --> 00:41:24,680 of the human body's internal network 552 00:41:26,170 --> 00:41:28,253 and then something curious happens. 553 00:41:31,240 --> 00:41:32,860 The pink fluid that you see here 554 00:41:32,860 --> 00:41:34,410 represents the blood in the human body 555 00:41:34,410 --> 00:41:36,730 transporting the signals that each organ 556 00:41:36,730 --> 00:41:39,763 secretes to one another allowing the cross talk to happen. 557 00:41:41,050 --> 00:41:42,980 Through using this device 558 00:41:42,980 --> 00:41:46,820 they are aiming to decode the dialogue between organs 559 00:41:46,820 --> 00:41:50,163 so that completely new sets of medicines can be developed. 560 00:41:53,330 --> 00:41:55,943 I do believe that an organ on a chip technology 561 00:41:55,943 --> 00:42:00,943 really could revolutionize the way that we develop drugs. 562 00:42:01,570 --> 00:42:03,720 DARPA's job is to be able to be at the beginning 563 00:42:03,720 --> 00:42:05,911 of these processes, just like ARPANET 564 00:42:05,911 --> 00:42:07,573 we are at the beginning. 565 00:42:10,350 --> 00:42:12,050 A new diagnostic procedure 566 00:42:12,050 --> 00:42:14,640 developed from research of signaling molecules 567 00:42:14,640 --> 00:42:16,523 has also been attracting interest. 568 00:42:21,230 --> 00:42:23,023 Its target is cancer. 569 00:42:27,210 --> 00:42:30,930 Until now a variety of methods have been used 570 00:42:30,930 --> 00:42:32,793 to detect different types of cancers. 571 00:42:34,020 --> 00:42:36,120 Not only are they invasive, 572 00:42:36,120 --> 00:42:39,793 but some can even be unreliable in early stages of cancer. 573 00:42:45,940 --> 00:42:50,080 A new method only uses a single drop of blood 574 00:42:51,070 --> 00:42:53,610 and it enables simultaneous detection 575 00:42:53,610 --> 00:42:56,810 of 13 different types of cancers, 576 00:42:56,810 --> 00:42:58,500 even in their early stages 577 00:42:59,860 --> 00:43:03,720 and its accuracy is over 95 percent. 578 00:43:06,430 --> 00:43:08,670 This blood test is looking for certain kinds 579 00:43:08,670 --> 00:43:10,010 of signaling molecules 580 00:43:15,870 --> 00:43:17,920 and the sources of these messages are 581 00:43:20,700 --> 00:43:22,230 cancer cells. 582 00:43:22,230 --> 00:43:26,313 Like our body organs cancer also sends out messages. 583 00:43:29,380 --> 00:43:31,260 Depending on the type of cancer, 584 00:43:31,260 --> 00:43:33,290 different kinds of signaling molecules 585 00:43:33,290 --> 00:43:34,623 are known to be released. 586 00:43:40,300 --> 00:43:43,270 So by checking the identity of these molecules 587 00:43:43,270 --> 00:43:47,043 it becomes possible to diagnose the specific type of cancer. 588 00:43:54,560 --> 00:43:56,930 Aiming for clinical use of this method 589 00:43:56,930 --> 00:43:59,053 research is forging ahead rapidly. 590 00:44:03,720 --> 00:44:06,480 My wish is for this test to become 591 00:44:06,480 --> 00:44:08,710 widely available to people. 592 00:44:08,710 --> 00:44:12,890 It enables early detection leading to early treatment. 593 00:44:12,890 --> 00:44:16,740 Our ultimate goal is to reduce mortality from cancer 594 00:44:16,740 --> 00:44:18,113 using this new method. 595 00:44:25,370 --> 00:44:27,120 As insights into our bodies 596 00:44:27,120 --> 00:44:29,640 internal networks become deeper 597 00:44:29,640 --> 00:44:31,970 some patients with hard to treat diseases 598 00:44:31,970 --> 00:44:34,623 are even starting to see dramatic results. 599 00:44:37,950 --> 00:44:39,683 This is Emi Shimizu. 600 00:44:40,630 --> 00:44:43,150 Since she became ill at age 11 601 00:44:43,150 --> 00:44:45,020 she has been in a constant battle 602 00:44:45,020 --> 00:44:46,453 with her serious condition. 603 00:44:51,480 --> 00:44:53,923 Emi suffers from rheumatoid arthritis. 604 00:45:08,740 --> 00:45:11,463 There are 70 million sufferers worldwide. 605 00:45:12,340 --> 00:45:14,530 It's a disease that causes terrible pain 606 00:45:14,530 --> 00:45:17,320 and swelling in the joints of the whole body. 607 00:45:17,320 --> 00:45:19,893 As the disease progresses the bones 608 00:45:19,893 --> 00:45:21,933 ultimately become malformed. 609 00:45:26,200 --> 00:45:28,060 These images track the changes 610 00:45:28,060 --> 00:45:30,873 in a patient's joints over 27 years. 611 00:45:34,810 --> 00:45:39,203 Gradually the bones become eroded and start to change shape. 612 00:45:41,230 --> 00:45:44,670 As the disease progresses the space between each bone 613 00:45:44,670 --> 00:45:47,803 becomes smaller until it finally fuses together. 614 00:45:49,330 --> 00:45:51,470 And this results in tremendous amounts 615 00:45:51,470 --> 00:45:53,020 of pain for the patient. 616 00:45:56,960 --> 00:45:59,910 For almost 30 years Emi has tried out 617 00:45:59,910 --> 00:46:02,330 many different kinds of treatments, 618 00:46:02,330 --> 00:46:05,053 but none have been able to put a stop to this disease. 619 00:46:11,740 --> 00:46:14,390 I've been in a dark place for such a long time now. 620 00:46:18,190 --> 00:46:19,440 I worry about the future. 621 00:46:21,730 --> 00:46:24,303 I've even wondered whether there's meaning to my life. 622 00:46:27,520 --> 00:46:29,360 We now know that one of the causes 623 00:46:29,360 --> 00:46:31,640 of this disease is related to problems 624 00:46:31,640 --> 00:46:34,080 with the communication between body organs 625 00:46:34,080 --> 00:46:35,783 through signaling molecules. 626 00:46:38,660 --> 00:46:41,253 So what are the problems inside Emi's body? 627 00:46:45,550 --> 00:46:47,933 The problems are caused by her immune cells. 628 00:46:49,940 --> 00:46:53,200 Immune cells are usually our defenders, 629 00:46:53,200 --> 00:46:55,800 protecting out body against invasion, 630 00:46:55,800 --> 00:46:58,053 fighting off enemies such as pathogens. 631 00:47:01,570 --> 00:47:04,240 However, messages from these immune cells 632 00:47:04,240 --> 00:47:05,553 can cause a disease. 633 00:47:13,690 --> 00:47:16,170 See these immune cells are vigorously 634 00:47:16,170 --> 00:47:18,393 secreting signaling molecules. 635 00:47:26,120 --> 00:47:28,670 It's called TNF Alpha. 636 00:47:28,670 --> 00:47:31,410 It's a substance that sends a red alert out 637 00:47:31,410 --> 00:47:32,910 that there is an enemy within. 638 00:47:38,890 --> 00:47:42,560 These molecules are received by other immune cells 639 00:47:42,560 --> 00:47:44,413 and stimulate them to multiply. 640 00:47:45,600 --> 00:47:49,300 As they increase in number they go into attack mode 641 00:47:52,330 --> 00:47:55,263 and their warning messages get sent out even further. 642 00:48:00,400 --> 00:48:03,783 But in reality there are no enemies in the body. 643 00:48:05,200 --> 00:48:08,710 They have mistaken the tissues in the joints as their foe 644 00:48:08,710 --> 00:48:11,193 and so are just sending out false alarms. 645 00:48:13,510 --> 00:48:16,880 Inside the joints that are now full of these false alerts 646 00:48:16,880 --> 00:48:19,423 flames are being fanned even further. 647 00:48:20,920 --> 00:48:25,100 Huge numbers of immune cells are now amassing here and there 648 00:48:25,100 --> 00:48:26,543 and start merging together. 649 00:48:28,040 --> 00:48:30,132 Then they transform themselves 650 00:48:30,132 --> 00:48:33,100 into cells called osteoclasts 651 00:48:34,020 --> 00:48:37,623 and now they are destroying precious bone furiously. 652 00:48:38,800 --> 00:48:42,790 These fake, incorrect messages of immune cells 653 00:48:42,790 --> 00:48:45,593 are the major cause of rheumatoid arthritis. 654 00:48:49,550 --> 00:48:51,380 The new knowledge of this mechanism 655 00:48:51,380 --> 00:48:53,493 led to the development of a new drug. 656 00:48:55,610 --> 00:48:59,110 Since Emi started taking this new drug four years ago 657 00:48:59,110 --> 00:49:03,973 her progressive disease has been stopped dead in its tracks. 658 00:49:15,370 --> 00:49:17,180 This cutting edge drug, 659 00:49:17,180 --> 00:49:20,610 an immunosuppressant, is injected into the joints 660 00:49:20,610 --> 00:49:21,860 through the blood stream. 661 00:49:23,360 --> 00:49:25,670 They latch on to the signaling molecules 662 00:49:25,670 --> 00:49:29,480 that are circulating false alarms, TNF Alpha, 663 00:49:29,480 --> 00:49:32,500 and block any erroneous messages from being received 664 00:49:32,500 --> 00:49:33,943 by other immune cells. 665 00:49:39,500 --> 00:49:41,440 Having been treated with this new drug 666 00:49:42,940 --> 00:49:45,380 Emi's joints have started to recover. 667 00:49:45,380 --> 00:49:48,703 Even the spaces between her bones are now reappearing. 668 00:49:54,260 --> 00:49:56,810 You can honestly call it a paradigm shift. 669 00:49:56,810 --> 00:49:58,550 I was so surprised by the results, 670 00:49:58,550 --> 00:50:02,220 there's no other way to say this. 671 00:50:02,220 --> 00:50:04,070 The key now will be to see how quickly 672 00:50:04,070 --> 00:50:06,320 and how well we can intervene with this drug. 673 00:50:11,460 --> 00:50:14,310 Emi's life has now turned around completely. 674 00:50:15,659 --> 00:50:18,150 (laughing) 675 00:50:18,150 --> 00:50:20,850 Her dreams of having a child, which had only ever 676 00:50:20,850 --> 00:50:24,483 been a wish up until recently have now become reality. 677 00:50:33,515 --> 00:50:34,765 I'm so lucky. 678 00:50:38,010 --> 00:50:39,450 What other drugs could never do 679 00:50:39,450 --> 00:50:41,100 was done with just one injection. 680 00:50:43,570 --> 00:50:46,080 I expect even more radical treatments will be developed 681 00:50:46,080 --> 00:50:48,830 and we may have very good drugs to remove our symptoms. 682 00:50:58,310 --> 00:51:01,010 Inside our bodies we have vast 683 00:51:01,010 --> 00:51:03,533 communication networks. 684 00:51:06,060 --> 00:51:08,950 Now that more clinicians are becoming aware of this 685 00:51:08,950 --> 00:51:11,030 cutting edge medicine is beginning to use 686 00:51:11,030 --> 00:51:13,796 non-conventional means in practice 687 00:51:13,796 --> 00:51:16,693 and starting to succeed in saving many lives. 688 00:51:22,519 --> 00:51:24,686 At this hospital in the UK 689 00:51:25,880 --> 00:51:27,273 a nurse calls on a patient. 690 00:51:31,608 --> 00:51:33,300 Hello, how are you doing? 691 00:51:33,300 --> 00:51:34,591 This is Pauline. 692 00:51:34,591 --> 00:51:37,640 Yeah, she's got an AKI amber alert 693 00:51:37,640 --> 00:51:38,490 that's popped up. 694 00:51:40,850 --> 00:51:43,290 This is Pauline Marner. 695 00:51:43,290 --> 00:51:45,470 She's been admitted for an infection, 696 00:51:45,470 --> 00:51:47,320 but the hospital's latest system 697 00:51:47,320 --> 00:51:49,420 has detected a kidney issue. 698 00:51:49,420 --> 00:51:51,943 The warning is for acute kidney injury. 699 00:51:59,250 --> 00:52:01,150 A sudden drop in kidney function 700 00:52:01,150 --> 00:52:03,080 can cause multiple organ failure 701 00:52:05,350 --> 00:52:06,250 and even be fatal. 702 00:52:14,110 --> 00:52:16,880 The precise number of acute kidney injury patients 703 00:52:16,880 --> 00:52:21,880 was unknown until this paper sent shock waves 704 00:52:22,250 --> 00:52:23,700 throughout the medical world. 705 00:52:25,240 --> 00:52:28,820 According to this report one in five patients 706 00:52:28,820 --> 00:52:31,011 admitted to hospitals in the developed world 707 00:52:31,011 --> 00:52:33,333 suffered from acute kidney injury. 708 00:52:37,000 --> 00:52:38,980 Why does acute kidney injury occur 709 00:52:38,980 --> 00:52:40,223 in so many patients, 710 00:52:41,240 --> 00:52:42,833 even those with other issues? 711 00:52:45,860 --> 00:52:48,360 It's because the kidneys are the major hub 712 00:52:48,360 --> 00:52:50,593 of the body's internal networks. 713 00:52:52,540 --> 00:52:55,450 So diseases in other areas of the body 714 00:52:55,450 --> 00:52:58,103 can still have a knock on effect on the kidneys. 715 00:53:00,030 --> 00:53:03,563 For example heart failure reduces blood flow. 716 00:53:06,260 --> 00:53:08,780 This inflicts serious damage to the kidneys 717 00:53:08,780 --> 00:53:11,473 that require a constant high blood flow. 718 00:53:15,300 --> 00:53:18,483 The kidneys are also closely tied to other organs. 719 00:53:20,290 --> 00:53:22,560 So problems with any of the body organs 720 00:53:22,560 --> 00:53:24,413 can filter down to the kidneys. 721 00:53:26,730 --> 00:53:29,110 And the reverse is also true. 722 00:53:29,110 --> 00:53:31,300 The chain reactions further continue 723 00:53:31,300 --> 00:53:34,323 and could make a critical situation even worse. 724 00:53:35,720 --> 00:53:39,230 Once the kidneys, the hub of our internal networks go down 725 00:53:40,100 --> 00:53:42,733 the whole body becomes compromised. 726 00:53:44,220 --> 00:53:46,653 This can result in multiple organ failure. 727 00:53:48,940 --> 00:53:52,010 A patient's condition will deteriorate in just a few days 728 00:53:54,260 --> 00:53:55,893 and can possibly end in death. 729 00:53:59,300 --> 00:54:01,310 Many fatalities were once attributed 730 00:54:01,310 --> 00:54:04,010 simply to multiple organ failure, 731 00:54:04,010 --> 00:54:06,160 but many of these cases may have actually 732 00:54:06,160 --> 00:54:08,503 been triggered by a failure in the kidneys. 733 00:54:13,280 --> 00:54:15,180 If hospitals can protect kidneys 734 00:54:16,030 --> 00:54:18,773 perhaps they can save countless more lives. 735 00:54:22,600 --> 00:54:25,040 Acute kidney injury is a major health problem 736 00:54:25,040 --> 00:54:26,580 throughout the world. 737 00:54:26,580 --> 00:54:30,540 By implementation of a relatively easy care button 738 00:54:30,540 --> 00:54:33,515 we simply can reduce the risk significantly 739 00:54:33,515 --> 00:54:35,760 in this group of patients. 740 00:54:35,760 --> 00:54:37,750 How much can we reduce it by? 741 00:54:37,750 --> 00:54:41,430 That's about six of these football stadiums full 742 00:54:41,430 --> 00:54:43,540 of people that die prematurely 743 00:54:43,540 --> 00:54:44,860 from acute kidney injury. 744 00:54:44,860 --> 00:54:47,923 Probably around 200,000 excess deaths a year. 745 00:54:51,160 --> 00:54:54,443 So how can we prevent kidneys from failing? 746 00:54:59,910 --> 00:55:02,293 One method has shown dramatic results. 747 00:55:04,880 --> 00:55:06,870 Well we've stopped them. 748 00:55:06,870 --> 00:55:08,950 So we stopped several drugs that she takes normally, 749 00:55:08,950 --> 00:55:09,940 which are normally good for her, 750 00:55:09,940 --> 00:55:12,580 but now that she's unwell we need to stop them 751 00:55:12,580 --> 00:55:13,930 for a short period of time. 752 00:55:15,740 --> 00:55:17,740 Science has learned that certain drugs 753 00:55:17,740 --> 00:55:20,293 can push weakened kidneys over the edge. 754 00:55:24,870 --> 00:55:26,840 With so much blood passing through them 755 00:55:27,860 --> 00:55:30,683 the kidneys have the highest exposure to drugs. 756 00:55:35,920 --> 00:55:37,630 Their intricate fine structure 757 00:55:37,630 --> 00:55:40,663 also makes them susceptible to damage from drugs. 758 00:55:45,280 --> 00:55:48,190 By suspending medications so that the patient's kidneys 759 00:55:48,190 --> 00:55:49,773 can be encouraged to recover, 760 00:55:50,630 --> 00:55:53,893 this hospital is succeeding in reducing the death rate. 761 00:55:58,080 --> 00:56:00,980 They developed a system to assess the risk to kidneys 762 00:56:00,980 --> 00:56:03,563 in real time using various data. 763 00:56:08,230 --> 00:56:11,130 The system monitors all admitted patients, 764 00:56:11,130 --> 00:56:13,263 not just those with kidney problems. 765 00:56:16,040 --> 00:56:19,760 Just as the heart rate is monitored with the pulse meter, 766 00:56:19,760 --> 00:56:22,040 they believe that the condition of the kidneys 767 00:56:22,040 --> 00:56:23,340 must be monitored as well. 768 00:56:32,510 --> 00:56:34,990 Having taken a break from medication 769 00:56:34,990 --> 00:56:38,553 Pauline is now out of danger and will soon be released. 770 00:56:40,310 --> 00:56:42,353 Okay, thank you very much. 771 00:56:42,353 --> 00:56:44,241 How do you feel now? 772 00:56:44,241 --> 00:56:45,074 Better. 773 00:56:45,074 --> 00:56:46,211 (laughing) 774 00:56:46,211 --> 00:56:47,878 Yeah, I feel better. 775 00:56:51,597 --> 00:56:52,980 Dr. Forni. 776 00:56:52,980 --> 00:56:54,641 Interesting to see the. 777 00:56:54,641 --> 00:56:56,850 Having seen the successful results 778 00:56:56,850 --> 00:57:00,100 achieved by this hospital more than 10 other hospitals 779 00:57:00,100 --> 00:57:02,710 in the UK are now considering the introduction 780 00:57:02,710 --> 00:57:04,713 of such a kidney monitoring system. 781 00:57:06,040 --> 00:57:11,040 Organ cross talk is dependence of one on another, 782 00:57:11,600 --> 00:57:15,000 is a phenomena particularly in critical care 783 00:57:15,000 --> 00:57:18,600 that we're becoming increasingly aware of. 784 00:57:18,600 --> 00:57:20,290 There are so many things that the kidneys do 785 00:57:20,290 --> 00:57:23,100 that people are just not aware of. 786 00:57:23,100 --> 00:57:25,230 And so you know this fine balance 787 00:57:25,230 --> 00:57:28,420 from this fantastic piece of engineering 788 00:57:28,420 --> 00:57:32,077 is vitally important and when they fail 789 00:57:32,077 --> 00:57:35,080 patients are doomed to an early death 790 00:57:35,080 --> 00:57:38,353 and numerous complications. 791 00:57:39,740 --> 00:57:41,570 More and more our body wide 792 00:57:41,570 --> 00:57:44,263 internal networks are beginning to be understood. 793 00:57:48,870 --> 00:57:50,814 Our intestines that take in nutrients 794 00:57:50,814 --> 00:57:54,120 are in fact consulting with our immune cells 795 00:57:54,120 --> 00:57:55,900 to protect the body from attacks 796 00:57:55,900 --> 00:57:59,763 by microscopic invaders such as pathogens and viruses. 797 00:58:03,790 --> 00:58:06,130 The brain uses signaling molecules 798 00:58:06,130 --> 00:58:09,950 to produce endless variations of neural communications 799 00:58:09,950 --> 00:58:12,423 helping us feel our wealth of emotions. 800 00:58:22,230 --> 00:58:24,822 And it's now clearer that these messaging molecules 801 00:58:24,822 --> 00:58:29,822 are also playing key roles in forming a whole human body 802 00:58:30,090 --> 00:58:32,703 from one single fertilized egg. 803 00:58:44,840 --> 00:58:48,000 Indeed without the workings of these messages 804 00:58:48,000 --> 00:58:50,333 we could not have even come into this world. 805 00:58:57,530 --> 00:59:00,590 At this very moment our internal organs 806 00:59:00,590 --> 00:59:03,880 are carrying out this molecular level communication 807 00:59:03,880 --> 00:59:05,453 that makes our lives possible. 808 00:59:09,510 --> 00:59:12,520 Shall we have a listen to their conversations?