We are living longer with an increase in human lifespan of 2.5 years per decade. Scientists are now focused on achieving healthspans, where we live disease free, which can match our longer lives.
This piece for Drivetime on RTE Radio 1, broadcast on 21st June, features interviews with three leading scientists working on different ways to solve the ageing ‘problem’; Luke O’Neill, TCD, Fergal O’Brien, RCSI, and Emma Teeling UCD.
Being human means our bodies, tissues and organs, will eventually deteriorate and malfunction. However, advances in medical science mean we can replace aging or diseased hips, knees, even hearts with advanced man-made materials. Many of our bodies, in this way, have become partly artificial or synthetic.
Advances in medical science and engineering mean that a lot more of us, in the developed western world at least, are set to have all manner of misfiring tissues and organs, maybe even our brains, replaced by something synthetic, better, and perhaps an awful lot better. The age of truly bionic man and woman is upon us.
The replacement of body parts with something man-made – what we now call bionics – is something that goes back a long way in human history.
Back as far as 1,500 BC there is a report of an Ancient egyptian mummy having its toe amputated and replaced by a prosthetic made of wood and leather. This was done apparently because the Egyptians felt that amputees would be cursed in life as well as the afterlife.
During the middle ages, crude prosthetic limbs ere available, but only to the very wealthy. These were made of wood, leather and metal, and the replacement leg would resemble a peg leg, with a hook replacing a hand.
Towards the end of the 18th century, in about 1897 the scientist Alessandro Volta – he of electricity fame – found that hearing could be restored by the use of electrical stimulation. This was a big advance in medical bionics.
However, it wasn’t until the mid 1970s that bionics entered the popular consciousness with the arrival of the Six Million Dollar Man and the Bionic Woman on our television screens.
The bionic man, played by Lee Majors, was human, had a bionic left eye, bionic legs, and a bionic right arm, while the Bionic Woman, played by Lindsay Wagner, had similar bionic limbs, but also had a bionic ear.
Science fiction becomes fact
What was science fiction then is now fact. A bionic eye, and ear have already been built, providing people with something even better than the original, while there have been remarkable advances in bionic limbs, including the human hand.
We could today, build a Bionic Man and Woman, with bionic ears, eyes, and limbs (not necessarily with the ability to run at 60 mph, but it could be done if felt necessary), but science is moving beyond what was speculation in the 1970s.
Neuroscientists have begun to decode the language of the brain, so that it is possible to know what word or series of words they are thinking. This is important because it means that people who are disabled, or paralysed can be now trained to move robotic limbs, or a new limb attached to their bodies.
Bionics and neuroscience is, thus, liberating disabled people from their physical dependence on people around them, and they can control their artificial limbs, or wheelchairs by simply thinking. At the same time, materials are becoming more sophisticated, and these can enhance malfunctioning biological tissues.
Bionic eyes, which pick up signals from the environment and transmit electrical impulses straight to the brain will soon help the blind ‘see’ again. A Bionic ear has been developed which restores hearing to the profoundly deaf via an implant which receives and transmits signals in the inner ear.
A bionic hand, with tremendous dexterity has been developed for a Danish man, which has been integrated by neurosurgeons with his existing nervous system. Bionic feet and legs under the thought control of the brain have been developed. A fully artificial heart has been successfully implanted, and there even moves to build an electronic implant to replace malfunctioing parts of the brain, or to construct a fully artificial brain based on the biological brain.
What this all means is that we are seeing a general trend towards humans becoming more artificial, as we live longer, and want to maintain the functioning of our limbs, organs and brain for as long as possible.
What do people want in life? They want to alive at the age of 90, but still active and healthy, physically and mentally. Bionics offers this, and its alluring.
No one knows where this all will end, or how artificial we will eventually become. Some believe that the trend towards having more and more bionic body parts threatens our humanity. How far can we go towards becoming artificial before we stop being human? It is a huge philosophical question we’ll face in future.
The majority of the work in Ireland in this area is on the repair of body parts, through what is called regenerative medicine, rather than bionics, which involves the complete replacement of a tissue or organ, with something new and artificial.
Bionics, and regenerative medicine are moving ahead together and in parallel. It is perhaps a bit like the car industry.
There will always be a market for a brand new cars. Some people will buy a new car because they can afford it, and they want the latest technology and performance capabilities.
Others might want a new car because they have crashed their old one, and is beyond repair. However, there are also people who do not feel the need for a new car, and are quite happy to have their old car service, fixed, and on the road for as long as possible.
Ireland, in this sense, is more in the service and repair market, than the new car sales market, but both are equally important areas.
In terms of bionics, researchers in the University of Limerick, led by Dr Leonard O’Sullivan, along with an industrial partner, MTD Precision Engineering (Cork) are aiming to develop a full body Bionic Suit to help the elderly.
The Axo Suit project aims to help the aging live independently and stay mobile. The suit needs to be light enough to allow them to do daily tasks, such as going for a walk, or putting clothes on the line, but strong enough to give support.
The goal is to produce an ‘exoskeleton’ or bionic suit, which will sell for between 5k and 10k. This could keep many people out of nursing homes.
It could also lead to printing of organs or tissues made up of a combination of natural and artificial components, or even totally artificial components. There has already been a successful transplant of an artificial heart, and with natural organs hard to come by, this trend is set to increase.
Also at TCD, Dr Mark Ahearne’s group are developing bioengineered corneas which can be used for cornea transplants to restore sight or relieve pain. The artificial cornea has been made by using artificial fibres that mimic the ability of natural collagen fibres in the cornea to allow light to penetrate through. The researchers believe this will help people suffering from corneal blindness.
Meanwhile, At the Regenerative Medicine Institute at NUI Galway, or REMEDI there is a clinical trial underway where stem cells are being used to tackle osteoarthritis. The idea here is to insert stem cells into, for example knee joints damaged by arthritis to facilitate the growth of new, healthy bone tissue.
The potential for knee repair is incredible. For example, Professor Fergal O’Brien, based at the Royal College of Surgeons in Ireland and AMBER, developed a new material which repaired the severely damaged knee joints of a competitive show jumping horse called Beyonce. The horse was facing euthanasia, but after the material was used, it began competitive show jumping again.
REMEDI researchers are also working with colleagues our Lady’s Hospital for Sick Children, to use stem cells to overcome congenital heart defects in children. In terms of organ repair, or fixing the sky is now the limit.
Is humanity threatened?
Bionics and regenerative medicine are set to help millions of people around the world who are suffering the effects of diseased or damaged tissues or organs. We are living longer, and this technology will help us live better, no doubt.
But, there are some issues, or concerns. For example, some well known scientists in the field, such as Hugh Herr at MIT, believe that synthetic materials such as titanium and silicon will one day replace flesh and blood.
Do we want that? Will this spell the end of humanity, at our own hand?
Herr got caught in a snow blizzard while climbing a mountain at the age of 17, and lost both legs to severe frostbite. Now in his 50s, he is the co-director of MIT’s Center for Extreme Bionics, where he is designing artificial legs (including his own) feet, ankles, knees and hips.
Herr’s view is that we will become more artificial, and eventually totally artificial, but that we will retain our humanity. We already have ‘augmented’ abilities, such as the ability to fly, and devices that improve our memory and ability to communicate.
Herr believes that our humanity, our ideas, our personalities, and our creativity, will become ‘embedded’ into artificial ‘designable’ bodies. We will come to see this as normal in the way, he says, and that artificial legs, or body parts will be considered part of us in the same way as biological legs are now. This is all part of the natural progression, or evolution, or humanity, Herr says.
Others disagree, and argue that as we shed our biology, we will shed our humanity, and that this technology represents an existential threat to mankind.
Stephen Sullivan is an Irish stem cell researcher working in the USA. He is a strong advocate for embryonic stem cell research in Ireland, and all the other types of stem cell research. He is passionate about his work, and believes stem cells have the capacity to alleviate human suffering. However, looking at the Irish situation in particular, he says he is disturbed that there are no laws governing stem cells. This creates the impression he says, that Ireland, as in its financial matters, is like the ‘wild west’ – a place where laws, if they exist, are ignored.
Stephen Sullivan grew up as the youngest child in his family by 10 years. A curious boy, he became well used to asking questions of the older people around him that seemed to know much more.
One of those people that knew much more was his Dad. Stephen had a great relationship with his father, and recalls having long chats with him about all kinds of things. They were both “ideas junkies” as Stephen describes it.
Meanwhile, Stephen’s eldest brother helped to pique an interest in ideas, and the nature of the world around him, by having a simple light microscope present in the house. Stephen recalls looking at pond water under this microscope and being amazed by the diversity of life he could see in it.
Though there were no scientists in the family there was plenty of education and learning about, with surgeons on his mother’s side, and psychiatrists on his Dad’s side, he says.
Stephen went to primary school in Beaumont Boys School, and secondary school at Ashton multi-denominational school, both in Cork city.
He recalls the influence in primary school of a series of books called ‘Out and About’. These were nature education books that described everything from bird migration to the life cycle of the salmon. That helped stimulate the interest in science that was growing in his young mind, as well as nature trails when the teachers explained what frog spawn was, and how trees lost their leaves.
He was well and truly hooked on science by the time the leaving certificate rolled around, and he took all three main science subjects, physics, chemistry and biology. At that time, he enjoyed the fun of the chemistry lab, but biology was less appealing due to the lack of practical work, and the ‘learning by rote’.
However, perhaps his most important ‘school days’ experience was his exposure at Ashton to people from a variety of cultures, creeds and classes. He looks back and says that, Ashton felt more like what he felt a university should be – a place to learn from others and exchange ideas – than UCC did later on.
The influence of teachers was crucial, as is so often the case and he found that he did best in classes where the teachers were in love with their topics and there were several science teachers at Ashton in love with science.
After an undergraduate degree at UCC, Stephen took a Masters degree at TCD. Then 1997 came, and the news that human embryonic stem cells – cells that are typically taken (with consent) from the excess embryos left over after IVF treatments – had been isolated for the first time. It was also the year that the world was introduced to ‘Dolly’ the sheep that had been cloned in Scotland.
These developments had a huge influence on Stephen and he saw immediately that stem cell research – where cells could be reprogrammed in the lab to become other cells – could be used as a new tool to combat disease.
He was determined now to do a PhD in stem cells, and he was also determined to do it at the lab that produced ‘Dolly’. He achieved that goal, to his great credit, due to what he calls his “natural stubbornness” and was accepted into the lab of the now world-famous scientists, Jim McWhir and Ian Wilmut at the Roslin Institute in Edinburgh.
At the Roslin, he became aware, he says, of how science is so often misrepresented in the media, sometimes to a ludicrous extent. Like one story that reported that ‘Dolly’ had eaten several shepherds as well as Ian Wilmut. This planted a seed that science, and stem cells needed to be better explained to the public, and that this side of things was crucial to the well-being of the field.
His career was now firmly on an upward curve, and after Roslin, he went to Cambridge, and then to Harvard in Boston. He learned all about the famous competitiveness of students at Harvard, but managed to avoid getting ‘burnout’.
A return to Ireland was always on the agenda, but he became frustrated with the lack of legislation governing stem cells here, the political apathy, and the splurging of funds into stem cell work that he considered of dubious quality. The situation in Ireland did not impress serious scientists looking in from abroad, he said, and made a mockery of the strategy of funding world-class science here.
He tried in vain to get a research group off the ground, but no proposal that even mentioned ‘embryonic stem cell research’ had a hope of getting funded. The politicians had no inclination to get involved in a row over funding research on human embryos, which would provoke fury in some quarters.
He decided to set up the Irish Stem Cell Foundation, along with other scientists, medical doctors, and bio-ethicists. The idea was to better educate people about stem cells, to advocate for all kinds of stem cell research here, and to push the law-makers to follow the UK, and introduce clear ‘stem cell laws’.
Meanwhile, he moved to the US, as he could not get support for the research he wanted to do in Ireland, and took at post at the California Institute for Regenerative Medicine. There he is simply let get on with his research, without worrying about politics. He is working, specifically, on finding new stem cells, in particular trophoblast stem cells. These are the cells that make the placenta. The ultimate goal of this work is to develop better drugs and treatments for disease.
It is very important to follow one’s own gut instinct when choosing a career, and to study subjects in university that you love, rather than have the points for, advises Stephen. This approach will lead to more happiness in life, he says.
His parents had bee ‘instructed’ to take careers in certain professions, and perhaps for that reason, says Stephen, they reacted against that pressure and told their own children to do follow their passion when it came to a career choice. The basic rule, he says, is that if you love science, you’ll probably be good at it.
“The points system and peer pressure can make people take choices not based on their innate abilities and interests, and that is a big mistake,” he advises. “You have one life, do what you like to do rather than what the system tells you, you have enough points for,” he adds.
One of the best things about being a scientist is that there is no reason why a scientist can’t work, and be very good at their job well into their 70s, says Stephen citing the example of Dame Anne McLaren, a lady who was in her 70s when he was working with her, and still “as sharp as a pin, and a great teacher as well as a superb scientist”.
G00d & Bad
Science is also one of the professions, he says, where it is possible to literally change the world. To make his point, Stephen said that he suffered badly from asthma between the ages of 7 and 15, but that his life was massively improved by an inhaler that could clear out his lungs. This demonstrated to him, at any early stage, how science and medicine can alleviate human suffering.
There is also the novelty factor – good for intelligent people that bore easily. Every day, says Stephen there is something new, and there is always the prospect of doing something in the lab that no-one has tried before. That’s and exhilarating feeling, he says.
What are the aspects of the job he doesn’t like as much? He says that he doesn’t like replying to correspondence from patients and their loved ones asking about where research currently stands in relation to the available treatments for injury and disease. At the moment, the answer is often that research has not yet gone far enough to actually provided ‘cures’.
But, if Stephen gets his way that will change some day in the not-to distant future, and researchers in Ireland will be helping to make it happen.