Abstract

We still do not understand the full extent of the complex systems the human body presents us with. Researcher Nina Tandon from Columbia stated that we are currently beginning the third age of medicine.Nina Tandon, a senior fellow at the Columbia University Lab for Stem Cells and Tissue Engineering, speaks at TEDx Berlin. (Credit: Stephen Shankland/CNET) The first age, most of human history, had only a primitive understanding of the body. The second age ran from the first dialysis machines in 1924 to today’s organ replacement procedures dependent on human donors and limited by the fact that many tissues are rejected by the body they’re being transplanted into. The third age builds replacement materials through tissue engineering. In the field of medicine, one of the greatest ad advancements has been the ability to create artificial organs that are able to restore the proper function of a patient’s body. The process is formed by linking two studies, stem cell research and tissue engineering.  The organs that can be replaced artificially are quite numerous, including the ears, ovaries, and even the heart and brain. This process is said to be familiarized towards the public in 2013. Comparing this to plastic surgery which was only recently accepted into the world we could assume organ replacements will become the same. It will become the norm in the near future. The mortality rates for middle to high classes will be bordering zero. The biological clock will stop and with it the theory of evolution will cease to exist. So the question I propose is the Ship of Theseus paradox. It raises the question of whether an object which has had all its component parts replaced remains fundamentally the same object. Will humans work the same way? Because of this, I believe there will be an identity seeking artistic movement in the future which is what I based my project on. Throughout this blog I will project the progressions and the potential of stem cell and tissue engineering research, illustrate two modern examples of this art movement and a futuristic example possible in the next century.

Research

There are two equally important parts to growing artificial organs, Stem Cell research and Tissue Engineering research. To put it in simple terms, Tissue Engineering gives the environment where the Stem Cells or “building blocks” are placed so that they can grow. Stem Cells are collected from the part that would contain the end result. For example, if a person wants a new finger they would need cells from the finger that would be replaced. It is in a sense cloning. Today we are quickly approaching a successful medical process where replacing organs is efficient and abundant. There will be no more shortage on donated organs. We are using this technology now to replace damaged organs or ones that show signs of cancer. With the development of the 3D printer it is easier to create the “mold” for where the cells can mature and form.

Tissue Engineering

Cells became available as engineering materials when scientists at Geron Corp. discovered how to extend telomeres (nucleotide sequences at the end of a chromosome which protects the end of the chromosome from deterioration or from fusing with neighboring chromosomes) in 1998, producing immortalized cell lines. (Immortalized – not applicable to the Hayflick limit)

From fluids such as blood, the cells are extracted by centrifugation or apheresis. From solid tissues it is more difficult. First the tissue is minced and then digested with enzymes trypsin or collagenase to remove the extracellular matrix which holds the cells. After, the cells are free floating which is extracted through centrifugation or apheresis.

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centrifugation- samples are placed into the machine which then are accelerated to a high velocity in a spinning motion.

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Scaffolds are the supporting artificial structures for the tissue. It is a place where the tissue will develop and form into the shape of the design. Scaffolds are usually made from collagen and some polyesters.

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There are many known techniques for synthesis and some are more advantageous than others however there are none free of drawbacks. Some are: Nanofiber Self-Assembly, Textile technologies, Solvent Casting & Particulate Leaching, Gas Foaming, Emulsification/ Freeze-drying, Thermally Induced Phase Separation, Electrospinning, and CAD/CAM.

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Stem Cells  

There are many types of cells but the one I would like to focus on is Stem Cells. This is because stem cells has high potential to becoming the backbone of cloning organs and even fully made human bodies in the near future.

Stem Cells are cells with the ability to divide and give rise to different forms of specialized cells. They are divided into two categories, adult, and embryonic. There are three different types of stem cells, multipotent, pluripotent, and totipotent. While adults are mostly multipotent the embryonic is mostly pluripotent. Rarely do scientists see totipotent as they are in a sense the “father” cell. To put it simply totipotent can become any specialized cell it wants as it is the earliest form of life in the human body, when the sperm meets the egg or zygote it creates totipotent cells which is then transformed into skin, blood, or any other types of cells. Pluripotent is right under totipotent as they cannot turn into any cell however can be developed into endoderm, mesoderm, or ectoderm cells. Endoderm cells are found in: interior stomach lining, gastrointestinal tract, and the lungs. Mesoderm are found in muscle, bone, and blood. Ectoderm found in epidermal tissues and the nervous system. Multipotent cells are the most static out of these three as they can give rise to different cells but have a limited number of lineages. For example a multipotent cell from a blood stem cannot develop new cells as a brain stem cell. These cells could be considered to be permanently committed to a specific function.

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The Results of present stem cell research.

This shows a pulsating cube that was grown in a bio-reactor. It is a big step forward in creating artificial hearts

In June 2011, surgeons in Sweden carried out the world’s first synthetic organ transplant.* A 36 year old man, suffering from terminal cancer of the trachea, received a completely new replacement windpipe. This was achieved using a nanotechnology scaffold - made from a spongy, flexible polymer - which was seeded with his own stem cells in a bioreactor.The scaffold was based on 3D scans moulded to the exact dimensions of his trachea. The cells were grown on the scaffold for just two days before transplantation into the patient. Since the cells used to regenerate the trachea were the patient’s own, there was no chance of rejection by his immune system.
This breakthrough in regenerative medicine will make future transplants far quicker and more accessible. It requires no human donation, takes just two days before implantation and is a perfect fit. It will particularly benefit children, for whom trachea donors are much less available compared to adults.
Other recent progress in this area of medicine includes tooth regeneration, synthetic arteries and the growing of thigh muscles and fingertips. In the 2020s, more complex organs and body parts will be developed, such as hearts. Later in the 21st century, entire synthetic humans will become a reality (though not without controversy)(Harvard Bioscience).

In June 2011, surgeons in Sweden carried out the world’s first synthetic organ transplant.* A 36 year old man, suffering from terminal cancer of the trachea, received a completely new replacement windpipe. This was achieved using a nanotechnology scaffold - made from a spongy, flexible polymer - which was seeded with his own stem cells in a bioreactor.The scaffold was based on 3D scans moulded to the exact dimensions of his trachea. The cells were grown on the scaffold for just two days before transplantation into the patient. Since the cells used to regenerate the trachea were the patient’s own, there was no chance of rejection by his immune system.

This breakthrough in regenerative medicine will make future transplants far quicker and more accessible. It requires no human donation, takes just two days before implantation and is a perfect fit. It will particularly benefit children, for whom trachea donors are much less available compared to adults.

Other recent progress in this area of medicine includes tooth regeneration, synthetic arteries and the growing of thigh muscles and fingertips. In the 2020s, more complex organs and body parts will be developed, such as hearts. Later in the 21st century, entire synthetic humans will become a reality (though not without controversy)(Harvard Bioscience).

Personal Thoughts and Proposal

This cloning process in a century will become common. People will cease to die. So as the ship of Theseus paradox states if every plank on a ship is replaced with a new plank from the same tree would that ship be the same original ship. Would we be the same if we get every organ replaced in our body? Because of this question I believe that artworks in the future will deal mostly with human identity. Similar to my artwork below there will be works that show the different types of bodies that will be available. Better advancements in technology will make it so that everyone could have the legs of the high school track champion or the arms of Arnold Schwarzenegger at his prime. Similar works of art could be overlapping your current body with past bodies that you had. Washing out all the similar parts and then only emphasizing the newly advanced body types.

In the future there will be a cafe type location where you could go to get your make up changed. The “make up” wouldn’t be only your face however your whole entire body. There will be an interactive system that you can choose to become whatever you would like to become. With the advancements we have made today in biotechnology it is not a delusion to think we could produce and transplant organs or limbs daily. It would be similar to today’s avatar creation in the virtual world. The system will consist of a section for your head/hair including all facial features, arms, legs, torso, and even organs that would take hours to transplant safely today instantly. This is fearsome as it challenges the concept of identity.

My artwork in the future is a simple however very complex pair of glasses that law enforcement would use daily. If identity can become hidden and obscure how is law enforcement going to figure who is who. Who is Mike Kim? The physical appearance would be so easily changed. Therefore my glasses will be an identity collecting database where they show the actual face of the person, what they were born with, and all their information included inside. It will be hooked up with the information database in these cafes and other means of transformation.

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These are the Google Glasses the artwork will be very similar.

History: Tissue Engineering

Tissue Engineering existed long before the modern era. During the Renaissance the painter Saint Cosmas and Saint Damian illustrated “The Healing of Justinian” which is recognized as the first projection of tissue engineering.

Saint Cosmas and Saint Damians The Healing of Justinian

In 1438, Angelico Fra depicted two saints healing a wounded soldier by replacing his leg with what appears to be a Homograft limb, which means that the limb is grown outside using the patient’s own cells. This is not far from the discoveries of stem cell therapy of today. The oldest sign of something that resembles tissue engineering however, comes from the bible. God turning one of Adam’s ribs into eve is truly the first example of growing human parts out of the body.

Adam and Eve

The first true beginning in the field of medicine of what came to be known as tissue engineering was in the 1970’s when a pediatric orthopedic surgeon at the Children’s Hospital, W.  T. Green, MD tried to create cartilage and implant this into a mouse. Although the experiment failed the doctor believed that the advent of biocompatible materials would help in creating scaffolds in which to transplant cells.

A few years later, two doctors from MIT and Massachusetts General Hospital worked together to create a skin substitute by using a collagen matrix to support the growth of skin cells.

The breakthrough came in the mid-1980s when Dr. Vacanti approached Dr. Langler of MIT about designing appropriate scaffolds rather than using naturally available scaffolds, whose chemical and physical properties could not be controlled. The use of these natural scaffolds led to unpredictable results. Dr. Vacanti designed and conducted many thorough studies attempting to generate tissue surrogates. He used a branching network of synthetic biocompatible and biodegradable polymers as the scaffolds, which were then seeded with viable cells. His original paper in 1988 showed the world the promise of this up and coming field. Five years later, he published, with Dr. Langer, a paper that might be the most cited work in Tissue Engineering.

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Tissue Engineering soon became to be known as “Miracle Grow.” It spread in the medicine community like wild fire and therefore a unifying organization was formed. The Tissue Engineering Society was created in 1994. The meetings were held bi-annually but as the organization grew all over the world meetings occurred annually. The name was also became TERMIS (Tissue Engineering Regenerative Medicine International Society). Along with the society, a new journal was created in 1994 called “Tissue Engineering.”

The most famous example of Tissue Engineering is the mouse with the human ear. Contrary to popular belief, the mouse has a cow’s ear. During the mid-1990s many more successful examples of tissue engineering was found over the world. Cartilage, skin and pulmonary arteries were mostly grown using the scaffolding technologies.

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 Dr. Anthony Atala one of the leading figures in Tissue Engineering today recently operated on a girl who had a serious bladder malfunctions called Spina Bifida. This operation was a bladder transplant of the first artificially grown bladder. The simplest of organs however still a very crucial one for survival. Dr. Anthony regularly uses tissue engineering (refurbish diseased or damaged tissue by using the body’s own healthy cells) to grow organs and tissues.

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Although there has been critical advancements in tissue engineering we are not at the stage of growing the crucial organs such as the brain and the heart. The future must hold bigger and better organ transplants. 

History: Stem Cell Research

Only when the microscopes were invented were cells recognized as the building blocks of life, capable of creating new cells and a key to uncovering the mysteries of the human body.

Stems cells were discovered in the early 1900’s by European researchers who realized that the various types of blood cells e.g. white blood cells, red blood cells, and platelets all came from a particular origin, ‘stem cell’.

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However, it was not until 1963 that the first quantitative descriptions of the self-renewing activities of transplanted mouse bone marrow cells were documented by Canadian researchers Ernest A McCulloch and James E Till.

Embryonic stem cells under microscope

Stem cell research has been ongoing since the 1950s as bone marrow transplants, actually a transplant of adult stem cells and have been used in patients since that time.

Due to the developments in biotechnology in the 1980s and 1990s it became possible to grow or alter genetic material and cells in the laboratory. This greatly aided in furthering stem cell research.    

Then in 1998 James Thomson, a scientist at the University of Wisconsin in Madison, successfully removed cells from spare embryos at fertility clinics and grew them in the laboratory. He launched stem cell research into the limelight, establishing the world’s first human embryonic stem cell line which still exists today.

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Since this discovery, a plethora of evidence has emerged to suggest that these embryonic stem cells are capable of becoming almost any of the specialized cells in the body and therefore have the potential to generate replacement cells for a broad array of tissues and organs such as the heart, liver, pancreas and nervous system.

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 (Stem Cell Foundation)

Timeline

Please Check out the fully detailed timeline located at Science Progress

http://scienceprogress.org/2009/01/timeline-a-brief-history-of-stem-cell-research/

References

http://www.army.mil/media/234075/

http://en.wikipedia.org/wiki/Stem_cell

http://www.telegraph.co.uk/health/healthnews/8443740/Scientists-create-human-kidneys-from-stem-cells.html

http://www.smartplanet.com/blog/science-scope/scientists-create-replacement-organs-using-bodys-own-cells/13685

http://en.wikipedia.org/wiki/Ship_of_Theseus

http://www.ncbi.nlm.nih.gov/pubmed/12751825

http://www.bmecentral.com/artificial-organs.html

http://echo.gmu.edu/bionics/exhibits.htm

http://philadelphia.cbslocal.com/2012/03/09/doctors-propose-solution-to-donor-shortage-grow-organs-from-stem-cells/

http://ngm.nationalgeographic.com/2011/03/big-idea/organ-regeneration-text

http://abcnews.go.com/Health/stem-cell-therapy-promising-regenerating-damage-heart-muscle/story?id=15576909#.UL2IJYbed8c

http://www.guardian.co.uk/science/2007/apr/02/stemcells.genetics

http://www.futuretimeline.net/21stcentury/2011.htm#synthetic-organ-transplant

http://news.cnet.com/8301-11386_3-57504295-76/donate-organs-no-grow-them-from-scratch/

http://www.newsobserver.com/2011/11/28/1675171/growing-organs-cell-at-a-time.html

http://www.time.com/time/health/article/0,8599,1679115,00.html

http://gorliv.ash.com/history.html

http://www.smithsonianmag.com/specialsections/40th-anniversary/Organs-Made-to-Order.html

http://en.wikipedia.org/wiki/Organ_transplantation

http://www.donatelifeny.org/all-about-transplantation/organ-transplant-history/

http://www.accessexcellence.org/RC/AB/BC/1977-Present.php

http://www.bristol.ac.uk/cellmolmed/stem-cells/

http://www.stemcellhistory.com/stem-cell-research-timeline/

http://scienceprogress.org/2009/01/timeline-a-brief-history-of-stem-cell-research/