Your 3D printed body
This is an ABC podcast. Hello I'm the Tesha Mitchell and a heads up a senior here about onsides. Friction today will be visceral that just for a moment or two. Winberg is a scientist obsessed with seaweed no. It's one of the most ancient organisms argue with highly intelligence that the seaweed on working without leaving fossils older than the dead for food very even working with payer runs her own company called Venus Shell Systems on the south coast of New South Wales developing and producing nutritional and other products from say Wade and collaborating on new sites including the possibility of using seaweed extracts to repair wounds and Burns such a diversity of Molecules. That are unexplored you know. We used to talk about rainforests diversity and opportunities in medicine and health. Oh the oceans are so untapped but one day last year pairs seaweed obsession became shockingly personal I was on a roll things. Were working really well and set up and I remember this clearly saying I'm just going to the refinery machines to get some seaweed extract. That should be ready. After the overnight process it was beginning of the day. And I'm often on my own in old paper mill where we are on the south coast which is a very spooky environment but a place. We had the opportunity to build our pilots facility and often. They're lying lucky day. I wasn't but I was aligning in the refinery factory itself. Got To work and I just remember bending down with my tied back with my work kept on and safety glasses and hearing protection to take my seaweed extract out of the TAP. My memory stopped justice. I was bending down memory neutral man. Nothing it's like your brains rewound little bit to a position where life is safe and find something. Truly horrendous had just happened pay. His pony tile had got cold in a pump remember clearly being wheeled in from the helicopter. The helicopter ride with it was a bit of a blur and I remember. The surgeon clearly signed to me. We've got your scalp and although I don't remember seeing carrying MY SCALP. I was sort of not surprised by that. Okay and and we're going to do our best to attach it and he said it's been ripped off so it's going to be hard but we're going to do our best. I remembered is with clearly. Pr had been skelped. An awful awful accident one. That's kind of given her this brutal insight into Wa. The science. She's doing actually matters. She hasn't lost Saad of that in the scenes. We'll come back to pair on that day in two thousand nineteen about her story sets the scene for science friction. This addition three a printing has taken the world by storm from backyard hobbyists to designers engineers educators. It's might all sorts of people kind of mini manufacturers but is it hurtling us towards an even bigger revolution so I can see a foot a heart that's been opened up probably a little bit of Ribcage may be there. I think another heart and another heart of hearts and on the other hand bigger. Oh and what did Vertebrae? Yeah Roy of ease Ho Roe V is. Here's a big part of what we're doing at the moment Gordon Wallace by looking at baby of three days printed plastic objects both living ear so that doesn't involve by printing but also we have a parallel project with the living near project. That's the print prosthetic ears which are not living but they feel like an ear and will look log in here but we are talking printing leaving things today. That's Three D. bio printing. Could it be used to print body beats like cartilage to fix worn out knees bone to mend breaks keen to heal burns or perhaps the pet shop damaged organs like is Ohio? It's could we even three print whole new organs look at Three D. Printing that's Take which uses what we would call structural materials to build things up layer by layer so you can create unique structures using three D. PRINTING. Three D printing is a subset of that wherein we introduce living cells during the printing process arranged in three day to ensure that we get optimal performance out of the farnell structure. We don't necessarily have to reprint the whole organ. What a bad if we can just patch it and we can facilitate the regeneration of that organ using the body's own biological processes and of course. When you do that then you learn you start to learn a bad hand. The Bala Ji Interacts with this three D. printed structure. That you've made maybe. The human body for these types of processes is the best laboratory environment we can use. -lating Australian surgeons are already getting on board but so too Bioethicists with some cautions. That will hear a bad. They're all working with Gordon Wallace and his teams at the Asa Santa for excellence for electron materials science and also tross it. That's the translational research initiative the cell engineering and printing by the University of Woolen Gong. One of them is a superstar of skin. That right from the word go. What I'm doing is I'm looking. How can this person? He'll what is that capacity to heal and then looking at the wounds in the extent of the wounded surface area. How deep is at a whereabouts on the body and then at this point in time as every point of time along my career as a writer. What is out there? What is the best technology that we can bring? Tha Right here right now. Professor Fina would director of the burn service in Western Australia? She's a trailblazing. Boone specialist and plastic surgeon and theon really became a household name and Australian of the year after she led the team that traded the horrific burns of survivors of the Bali bombings. Some had burns to over ninety percent of their bodies. She's known for trail-blazing a spray on skin as well but she is not stopping there. I don't think we do well enough every time I turn around. I see scar and we need to really think. How can we eradicate that? How can we foster regeneration scheme? Ease the largest organ of our body holds us together. Protects us from infection helps control at temperatures Since the world whole lot more so repairing it after severe bins ease Motti Hod and in the depot birds we use domo scaffolds for the deep areas and they can now be the biological synthetic and then after period of usually about three weeks vascular. So it's blood. Supplies GO IS NERVE SUPPLY. Then we come back and replace the surface. And that's where the sprouts get cells. Come in because that's the more of the surface it's the waterproof layer but in associated with traditional techniques but that's intrinsically that has that to two stage process. What I'd like to see is can we bring the world close outright down so that I can put the scaffold the Matrix and the cells into the wound and facilitate tissue guided regeneration? Can I put the building blocks there so that the body heals itself as a the bio printing story gives us a level of sophistication in placement of the elements so that they can actually grow themselves? That would be enormously exciting. You know which is Wi fi on award jumping out of her skin. We excitement over the idea of three D. bio printing skin. So just to help you. Visualize right. Think of this is using a three day printer to print easing by wink of some salt will come to that to print a kind of Mesh or scaffolding that is compatible with the body and with growing healthy cells and then seeding that scaffolding with stem cells the continuing to the silver repair in a damage body part. This is how Fiona came to start collaborating with Gordon. Wallace's three day by Printing Tame and SE. Wade scientist Pei Winberg. He's was really having a cocktail event with With the professional and Wallace you know I just got to asking him. So what do you do? Actually because scientists tend to stick in this is I'm marine. Scientists do buy materials medical stuff. But we were having having drink. And that's the best way to unlock ideas. And he said you'll I print medical devices and materials all right and so what we've and he said Alginate as if that's the chemical off the show for sigma and that's how he sees it something you buy from the chemical store and I said all right. So you're a seaweed scientists because I know that alginate comes from seaweed and he's like what excites me now. It never did. Well remember as kids. We used to eat seaweed in a bag dress up with it and pretend all right. I got didn't go that far so seaweed off learned a lot of bad seaweed since I in cantered PIA and those molecules are just extraordinary in terms of their multifunctionality. And it's no accident. Of course O. All of those properties like the antibacterial affected they survive for long periods of time in in nature. Those molecules have evolved over time. And here they are sitting in a seaweed farm and we get the mad in India boiling. Let's use them. And Gordon does seem collect collaborations. He's probably got more running at the same time than any other. Australian scientists have encountered without the scientists with surgeons technologists social scientists and all over the world as well and we found a naked endemic Australian. Only spacey's a green say. Wait and that's the one. That's a really exciting profile. That mimics human skin connective tissue whereas Brown say. Wade's like alginate. Skin cells wouldn't recognize it or attached to it. There's good moisture absorbing properties around it and and protection of skin in Mechanical Way. But there's not the molecular signature there to stimulate cell attachment an so gross and Collagen production. So it's exciting to now be on part of the journey towards a pellet of bio inks that are the missing link. I feel like in many of the Three D. printing technologies and because we are in a has a skin spray. Well that's really low hanging fruit twelve. Her skin spray works. But it needs better structure. If you just pray skin cells. They land in land in a puddle. Basically so if we spray it onto our Seaweed Three D. printed scaffold. Which is the shape and I mentioned that we wanted within. Maybe the skin can have better properties when it's fully formed. We've got the printers. We've got the cells but you've got to have this functional. Matrix scaffold the closer together and support said but not just as a dumb structure. These molecules have very specific designed to do very specific things and some of them tell cells to make Collagen and some some of them tell cells to attach and grow so the future of this is is huge because we're only scratching the surface. Wouldn't it be nice if we could make it anti microbial so that we didn't get infection? Wouldn't it be nice if we could put something? That actually prevented the stimulation. So we didn't have pain. Yes so we could make this really clever so we could make the the put the cells and the for the skin elements within that and then what about subtly change in those that chemistry so that a half local can develop and then the idea is that you'd put that over the wound or implanted into a wind side so that it would integrate and then the skin replenishes regina rights and so it goes so it's an alternative to a skin graft? Yes that's right. And but that's where fearing is technology with developing skin spray harvesting. Just a few cells and then spraying them. On a wound can allow the cells to Grove. Multiply and slowly start to create new tissue. If you just by skin cells. They land in Atlanta puddle basically And the scaffold will give them structure and direction In creating new skin tissue and that could either be grown to the side and then placed on skin or could be directly printed in surgery in the future potentially. That's the sort of ideal scenario that the surgeons would like to have and that's where it's important to communicate because as scientists you can have all these ideas all yeah. They could do this in surgery but we really don't know what are the challenges and what are the things you would love to have is a surgeon to solve these problems. It's very early days. Ovo Plastic Surgeon Fiona would has just started some trials of implants in animal models. But let's come back to that moment just over a year ago where this all became terrifyingly personal for marine scientists P. A. Winberg. We lift earliest sampling though is healing extracts in his seaweed refinery that morning and a warning. This graphic for a few moments I do then recalled becoming conscious wondering why am I stuck to these machine with my hair and I couldn't see because it was tangled around the machine. I remember looking at the hands and they were covered red blood and I just thought that's odd. Just get these hair untangled. It was a bit like hair tangled around hairbrush. You know you don't know which way to untangle it. That's the very short snippet of memory have that. Apparently I would have worked pulling my scalp out of the drive shaft in which he has stock in. Shut DOWN THE PUMPS. You'd think skilled by the pump out by the punk yet. Then I apparently took my scalp and looked two hundred and fifty meters to go and get someone call an ambulance carrying my scalp. And my case I find but I have no memory of that whatsoever and even after losing two and a half ladies of lot is so lucky to survive that amount of blood loss. I guess that was lucky. That was lucky someone was there to call an ambulance and on so lucky to be here where an ambulance get their ten minutes. Four ambulances get there in ten minutes helicopter gets to twenty minutes and surgeons awaiting Sydney operate for six hours to try and save your scalp and miss case that didn't work but to put a skin graft on to save my skull in my head and they did that and it was amazing. So all I've felt is just wow nitro ma. And everybody's hoping thirty percent of peers scope had gone. After six hours of surgery. The surgeons would able to reattach her own schedule but they instead took a skin graft from his thigh and effectively stifled to her skull. Gordon Wallace remembers when he heard about what had happened when she had her accident. What went through your mind when you got that news. Do you remember the day that was pretty horrific so but you know I spoke to Pierre probably within a die of and she was on the email and With telling me that she had some new insights in the wound healing and it was just amazing. She is an amazing character and all through that experience. Which of course pays still going through. She's never said a negative word a bad it other than that so thankful she's alive and we can work together on getting solutions. That will make it better for people who are involved in those situations. It's a sort of a sweet injustice of this work that she became the patient whilst also being the scientist. Yeah Amazing Look. I don't know any other individual that would have handled it the way Pierre has handled it. Such a positive ad look and search determination to make sure that we deliver new technologies. That make a difference. There is no reason that once we get the right kind of scaffold. I mean it was my own tissue. They had to cut off to create the scaffold and our point is well. Why do you have to do that? And especially with Burns victims with eighty percent of their body. Well wow if we could create a scaffold. That's not their skin if we could three D. print and recreate that and then use the person's own skin cells to stop growing on that scaffold. And that could have. That could have been something deployed on my scully. I if that had been made available and so for me that's fine. It wasn't today. I'm amazed with the help I'm getting but it just really makes me understand what the limitations of the science are today and the surgical applications and what actually surgeons might need. Payer is still in the process of healing and having HER SCALP. Reconstructed and positively is just phenomenal. Let's go just have a look at some of the prototype bar printers in the mix that Liberia. The team are custom building. Three-day bio printers. That are practical and small enough for surgeons to use in their feet is one looks rather like a pain that could print a concoction of cells streit into a damage me so some of the applications bull multiple printing of multiple cells for example where we're looking at a printer and a printing protocol dedicated to creating more efficient structures for audit cell transplantation to treat diabetes. There were looking at printing three different types of cells all carefully arranged in a three d structure to get the best performance out of the the oil itself. Which is the donor cell? Which is used to treat the patient with diabetes? So these are the insulin producing cells in the body. That if you've got taught one diabetes. You don't have enough of those old. I don't work anymore exactly and and so one of the treatments for that is to do this. All IT cell transplantation getting ourselves from Downer printing them into a three D. SCAFFOLD. Where you've got other cells the t regulatory cells it will help fight off the immune reaction that also endothelial progenitor cells which help degenerate the bus colorization within that structure. So those cells get a blood supply. Yet islet stem cells for diabetics stem cells to rebuild college in Guinea nays or a whole year or to regenerate the cornea in the I pop them in a three day by a printed scaffolding and the possibilities look really significant now. None of this is ready for human trials yet but that might not be so far off. What sorts of risks in will the first recipient of a custom made leaving by printed implant made to be worn combat? And how will I be protected from I think that there are regulatory gaps ethicist Professor Susan Dogs Ease One of a consortium bioethicists and legal scholars working inside Gordon's team to interrogate the ethics and regulatory challenges of their work. Susan's Deputy Vice Chancellor for research and INDUSTRY ENGAGEMENT AT LATROBE UNIVERSITY. We have had a tendency to view. You take my adult cells. Stimulate them into becoming a stem cell product. Put them back inside of me that that has tended not to be well. Regulated Australia's recently refined understanding of biologics in terms of the things. You might do well. It's outside I'm body and that's where the three D. printing would mean that it does fall under the regulation of biologics but in other jurisdictions. It's possible that there continued to be gaps about exactly. At what point does something ceased to be simply removing cells from a person and putting them back inside that person and becomes something which fits within a regulatory environment at this point? We can't be confident that there's complete harmonization across jurisdictions but I think that for those researchers who wish to be able to develop something that they want to stake their career on. There's good incentives for them to try to work within the regulatory environment. Notwithstanding the fact there'll be some rogues in the world and there are rugs in the world and what's to stop some of those some shonky stem cell clinic doctors from doing three day by printing. They're using stem cells already from patients. They doing it openly. They marketing touting their ways publicly on websites and in Ed's it's very highly possible. It's possible and there certainly have been people who haven't been doing three D. Printing. Who claimed that they were doing? Three Depot Printing You may be aware of Macarena case in Europe where a highly esteemed researcher was found to have created on plastic implants implants for people who had trachea defects and put some stem cells within them presented as a three D. bio printed Therapy which then had serious risks and several people died as a result of being offered something as a therapeutic but experimental treatment Which we had not been properly tested had not gone through. The proper was but that person failed to meet the existing Regulatory Environment. They were in. They did things that fell outside a pretty well. Designed robust system The fact that it was three D. printing that they were claiming to have done. I don't think the real issue the real issue is. They shouldn't put something into people's bodies without having properly tested it in the first place. He was incredibly successful. I mean he took a massive public stage. I think even politicians probably supported. He's if it's that's true and this is where that question of both a critical public being able to Assess claims being made a slight tendency. I think within the research environment of wanting to only back we noticed And therefore not encouraging researches to talk about things that they have found don't work An extremely good media machine on that person's part and both consumers patients and And the the the wider media being very keen to run with something that seemed exciting and new. It tells us all we need to be much more careful and skeptical about the claims of great success. So what about the clinical ethics of tasting these things of tasting three day by printing? Because often this is talked about as being a very personalized approach to medicine you know. H by printed object would be custom for one particular patient so then. Hattie create trials on this stuff to make sure they're safe. And if a catious that's a real issue that everyone's grappling with at the moment that you're exactly these are customized solutions for an individual and say we need to work with the regulatory authorities for those who develop and new clinical protocols and figurehead had had do improve the efficacy of these procedures Because it's not in the same way as we do it for traditional medicine sort or even traditional implants. What could it look like? I think there will be an aspect. There has to be an aspect of customization. And that's why we're doing it to try and get the best result for that individual. I imagine that eventually it has to be the processes that are regulated and has to be that. You've got a a licensed operator to do it. That you've got licensed equipment to do it If you follow this protocol it will be a safe procedure and hopefully be a successful procedure but and of course surgeons are sort of used to that. Surgery is pretty customized in general but this has taken it to a new level. But then you've got to get these cells inside the three day printed scaffolding into a body and so far that hasn't happened in humans yet but this has been animal trials. And then head you determine and this'll be the challenge for clinical trials. Had you determine what those cells then do that they behave in a normal way? But they don't suddenly proliferate into cancerous tumors for example. There's a stem cells. I could go anyway. So that's an issue. What if they mutate or migrate to bits of the body that you don't want them to add to the scaffolding and saying CEO? I'm going on holiday in another part of the body where I don't where I'm not welcome log anything that's implanted into the body. There'd be extensive experimentation around that is to have the cells behave what the resulting tissue regeneration processes are how long they last so extensive studies to be done and some of those will be more complicated than others of course cartilage in the knees where we one of those simpler examples You know you can localize that you can study it quite easily. You can imagine the transplantation of the scaffolds with the oil. It's multiple cells. That's going to be more difficult to characterize into to verify. The the efficacy of bioethicists also writes questions about where the stem cells for. Three Day by pruning would be sourced from the source of the cells. Very often these days would just be adult stem cells so that might be come from swab the inside of someone's mouth or from blood cells or something else but initially there was some question about whether we might want to draw on the spare embryos leftover from IVF but obviously that would raise a set a set of issues about destructive use of human cells but also there may be cells that might come from other organisms And so that if we were then going to use them for implants into humans we might have questions about who sells them. I getting other another human being's or from another species and that raises questions about cameras that idea of a mixing of human and animal material or whether we might take human derived cells into a three D. printed implant and put them into another animal and therefore at possibly end up with a camera of that's based around say a rat body with a bit of human tissue inside of it most of the conversations around three by printing around using adult stem cells and people have a perception that okay so if a patient was going to have a three D. printed body part or implant and their own stem cells. Were used then. That is somehow ethically cle- AH is it? Well ethically tidier Insofar as you not asking one person to provide cells to support another and you don't have some of the concerns about that and you would avoid of the the risks of rejection that you find in some transplantation of organs for example but there are still risks associated with that because stem cell lines may lead to which develop with a higher risk perhaps of cancerous growth or of other infection or damage to the tissue as a grow. So it's not rescreen free but it may reduce the risk those infections. But because one of the points of Three D. bio printing is. You're also introducing a scaffold restructure in which those cells are implanted initially in order to be able to grow a piece of tissue which may be in simple cases things like blood or skin which is still complicated enough that there are risks associated with the structures that you're using as the basis for those cells to get a three d structure rather than just two-day structure so they have something like you know. Lego lifetime structure Within which the cells grow and work with each other and the irreversibility of these sorts of leaving implants is another concern. Clearly that ability to integrate into the body is one of the great promises. Which means that. It's going to be very difficult to extract and if we think about some of the further down the track more horizon work where we might be creating neural implants that am engaged with our nerves that we really want to be careful that we aren't doing damage to the very process. We're trying to support you know whether it's To improve some form of brain function or to be able to deliver targeted therapies directly to the brain that that integration of brain tissue seems to cause us more concerned because of our views about the brain But you know I could imagine a world in which heart muscle tissue might be developed as a patch and it seems to me highly desirable to be able to have a fully integrated patch on the heart. Assuming you do things that existing pacemakers can't rather than waiting until my heart is so damaged that I need to have a full heart so I think that there's some opportunities here but we just need to be really careful to say what would give us the evidence in order to say that we fill the person could then go out and live their lives. Having had such new. The therapeutic goods administration with consultation has slighted. A number of changes to the White three-day by printing will be regulated in Australia. My thanks to pay a Wynberg especially to Professor Gordon Wallace for showing me around his labs to professors and dogs and also to associate professor John Nielsen from the University of Tasmania's law faculty who was very helpful on all these talk to me on twitter at Tesha mutual or Emami from the science fiction website. Love to hear from you. Also check out the new daily podcast Corona cast tracking the latest developments in answering your questions on the covered. Nineteen pandemic take care in the world by saying you've been listening to an ABC podcast discover more great ABC. Podcasts live radio and exclusives on the ABC Listen Up.