We know there are about thirty thousand diseases known to human beings and of
those about three-quarters have no treatment whatsoever.
You have an ageing population worldwide,
there are a lot more chronic disorders coming through and
these patients need new treatments which are offered on a continuous basis.
We see a very big change in therapeutics coming up and we're on the cusp of that
change now where you're getting multiple disciplines in brand new technologies
and much more understanding the biological science behind it and the net
result of all of that is it should introduce new therapeutic
modes into the general public.
So there's a revolution going on in medicine that
we want personalized health care, we want to understand our own bodies, the
individual nature of those and for that we need sensors but not just on the
outside we need sensors on the inside. And we've not been very good at making
those so nanoscience and nanotechnology is driving towards making
new sorts of devices that will really revolutionise medicine.
This is the idea of personalised medicine as a whole: how do we actually
know how we're working as a human? When you go to a doctor they always ask you
how are you feeling and part of the reason is they have no machine which can
measure how you're feeling. So it's about how do we create technologies that
actually can read that out and do something much more profound, actually
watch how you're living and then start to warn when maybe something is going wrong.
Now on the very, very future scale what we actually really want to do
is to put nano machines inside our bodies. We want them to go and scavenge
away and repair parts which are broken, remove clots and all at the moment this
is rather large scale interventions that surgeons have to push something in your body.
What we'd really like to do is to use what the body does and so
nanotechnology's learning how to build these sort of nano machines.
Humans are living longer and longer and of course we've dramatically changed life expectancy
over just the last hundred years or so with the introduction of antibiotics and
so our tissues, the quality of our tissues
decreases with time and that means as we live older and older we're gonna need
more and more replacement parts not necessarily just to stay alive but for
our quality of life as well.
So we study natural materials
because if we want to make artificial materials that are similar to
the natural materials we have to understand the natural materials
themselves first.
Scaffolds are used for tissue engineering when we make an
artificial tissue. Tissues have two components - they have cells and the
material, the extracellular matrix. So our scaffolds mimic the material
parts and then if you add cells to that then you can engineer a new tissue.
Other organisms have enormous powers to regenerate.
They can regenerate limbs that are lost
or hearts that are damaged. Humans - we don't have that ability.
When somebody has a heart attack part of their heart muscle dies. They can
lose a billion cardiomyocytes and the heart never repairs that,
it's just replaced by scar.
What we'd like to do is develop a tissue engineered cardiac
patch made out of stem cells that can replace and restore normal function to
the heart.
What we're using is embryonic stem cells that can form heart muscle
and all the other structures of the heart and what we want to do is to improve
the heart function not just by a couple of percent but completely back to normal.
I mean the future is actually very bright for regenerative medicine as a whole
because other people are working on other organs. So kidneys, livers, repairing
damaged brain - even spinal cords. So there's a huge area of promise here
I think that that's what the future holds looking far ahead.
Immunotherapy is really revolutionising the way in which cancers can be treated.
My lab is interested in understanding what makes a really good
killer cell.These are the cells that recognize and destroy both the cancer and virally
infected cells in your body. So as effective and revolutionary as
immunotherapy has been, it doesn't cure all patients and so it becomes
incredibly important to understand in detail what tells a killer cell to kill
and how it does so. So what my research is aimed at is understanding what makes
a really good killer and what are the mechanisms that control that killing.
One of the approaches we use is to study cells in patients with genetic diseases
where the killer cells don't work to try and understand why things don't work when
one components missing. Another approach that we use is to look at the genes that
need to be expressed to train a cell to be a really good killer and finally we
use a lot of high resolution imaging on live cells to see what happens to make
the killing effective.
What we really need is a big enough bag of tricks to
understand in detail the mechanisms that control the killer T cells so that every
time a cancer cell comes up with its new strategy to try and avoid the immune
system, that we have a trick up our sleeve to deal with that.
I head up a team
that's a new team really working and focusing on a new type of technology
really on a new breakthrough called CRISPR or genome editing.
This is a new technology that allows us to essentially rewrite the DNA that's
within all of our cells, correcting mistakes in that DNA.
So the field has really exploded
over the last few years and we're really able to do more now
than we've ever been able to do in the entirety of history.
Now CRISPR is essentially
the exploitation of an antiviral defense system that exists in
all sorts of different species of bacteria and scientists have taken that
and taken components of that to be able to rewrite DNA in all manner of cells
and all manner of organisms.
Gene editing is really essentially a two-part system
there is a GPS location and there is a pair of molecular scissors. The GPS
locator directs the molecular scissors to a specific part of the DNA to be able
to make its cut and at that point there, the cut, the removal and the
replacement of the DNA can occur.
What we hope to be able to do is once we've
corrected the cells in the petri dish, is to be able to put them back into the patient.
Now what that will do is, it will not be
a therapeutic against a particular disease or it will alleviate the
disease - that could potentially be a complete cure for that disease, for that individual.
What this technology also does is that it
allows us to look down within a cell and to tinker and really understand what's
going on, how cells work at the most fundamental of levels and that allows us
to do all sorts of things. That allows us to turn a cell into a computer for
example, to record information into a cell, to program cells to do specific
things. Very soon in the near future we'll see some diseases being completely
cured, simple diseases being cured by CRISPR technology or genome editing
technology with more and more complex diseases being tackled over the next
few years.
So we're working with regulators and with clinicians to ensure
patient safety is paramount.
Clearly the field of therapeutics offers many exciting new treatments, the
prospects of all sorts of amazing discoveries but it's important to
remember that these benefits are not free from risk or controversy.
Topping most people's lists of issues to be concerned with is the prospect of
designing some sort of post human race.
So to avoid the metaphorical shipwreck
it is really important that we bring together people who are expert in all
aspects of technology and society including law and ethics to identify
and evaluate the various risks, benefits, themes and trends.
So I think in 50 years
that we really will be able to manipulate these cells with exquisite
specificity and I think being able to control what is
a fabulous and effective little cell within our body to help the immune
system when it needs to be helped or when it begins to go rogue, we'll be able
to do that in 50 years.
Gene editing itself is so versatile it feels a bit
like sometimes the sky is the limit.
I could see a situation where in twenty, twenty five years
in the future, that people could be engineering synthetic cells that go
inside people and survey around their body looking for disease and dealing
with disease as it arises.
Right now if something goes wrong you might need a
donor in order to get a replacement part but in 50 years we might just be able to
walk into a room and have there be shelves full of donor parts for all
different tissues in the body because of tissue engineering.
What my vision is, is
that people who have heart attacks, who have damaged hearts, we'll be
able to provide a patch through a cardiac surgeon as you go for a bypass
now you'd go from bypass and maybe a heart patch as well and we'll be able to
restore those hearts back to normal which means that people who currently
aren't able to do simple things like walking up stairs or having a normal
life can get back to doing just normal things that you and I take for granted
and having a normal lifespan as well.
In terms of the future and I'm aiming the
longer term future now, I see a very large change in the way the healthcare
delivered so you have new therapeutic regimes which may be done for example
in the home environment and maybe the diagnostics will be done there and
even eventually the treatments in the home and very much angled against
the individual, so it's personalized in the home environment or if it's a more
serious disorder, a longer term disorder, that may be that will be
conducted in a hospital environment but because of the therapeutics can be
delivered by the patient with the patient's own materials it's probably
going to change the way hospitals are established, the way the companies interact
because they'll have a product which
actually comes to the patient side or the bedside and very different geometry
from the way it's done right now. And if you can get to that stage you can of
course save masses of money in the final healthcare treatment regime.
I think the most exciting thing from my point of view is the fact that you're
bringing into into therapeutics and treatments of patients a whole range of
technologies. It's called convergence in the technical jargon but you're bringing
them all together to create a totally new treatment regime and that's right
the way from how you handle the patient to actually delivering the final
therapeutic product and that's the exciting thing I think.