>> Doctor Elisseeff, please.
>> So, I come from an engineering background,
and I think one of the great things about being at Hopkins
is that engineers can work together with clinicians
to provide new clinical solutions.
Engineering can also be considered a bridge
between the basic science, these new discoveries,
and how are we gonna actually have this help a patient?
Alright, there's a lot that goes in
to taking this basic science discovery,
and build a product out of it that can be delivered.
So, I can go to my surgical colleagues and say,
"well, what is the problem
"that you've faced the most today?
"What are your biggest challenges?"
And we go back to our sort of engineering design,
come up with a prototype,
and then can go back to our surgical colleagues and say,
"what do you think of this?"
"Well, this is great, but I don't like that."
So we go back and redesign.
So that applies to the field of tissue engineering too.
So tissue engineers, sort of the evolution of devices.
So you think of artificial hearts,
artificial knees, and hips.
Alright, those replacements were able
to perform the function of the knee and the hip.
But they're not yours.
They're not made of the same thing in your body.
So what tissue engineering is trying to do is,
give you a tissue replacement
that is actually from your own body.
So initially, the field developed such
that we built biomaterials
that served as a temporary scaffold for cells,
and that temporary scaffold will give directions
to those cells to grow and make new tissue.
And the scaffold goes away,
and what you're left with is just your functional tissue.
So we noticed,
when I first started at Hopkins a few decades ago,
that this was very exciting.
But, it wasn't reaching the clinic yet.
So, we went and looked at building materials
that we could use to induce your body to repair itself.
So we have some repair capacity,
maybe not as good as the salamander,
but there's still some there.
And how can we put in materials that can direct your body
to be able to repair better.
We first started in cartilage in the knee joints,
and now we're moving to soft tissue.
We've done a couple of clinical trials,
and the ability to not just design products
with our clinical colleagues,
but to actually translate those,
and run clinical trials had a huge impact
in helping these things to reach the clinic,
but also teaching us what we should
be looking at in the laboratory.
And one example of that goes back
to what we heard about this morning,
the immune system.
So, in one of our clinical trials,
we noticed that the immune system seemed
to play a really important role in the biomaterial response.
And so, I didn't really know anything
about the immune system,
so that was a great opportunity to go away on sabbatical,
and learn something about it,
and come back to Hopkins
and work with immunology colleagues at Hopkins
to see how we could leverage your immune system
to promote tissue regeneration.
We're calling this Regenerative Immunology.
So we're very excited about that.
As a future, we're really not working
with stem cells too much anymore,
but how can we use immune cells
to help direct your body's own stem cells
and other capabilities to regrow tissues.
Now, we had some collaboratives come to us
and talk about the challenges of both regeneration
and chronic disease associated with aging.
And so, why is it harder to repair things,
repair your tissues when you're older?
Well, there's a cell type that accumulates with age,
called a senescent cell.
And initially we thought,
well this senescent cell is just tired,
it's pooped out, it's not dividing anymore.
But, it's not actually just a quiet bystander.
It's secreting a lot of things that promote inflammation,
the negative kind of inflammation,
that is affiliated with chronic disease,
and also impedes regeneration.
So we're looking at ways that we can get rid of these cells,
so we don't have any more of these sort of,
senescent bystanders that are impeding
the local environment,
and we can put in our materials,
we can put in our technologies to induce
your own repair capacity,
or work with stem cells to try to rebuild new tissues.
So, it has been slow over the past decade or two,
these technologies reaching the clinic.
But I really believe there is a real revolution
happening now with new approaches
and real practical technologies
that come from working with our clinical colleagues,
and understanding what is feasible
to work in the doctor's office or the surgical suite.
What do we need to do to design something
that will solve those problems,
in addition to the biology of rebuilding your tissues.