New (body) parts for old

Earlier this week, we started out on replacement organs. We started with a look at news of an artificial eye – a video camera, which directly stimulates the patient’s retina. Today, we’ll continue – taking a tour through various synthetic body components, such as joints. We’ll go on to cover bioengineering, a technique where we encourage living tissues to grow outside the body. This is done using carefully-constructed scaffolds, often obtained by stripping cells from a donor organ. We’re going to be continuing this theme today.

I’ll crack on…

Artificial livers

Currently, artificial livers are unwieldy machines, which have to be placed at the bedside. They work by trapping liver cells from a donor (human or animal) and passing blood plasma over them. A membrane means the incompatible cells don’t mix, preventing an immune system reaction. Presently, they’re not the kind of thing you could be plumbed into while playing rugby – or even watching it. However, it’s possible that a far smaller version can potentially be brought to market. The proposed device is around the size of a small drinks can. While it can’t fully replace the liver, it will allow the weakened organ time to regenerate. Alternatively, it may help the patient stay alive long enough to receive a transplant.

Firms to watch: Vital Therapies.

Joint replacement

I almost forgot to include this, as it’s now so routine a procedure. Both my paternal grandparents had hip replacements well over a decade ago. My final year project at university was working with a firm that made artificial hips. We have also been able to replace knees and ankles for decades. Despite being an established field, there’s still ongoing progress – and a rapidly-expanding market, due to ageing and affluence. However, if you’re looking for a breakthrough, check out the cartilage firms instead, as these are going to put a lot of pressure on the joint replacement market. Nevertheless, the expansion of advanced healthcare into middle-income countries should secure a bright future for these prosthetics, in decades to come.

Firms to watch: Stryker, Biomet, Implantcast, DePuy.

Artificial corneas

The cornea is the outer part of the pupil – a thin, transparent layer on the outside of the eye. Injury or infection can cause it to become damaged, meaning that a transplant is needed. Corneas are in demand. Luckily, they’re one of the few donor organs that don’t degrade immediately after death – easing supply constraints. Nevertheless, as with all transplant surgery, there are still issues in ensuring an adequate supply of clean, healthy donations. In future, we may be able to grow living corneas on a scaffold material (a technique known as bioengineering). The technology is at the Phase I trial stage, with promising opportunities for other tissues, such as bone, in due course. Building new parts for eyes is nothing new. We’ve had synthetic lenses for decades, which are routinely used in cataract operations. The difference here is that the new corneas are actually made of living tissue.

Firms to watch: Electrospinning Company.

Penis and vagina construction

I’ve always been fairly comfortable with my gender, but it’s becoming clear that there are large numbers of people worldwide who aren’t. The more realistic and natural that gender reassignment surgery can become, the more easily patients can return to having a normal life afterwards. Such treatment might seem like a nice-to-have, akin to a facelift. That view is entirely incorrect. The shocking suicide rate among transgender people shows that it’s a very serious health problem. From a healthcare economics point of view, cutting suicide is important – not least as it often happens at the start of an individual’s economically productive life.

A connected organ, the bladder, is bag-like and therefore more complex (Level 3). Bioengineered bladders have already been produced and implanted. An equivalent procedure is potentially available for men, with bioengineered penises having been successfully implanted on to rabbits. We know it was successful, because they went at it like rabbits – producing the offspring to prove it. However, as a solid organ containing complex tissues (ie, a Level 4 organ), producing human-sized penises is difficult. Furthermore, the process still requires a decellularised donor organ, into which the patient’s own cells are implanted, and these aren’t readily available. Such complexities mean it’s likely that components of the penis, such as the erectile tissue, will be more commonly replaced than will the whole organ. That’s the same approach which we discussed previously, in the context of heart valves.


We’ll be back on this theme tomorrow, to finish up our mini-series. Feedback’s best sent then – but you can also write in now: andrew@southbankresearch.com.

Best,

Andrew Lockley
Exponential Investor

Category: Genetics and Biotechnology

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