Dr. Sheng Ding at Scripps Research Institute

SingularityHub.com, February 16, 2011, by Peter Murray  —   Dr. Sheng Ding pioneered a method by which skin cells are converted to heart cells without going through an induced pluripotent stem cell state.

It’s faster, more powerful, and user-friendly. No, I’m not talking about the latest generation tablet, I’m talking about the latest upgrade in stem cell research. The transformation of adult cells from one type to another is common enough. We’ve reported on researchers successfully transforming skin cells into heart, blood, and intestinal cells. This process typically involves converting the adult cell to a pluripotent, stem cell state, from which it can differentiate into one of the specialized forms. As if the cell one day realized that it never really wanted to grow up to be a skin cell, scientists could help revert it back to its infant—or, embryonic—state so it could have another go at life. A recent study by scientists at the Scripps Research Institute in La Jolla, California showcases a different method that bypasses this initial transformation to the stem cell state. Apparently you can teach an old dog new tricks.

Over the last decade scientists have had increasing success in converting skin cells and other types of cells into something different, including heart and blood cells. Efforts are underway across the world to improve the techniques and clinical viability of these cell conversions. The work by Dr. Sheng Ding and his colleagues at Scripps qualifies as a major improvement. The road ahead still requires much work, but it’s clear that each day mankind moves closer to producing cells of every type, custom made for your body.

Faster

The novelty of the new research coming out of Scripps is not going from skin cells to heart cells beating in a dish—that stuff’s becoming old hat—but that they accomplished it in just 11 days. It is normally a two step process that requires four to five weeks. It also requires a lot more work, owing to the step where the skin cells are converted to induced pluripotent stem cells (iPS). This is done by introducing four genes recently discovered to reprogram differentiated adult cells to embryonic stem cell-like pluripotency. The four genes encode transcription factors, proteins in the cell nucleus that regulate the expression of other genes. Typically the four genes are active for two to four weeks before the differentiated cell is converted to an iPS cell. Ding’s group modified this protocol by allowing the genes to work for as little as four days before deactivating them. The result are skin cells “pushed” in the direction of the induced stem cell state without actually becoming iPS cells. Turns out that’s enough, which, aside from saving time, reveals something new about stem cell biology. The current work was performed using skin cells from mice and it remains to be seen if the shortcut can be applied to human skin cells. Nevertheless, to render the iPS cell stage unnecessary is a major paradigm change for the field and it will be interesting to see if the new paradigm bolsters progress in the near future.

You can see the beating cells in a video below from newsy.com’s coverage of the study:

More Powerful

In addition to being faster, Ding’s protocol boosts efficiency. The old protocol yields an estimated maximum of approximately 0.2 heart cells for every skin cell plated. Skipping the iPS cell stage yields a whopping 1.2 heart cells per skin cell. In the paper the team speculates that the increased efficiency is due to the generation of mitotically active cells which are able to divide and multiply. Resembling heart precursor cells, they speculate further that “these intermediate cells, if successfully isolated and stabilized in culture, could become an expandable and renewable source for not just cardiomyocytes, but many other terminally differentiated cardiovascular cells as well.” In the paper they extend this thought, suggesting that the principle of a versatile intermediate might be important, not only for creating the numerous types of cells that go into making a heart, but for stem cell applications in all tissues.

Scientists at the Scripps Research Institute needed just eleven days to convert skin cells

into beating heart cells.

User Friendly

The four genes that researchers use to produce the iPS cells is risky because these same genes can turn cells into tumors. Inactivating them after only a few days instead of a couple weeks reduces this risk. And, like any self-respecting technology, an upgrade is in the making. Because they can turn cells cancerous, stem cell researchers have been searching for a way to reprogram differentiated cells into iPS cells without using the four genes altogether. Demonstrating that the genes are only needed for a few days instead of weeks simplifies the problem and makes the genes easier to replace.

To be sure, stem cell research has a lot of ground to cover before it becomes an effective treatment for disease. For example, the current study was done in mice and it remains to be seen whether or not the shortened protocol produces the same results in human cells. I find it impressive, however, that the four genes widely used by researchers to convert fully-differentiated, adult cells into embryonic-like, pluripotent stem cells were discovered less than five years ago. Since then iPS cells have been gotten by converting other cells besides skin, including cells from the stomach and liver. The current study was the first that we are aware of to bypass the iPS cell stage for differentiation to heart cells, but this shortcut has already been taken for differentiation into blood cells. It is exciting to note that human cells were used in that study.

But in case you hadn’t heard, stem cells have already been used in tissue replacement therapies. We’ve previously reported on tracheal transplants of two women. This involved a donor trachea (from a cadaver) that was coated with a layer of the patients’ stem cells which fostered regrowth of the trachea. Because the new layer of cells originated from the patient the risk of an immune response against the new trachea was minimized.

From my vantage point, it seems that stem cell therapies are inevitable. I also believe that the day is long in coming. Unfortunately it seems that many people have been set up to hope for miracles after the hyperbolic political battles over stem cell research in the past. But therapies rarely come from sudden miracles. Instead it is the incremental advances and shifts in paradigm, such as that achieved by Ding and his colleagues, that will bring us the stem cell therapies we are hoping for.

[image credit: The Scripps Research Institute]

SingularityHub.com, February 16, 2011, by Aaron Saenz  —  HealCam pairs patients with similar conditions for anonymous web chats. It doesn’t seem to be getting much traffic. Maybe they really should get Jessica Alba to log on.

A new website is looking to pair up patients anonymously to help them find a community of their peers. When you have a serious or chronic illness, it can feel like no one understands what you’re going through. Doctors may be able to explain what happens to you, but can they empathize with the pain, the discomfort, and the depression? Maybe you should talk to another patient. Maybe you should use HealCam. Created by doctors Michael and Gene Ostrovsky of MedGadget, Healcam lets you chat with others anonymously via your webcam. There are no forms to fill out, no registration needed, you simply select the topic you wish to discuss and the gender with which you’re most comfortable. HealCam will pair you with other patients so you can discuss the medical issues on your mind. Don’t like who you’re talking to? Press a button and you’ll get paired with someone new. It’s like Chatroulette, but with more compassion and less full frontal nudity. So far, HealCam is off to a slow start, but it’s another example of how the web is empowering patients to find ways they can support and treat themselves.

The concept behind HealCam seems fairly simple. Patients talk to other patients to exchange stories and draw comfort from shared experiences. They may even use the conversation to learn about new treatments or new research. In that way, HealCam isn’t that different from other patient communities we’ve seen before, including the Patients Like Me site that Jamie Heywood promoted at TEDMED two years ago. In the ecosystem of patient communities, HealCam operates in a valuable niche: anonymous connections with quick video chats. It’s not an all-encompassing concept by any means. Patients who want to track data with other patients, or share in a more public forum, will have to transition to other sites. Still, for what it provides, HealCam is a great idea.

Which is why I’m hoping it starts doing better soon. While the Ostrovsky’s have had success building a website before (MedGadget) HealCam seems to be floundering. The site opened on June of 2010, but according to comments Michael Ostrovksy made to ABC News, it still is only getting up to 2000 visitors a day, and that’s in uneven spurts. When I logged on to HealCam recently there was exactly 1 visitor – me. Which is less than optimal for a webcam conversation. Even if my trial was a complete rarity, HealCam will still probably need to garner many more regular users before it can be a great help to any of its visitors. I hope the good doctors Ostrovsky have more luck in the future.

Was I really the only one on HealCam on a weekday afternoon? A fluke perhaps? Hopefully traffic will get much better for the fledgling site.

If they fail, however, I’m fairly confident that someone else will take their place in some new form. The general trend of patient empowerment continues because of the underlying promise the internet holds to that end. The merger of information technology and medical is poised to revolutionize healthcare, but we haven’t quite seen the benefits yet. There have been several promising technologies in the works, including AI programs that could assist doctors in diagnosis, growing databases of research on specific disorders (like Autism), and large biobanks of samples linked to patient histories. Once fully realized, the combination of IT and medical research will give doctors a flood of new insights into our health.

But it is still our health, and information technology is a tool that patients can wield as well. We’ve seen continuous body monitors that you can use to track your own vital stats. There have even been extraordinary patients who, by taking their treatments into their own hands, have expanded upon and improved healthcare for other patients who share their illness. Healcam, or a site that succeeded in a similar mission, could be a valuable tool in bringing patients together to help them share their personal insights in a way that empowers them all. There is strength in numbers and comfort in knowing you’re not alone. HealCam has the right idea, let’s hope that they get it to work.

[image credits: HealCam]
[sources: HealCam Blog]

Heywood at TEDMED – Information is a Patient’s Power (Video)

Heywood’s website, Patients Like Me, uses analysis to find insight into healthcare

for those with debilitating illnesses.

SingularityHub.com, by Aaron Saenz  —  Jamie Heywood is out to convince you that the most powerful tool in medicine is information. He is the head of Patients Like Me, an online community of more than 45,000 patients with serious illnesses who track their experiences over time. Of all the presentations at TEDMED I’ve seen so far, Heywood’s is perhaps the most touching and personal. On a quest to save his brother from ALS, he created a system that could harness the collective knowledge of patients into a useful tool for guiding their treatment. His brother died, but now those with ALS, HIV, MS, and many other long term debilitating illnesses can compare their symptoms and healthcare choices with a larger community of patients. The same sort of analysis that we’ve been using with stocks and economic models is applied to medical records, and the result is an amazing array of predictive tools that could change the way we view healthcare. Check out Heywood’s presentation below. Many thanks to TEDMED for making these videos available online.

If you don’t have 17 minutes to watch the entire talk, here is an outline I’ve put together which can help you find the parts you’ll find most enlightening:

0:24 – Heywood begins his talk and tells the story of his brother Steven who was diagnosed with and died from ALS.
2:08 – Steven’s status (emotional, physical, etc) was recorded over time and converted into data.
3:50 – The idea of converting stories and status into computable information gave birth to the online community Patients Like Me (PLM)
5:00 – PLM lets people on prescription drugs share side effects, successes, and failures on an open network that anyone can access.
6:20 – Looking at a specific profile on PLM let’s you see how that patient fits into the wider statistical dataset. The result is stunning analysis and integrated data comparison.
7:40 – Heywood shows how PLM can take a word cloud of Steven’s data and place it into a comparison chart that gives insight into how prescriptions, lifestyles, etc may influence symptoms.
9:00 – Patients and doctors alike can use a PLM fact sheet, complete with graphs, to help make informed decisions on treatments.
10:05 – A paper published relating the use of lithium to improvements in ALS patients lead some PLM members to take the drug as a possible treatment for their condition.
11:30 – For the next several minutes, Heywood steps us through the analysis of what this non-clinical trial of lithium meant for the patients who tried it. By comparing patients with well matched datasets, you could see that the lithium didn’t lead to improvement. Heywood predicted the failure of lithium to treat ALS one year ahead of the FDA clinical trial which came to the same conclusion!
15:05 – Heywood ends his talk by looking at a stem cell treatment his brother received. Using current analysis on PLM, he can see that the trial was unlikely to work. If he had known that then, he could have saved he and his brother millions. That same tool can help save others now.

Heywood isn’t the only advocate of patient enabled data analysis.  Curetogether.com offers a similar service that has been expanding and improving in recent months.  The recent Health 2.0 conference took this issue as its central focus.  These innovators are finding that collecting and sharing data in a reliable way is an immensely powerful tool for maintaining your health. With the growing availability of continuous body monitoring systems, the available data is increasing and so must our analysis. I love Heywood’s idea of leveraging the analytical might of the financial industry for the medical field. The more we know, and the better we know it, the smarter the decisions we can make. And when it comes to medicine, living smarter means living longer and healthier.

[screen capture and video credit TEDMED]

Hello…Doctor?

SingularityHub.com, by Keith Kleiner  —  One of the exciting ideas being tossed around recently over at the Xprize Foundation is the creation of an Artificial Intelligence physician that you could access from your smartphone.  Have a strange rash on your arm and chest?  Take a photo of the rash with your phone and allow the AI physician to compute whether your rash matches smallpox or poison ivy from it’s image database.  Want advice on whether your chest pain is heartburn or a heart attack?  Ask the AI!  The possibilities are enormous.  Especially for the billion plus people around the world who live more than a few hours walk or drive from the nearest doctor, the AI physician would represent a revolution in health care.  Singularity Hub has exclusive footage of an Xprize promotional video that shows the vision for an AI physician.  Check it out below:

The Xprize foundation hopes to propel the world as quickly as possible towards the creation of an AI physician by hosting a multimillion dollar competition for the first team that can create an AI that meets certain criteria.  Sadly, the Xprize has yet to get the competition up and running.

Yet with or without the help of the Xprize, technology is advancing in ways that are making it ever more possible to develop a useful AI physician.  Modern smartphones already have ample broadband speed, processing power, and access to the world’s information at their disposal.  Combine this with recent advances in narrow AI, such as voice recognition and image comparison capability, and clearly the pieces are already in place.

Even though a formal AI physician has not yet seen widespread success, smartphones have nevertheless made several strides in this direction.  AirStrip Technologies is developing a suite of hardware/software solutions that allow physicians and nurses to monitor important vital signs from their smartphone.  Several hardware attachments, such as a microscope, have been created to transform your smartphone into a medical device.

Considering all of the individual applications and hardware attachments that are out there,one might even argue that the AI physician is already here.  But this I think misses the point.  Hardware is a different matter, but at least on the software side what we really need is a single application for our smartphones that brings all the pieces together in one place.  When sickness calls, we cannot be expected to search through all of the different resources that are out there to solve the problem.  Instead what we need is a single AI application that we can tell our problem to, and then allow this application to take care of the rest.  I hope the Xprize can get its AI physician competition up and running soon.  Entrepreneurs, if you are listening, please get on it already – the improved healthcare of billions is at stake.

[image credit: http://iphonedoktor.dk/]

The song I Am the Very Model of a Singularitarian begins

I am the very model of a Singularitarian
I’m combination Transhuman, Immortalist, Extropian,
Aggressively I’m changing all my body’s biochemistry
Because my body’s heritage is obsolete genetically,
Replacing all the cells each month it’s here just temporarily
The pattern of my brain and body’s where there’s continuity,
I’ll try to improve these patterns with optimal biology,
(“But how will I do that? I need to be smarter. Ah, yes…”)
I’ll expand my mental faculties by merging with technology,
Expand his mental faculties by merging with technology,
Expand his mental faculties by merging with technology,
Expand his mental faculties by merging with technology

And with our new technology, renewable clean energy,
Remove our pathogens and overcome hunger and poverty
In short I am a Transhuman, Immortalist, Extropian
I am the very model of a Singularitarian
In short he is a Transhuman, Immortalist, Extropian
He is the very model of a Singularitarian

Charlie Kam was the author and singer of this song and is Conference Chairman of TransVision 2007, Sustaining Donor for the Singularity Institute for Artificial Intelligence, and President of Greenpack Construction in Chicago, building state-of-the-art, solar powered homes that implement all types of recycling.

A Chicago native, Charlie is a renowned singer/song writer and entrepreneur as well as a member of the World Transhumanist Association, Immortalist Institute, World Future Society, Singularity Institute, and Alcor.

He is best known for his musical parody of Ray Kurzweil’s Singularity, “I am the very model of a Singularitarian” which has been a favorite among transhumanist and futurist community blogs. IEEE Explore magazine recently compared his song to Kurzweil’s definitive work, The Singularity is Near suggesting that you can just listen to his song if you don’t have time to read Kurzweil’s 600+ word tome. Charlie boasts a number one ranking on Last FM online radio, “the social music revolution” and a video version of the Singularitarian song on YouTube.

As Founder of Greenpack Construction, Charlie builds state-of-art, solar powered homes that implement all types of recycling. He believes that the potential of solar power to safely and cleanly, solve most all of our world’s energy problems, and decrease much of the pollution and environmental destruction caused by using fossil or nuclear energy, has been conspicuously ignored. He is taking action by building homes and buildings that attempt to provide all of the power by way of solar energy. Greenpack Construction has the first market rated L.E.E.D. certified platinum level green energy condominiums ever constructed in the city of Chicago.

The LEED Green Building Rating System is a standard that measures sustainability. There are four levels that buildings can achieve from the LEED rating system: certified, silver, gold and platinum being the highest. As of July 2005, there are only nine platinum-certified “new construction” buildings in the entire world — two of these buildings are located in India and six in the United States.

You can find some of his songs on YouTube: I Am the Very Model of a Singularitarian, Transhumanism, Cryonic World, Heaven Can Wait, Atheist, Transvision 2005 Conference in Venezuela (theme song), and Transvision 2006 Conference in Finland (theme song). Read his song lyrics.

Elephants blamed for TB outbreak at Tenn. refuge

GoogleNews.com, FORBES.com, February 16, 2011, by Mike Stobbe, ATLANTA — A tuberculosis outbreak among workers at a Tennessee elephant sanctuary is being blamed on the pachyderms.

Elephants can carry TB, and there have been reports of them spreading it to people who touch them. But three of the eight workers infected with TB in 2009 weren’t in direct contact with the elephants.

The three worked in a building next to an elephant barn at the refuge in south-central Tennessee.

Investigators believe the TB bacteria spread through the air when the elephants sneezed, or through pressure washing or dust from sweeping the barn.

The Centers for Disease Control and Prevention released the report this past Wednesday in the journal Emerging Infectious Diseases.