Aaron Morris How your body could become its own diagnostic lab TED Fellows
[SHAPE YOUR FUTURE]
(Slam)
Ow!
As anyone who’s stubbed a toe in the dark
or spent an hour
searching for their keys knows
we’re often limited
by what we can or cannot see.
In fact, even our own bodies
can be black boxes.
Today, I want to take you
through a vision of health care
that scientists and engineers,
myself included, are building.
We are creating a diagnostic lab
inside your body
that can provide a continuous
analysis of your health
so that we can better see
what’s happening in patients.
Currently, if someone is sick,
we may diagnose them by using a biopsy
to bring disease tissue
outside the body where we can see it.
We do this if we suspect, for instance,
that a growth might be cancerous.
Unfortunately, this approach
can’t work all the time
because of two major problems.
First, some tissues,
like brains or spinal cords,
can’t be routinely biopsied.
And second, doctors often don’t know
which tissue is causing the problem,
so they don’t know what to biopsy.
So far, we’ve dealt with these issues
using external medical tests,
like MRIs or blood tests.
These provide a broad overview
of the health of a patient,
but they can’t see
the molecular and cellular changes
that occur within tissues,
and they certainly
can’t provide enough information
to proactively treat patients
before symptoms develop.
This is unfortunate
because it’s these invisible changes
that ultimately cause disease.
Our inability to measure these changes
results in a disparity
between what we can see on a test
and what we know is happening in patients.
Let’s take multiple sclerosis
as an example.
In MS, which is an autoimmune disease,
the immune system
attacks two specific tissues:
the brain and the spinal cord,
resulting in damage
and in some cases, paralysis.
Now, we obviously can’t catch MS
by routinely biopsying people’s brains,
where there would be abundant
and active disease-inducing cells.
And we can’t catch it using a blood test
because the MS-inducing cells
are so rare and inactive in the blood
that we simply can’t see them.
Even brain imaging technologies like MRI
can’t provide the information we need
to be proactive about MS.
So we need to rethink how we see.
My coworkers at the University of Michigan
and I decided to do just that.
Instead of taking an outside-in
approach to diagnostics,
we’re taking an inside-out approach.
We are creating implantable sites
that have similarities
to other sites in the body,
and will improve our vision
by giving us real-time access
to molecular and cellular information
about diseased tissues.
These insights will enable us
to predict the onset of disease
and even identify therapies
likely to work in an individual patient.
So what does this
inside-out approach look like?
Step one is to engineer new tissues
just under the skin.
These tissues have similarities
to other inaccessible sites in the body,
like the brain or the lungs.
By implanting a porous plastic disk
made of FDA-approved biomaterials,
I can harness the body’s natural responses
to allow cells to migrate into the disk,
survive at the site and form a tissue.
Eventually, we’re left
with an engineered tissue
with integrated immune cells,
just the cells we need for diagnosis.
Although these tissues are complex
and chronically inflamed,
they’re also innocuous
and after a few weeks,
nearly imperceptible.
Our engineered tissues contain information
not present in the blood,
and they can help bridge the gap
between what we can see
on a traditional test
and cellular changes
we know occur in disease.
Step two is to read this signal.
Currently, I could take a biopsy
of my engineered site and analyze it
because I made them accessible
just under the skin.
But it would certainly be better
if we could incorporate
and read a sensor noninvasively.
Within the next decade,
rapidly converging technologies
could enable diagnosis at such an implant
by harnessing simple detectors,
like a blood pressure cuff
or smartwatch does now.
The mechanisms for diagnosing
and monitoring disease
could be as simple as opening an app,
like Candy Crush on your phone.
Step three is to harness
the huge array of knowledge
in fields like engineering
and material science
to improve these implants
and our ability to read their data.
Eventually, tens, if not hundreds
of individual engineered tissues
with integrated sensors
may be implantable
with a single application.
Now, this approach to diagnosis
is unconventional, to be sure,
but it is robust.
So far, my colleagues and I have used it
to diagnose models of metastatic cancer,
type 1 diabetes, multiple sclerosis
and organ transplant rejection.
But this is just the beginning
of what we can see.
With continuous improvements,
we will be able to truly create
a diagnostic lab inside your body
that provides a continuous
analysis of your health.
By changing how we see
what’s going wrong in patients,
we will be able to diagnose
and treat diseases better
and faster than ever before.
If you’re willing to rethink how you see,
you may be surprised what comes into view.
Thank you.