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  • I'm going to talk to you today about

  • hopefully converting fear into hope.

  • When we go to the physician today --

  • when we go to the doctor's office and we walk in,

  • there are words that we just don't want to hear.

  • There are words that we're truly afraid of.

  • Diabetes, cancer, Parkinson's, Alzheimer's,

  • heart failure, lung failure --

  • things that we know are debilitating diseases,

  • for which there's relatively little that can be done.

  • And what I want to lay out for you today is

  • a different way of thinking about how to treat debilitating disease,

  • why it's important,

  • why without it perhaps our health care system will melt down

  • if you think it already hasn't,

  • and where we are clinically today, and where we might go tomorrow,

  • and what some of the hurdles are.

  • And we're going to do all of that in 18 minutes, I promise.

  • I want to start with this slide,

  • because this slide sort of tells the story the way Science Magazine thinks of it.

  • This was an issue from 2002

  • that they published with a lot of different articles on the bionic human.

  • It was basically a regenerative medicine issue.

  • Regenerative medicine is an extraordinarily simple concept

  • that everybody can understand.

  • It's simply accelerating the pace at which the body heals itself

  • to a clinically relevant timescale.

  • So we know how to do this in many of the ways that are up there.

  • We know that if we have a damaged hip, you can put an artificial hip in.

  • And this is the idea that Science Magazine used on their front cover.

  • This is the complete antithesis of regenerative medicine.

  • This is not regenerative medicine.

  • Regenerative medicine is what Business Week put up

  • when they did a story about regenerative medicine not too long ago.

  • The idea is that instead of figuring out how to ameliorate symptoms

  • with devices and drugs and the like --

  • and I'll come back to that theme a few times --

  • instead of doing that, we will regenerate lost function of the body

  • by regenerating the function of organs and damaged tissue.

  • So that at the end of the treatment,

  • you are the same as you were at the beginning of the treatment.

  • Very few good ideas -- if you agree that this is a good idea --

  • very few good ideas are truly novel.

  • And this is just the same.

  • If you look back in history,

  • Charles Lindbergh, who was better known for flying airplanes,

  • was actually one of the first people

  • along with Alexis Carrel, one of the Nobel Laureates from Rockefeller,

  • to begin to think about, could you culture organs?

  • And they published this book in 1937,

  • where they actually began to think about,

  • what could you do in bio-reactors to grow whole organs?

  • We've come a long way since then.

  • I'm going to share with you some of the exciting work that's going on.

  • But before doing that, what I'd like to do

  • is share my depression about the health care system

  • and the need for this with you.

  • Many of the talks yesterday talked about

  • improving the quality of life, and reducing poverty,

  • and essentially increasing life expectancy all around the globe.

  • One of the challenges is that the richer we are, the longer we live.

  • And the longer we live, the more expensive it is

  • to take care of our diseases as we get older.

  • This is simply the wealth of a country

  • versus the percent of population over the age of 65.

  • And you can basically see that the richer a country is,

  • the older the people are within it.

  • Why is this important?

  • And why is this a particularly dramatic challenge right now?

  • If the average age of your population is 30,

  • then the average kind of disease that you have to treat

  • is maybe a broken ankle every now and again,

  • maybe a little bit of asthma.

  • If the average age in your country is 45 to 55,

  • now the average person is looking at diabetes,

  • early-onset diabetes, heart failure, coronary artery disease --

  • things that are inherently more difficult to treat,

  • and much more expensive to treat.

  • Just have a look at the demographics in the U.S. here.

  • This is from "The Untied States of America."

  • In 1930, there were 41 workers per retiree.

  • 41 people who were basically outside of being really sick,

  • paying for the one retiree who was experiencing debilitating disease.

  • In 2010, two workers per retiree in the U.S.

  • And this is matched in every industrialized, wealthy country in the world.

  • How can you actually afford to treat patients

  • when the reality of getting old looks like this?

  • This is age versus cost of health care.

  • And you can see that right around age 45, 40 to 45,

  • there's a sudden spike in the cost of health care.

  • It's actually quite interesting. If you do the right studies,

  • you can look at how much you as an individual spend on your own health care,

  • plotted over your lifetime.

  • And about seven years before you're about to die, there's a spike.

  • And you can actually --

  • (Laughter)

  • -- we won't get into that.

  • (Laughter)

  • There are very few things, very few things that you can really do

  • that will change the way that you can treat these kinds of diseases

  • and experience what I would call healthy aging.

  • I'd suggest there are four things,

  • and none of these things include an insurance system or a legal system.

  • All those things do is change who pays.

  • They don't actually change what the actual cost of the treatment is.

  • One thing you can do is not treat. You can ration health care.

  • We won't talk about that anymore. It's too depressing.

  • You can prevent.

  • Obviously a lot of monies should be put into prevention.

  • But perhaps most interesting, to me anyway, and most important,

  • is the idea of diagnosing a disease much earlier on in the progression,

  • and then treating the disease to cure the disease

  • instead of treating a symptom.

  • Think of it in terms of diabetes, for instance.

  • Today, with diabetes, what do we do?

  • We diagnose the disease eventually, once it becomes symptomatic,

  • and then we treat the symptom for 10, 20, 30, 40 years.

  • And we do OK. Insulin's a pretty good therapy.

  • But eventually it stops working,

  • and diabetes leads to a predictable onset of debilitating disease.

  • Why couldn't we just inject the pancreas with something

  • to regenerate the pancreas early on in the disease,

  • perhaps even before it was symptomatic?

  • And it might be a little bit expensive at the time that we did it,

  • but if it worked, we would truly be able to do something different.

  • This video, I think, gets across the concept that I'm talking about quite dramatically.

  • This is a newt re-growing its limb.

  • If a newt can do this kind of thing, why can't we?

  • I'll actually show you some more important features

  • about limb regeneration in a moment.

  • But what we're talking about in regenerative medicine

  • is doing this in every organ system of the body,

  • for tissues and for organs themselves.

  • So today's reality is that if we get sick,

  • the message is we will treat your symptoms,

  • and you need to adjust to a new way of life.

  • I would pose to you that tomorrow --

  • and when tomorrow is we could debate,

  • but it's within the foreseeable future --

  • we will talk about regenerative rehabilitation.

  • There's a limb prosthetic up here,

  • similar actually one on the soldier

  • that's come back from Iraq.

  • There are 370 soldiers that have come back from Iraq that have lost limbs.

  • Imagine if instead of facing that, they could actually

  • face the regeneration of that limb.

  • It's a wild concept.

  • I'll show you where we are at the moment in working towards that concept.

  • But it's applicable, again, to every organ system.

  • How can we do that?

  • The way to do that is to develop a conversation with the body.

  • We need to learn to speak the body's language.

  • And to switch on processes that we knew how to do when we were a fetus.

  • A mammalian fetus, if it loses a limb during the first trimester of pregnancy,

  • will re-grow that limb.

  • So our DNA has the capacity to do these kinds of wound-healing mechanisms.

  • It's a natural process,

  • but it is lost as we age.

  • In a child, before the age of about six months,

  • if they lose their fingertip in an accident,

  • they'll re-grow their fingertip.

  • By the time they're five, they won't be able to do that anymore.

  • So to engage in that conversation with the body,

  • we need to speak the body's language.

  • And there are certain tools in our toolbox that allow us to do this today.

  • I'm going to give you an example of three of these tools

  • through which to converse with the body.

  • The first is cellular therapies.

  • Clearly, we heal ourselves in a natural process,

  • using cells to do most of the work.

  • Therefore, if we can find the right cells