The history of science is punctuated with medical breakthroughs that seemed unlikely in the times from which they arose. Infections from simple cuts or sore throats laid waste to millions of people before the 20th century. Where was the cure? Certainly nobody in the 1920s imagined that it would come from green mold that formed on a petri dish in the lab of a London professor who was away on vacation. But the story of penicillin symbolizes the unlikely event that changed the world. It also got us wondering about the unlikely cures that medical science is working on today. The answers are many, of course, but we narrowed the list to five remarkable developments with potentially widespread applications.
The Power of Poop
Human feces was the scourge of early civilization, causing disease and death. So it sounds more than unlikely, it sounds downright bizarre, to report that poop has the power to heal. Surprisingly, human fecal matter contains trillions of microorganisms with potential healing properties.
In 2008, U.S. doctors transplanted human feces into a Minnesota woman suffering from an antibiotic-resistant intestinal infection caused by the bacteria, Clostridium difficile. It was the medics’ last resort. Within days the patient’s infection cleared. “I wouldn’t have predicted it,” says Janet Jansson, a microbial ecologist from the Lawrence Berkeley National Lab who worked on the case. “But it was a paradigm shift that you could take a microbial community and establish it in a new host.”
The poop cure represents the growing field of “bacteriotherapy,” which works by transplanting microbes from healthy individuals into those who are ill. (The stool in the Minnesota case came from the patient’s husband.) Our “microbiome,” the collection of microbes that live in and on our body, plays a vital role in our well-being. In an adult, there are 10 times more microbial cells than human cells. Imbalances in our microbial communities can cause health problems and infections. Most infections are treated with antibiotics, which destroy bacteria, often with side effects.
Bacteriotherapy won’t be a one-size-fits-all, as every person is unique and human microbial communities are diverse, says Jonathan Eisen, who studies microorganisms at the University of California, Davis Genome Center. “But the potential for treating some conditions with transplants, either directly from a donor or in a controlled manner from the lab, is enormous.”
Erasing Bad Memories
It made for a great movie, but it sure seemed unlikely in Eternal Sunshine of the Spotless Mind when Jim Carrey had painful memories of his love affair with Kate Winslet erased by bohemian brain technicians in a dingy New York City apartment. But lessening the emotional blow of traumatic memories is not a cinematic fantasy. Karim Nader, a professor of behavioral neuroscience who studies memory at McGill University, explains that sunshine can be restored to a cloudy mind.
Each memory, Nader says, is “filed” into different places in your brain. Your amygdala records the emotional aspect of the memory, while the hippocampus retains its cognitive part. To achieve this, neurons in all areas of the brain have to produce new proteins that become the “physical enunciation of the new memory,” essentially its building blocks. That’s why new memories don’t get “saved” instantly. “It takes about four hours to get wired into the brain,” Nader says.
Lessening the emotional blow of traumatic memories is not a cinematic fantasy. Sunshine can be restored to a
If a new memory is traumatic, it’s possible to “take out” its emotional part by preventing the protein formation in the amygdala. The prefrontal cortex can act like a brake on the expression of emotions. “People used to think that this was impossible,” says Nader. But if given within hours of traumatic experiences, propranolol, a drug originally used to treat hypertension, has proven to reduce post-traumatic stress disorder (PTSD). Blocking the proteins’ formation in amygdalae wouldn’t affect the mechanism of conscious memory storage in other brain areas, so the person would still remember the event. Only its traumatic intensity would diminish, Nader explains.
However, when memories are retrieved, they are often recorded back into the brain, Nader says. That gives scientists additional opportunities to interfere with the protein production of unwanted reminiscences. A recent study showed that when PTSD patients took propranolol immediately after recalling and writing down their painful experiences in detail, their symptoms decreased. “We found that people who had PTSD for 30 years had their traumatic memories reduced to the non-PTSD levels,” Nader says. He adds that with memory therapy, PTSD may one day become a thing of the past. “I think we’re pretty close,” he says.
Bones, Made to Order
Bones can be broken, made from synthetic materials, or carved from other bones in our body. But grow new bones? That just doesn’t happen. Until now. Scientists at Columbia University have shown they can make bones to order.
“Tissue engineers,” those working to grow new organs, including the heart, from stem cells, have been operating for decades. But creating new bones, given their varied density and shapes, is “more complex,” says Gordana Vunjak-Novakovic at Columbia University’s Department of Biomedical Engineering. In their first experiments, the “bone engineers” started small, with facial bones. Recently, Vunjak-Novakovic and Sidney Eisig, a professor of craniofacial surgery at the Columbia University Medical Center, grew parts of the jawbone located by the ear—the vertical ramus and the condyle—and successfully implanted them in a pig.
Creating new bones would allow doctors to avoid the injurious process of carving them out of other bones in a patient. It would bypass the potential rejection of synthetic bones in some patients. To create new organic bones, the Columbia team seeded stem cells in a scaffolding—a piece of an animal bone stripped of all cellular material and carved in the required shape—and pumped nutrients through the growing bone to deliver them to the cells on the inside. As the new bone gets formed by special cells called osteoblasts, the old scaffolding is dissolved by their counterparts, osteoclasts. The result is a fully viable, live bone. With scaling, the same technology can be used to grow any other bones, including vertebrae. “If it works in the face, it can work in the other parts of the body,” Eisig says.
Imagine tiny robot surgeons running through your body to make repairs. It’s on the cusp of coming true. Scientists and surgeons at Columbia University and Vanderbilt University have built Insertable Robotic Effector Platform (IREP), which can enter the body through a single 15 millimeter incision, unfold from its capsule, and, following a surgeon’s instructions, move toward a particular organ to execute surgical tasks, such as clamping arteries and tying sutures.
IREP has gone through several development stages. First, Columbia University computer scientist Peter Allen devised an insertable camera that tilted, panned, and followed the movements of surgical instruments from inside the abdomen, and projected its vision onto a computer screen. To test it, surgeon Dennis Fowler performed a number of appendectomies, nephroscopies, and other operations on porcine models. Then, mechanical engineer Nabil Simaan at Vanderbilt University equipped IREP with two snake-like arms built from a series of vertebrae strung together with wires, which can bend and twist the arms in the required directions. Simaan also gave IREP wrists and grippers to manipulate objects. IREP was tested using the standard laparoscopic surgery exam setting, which all surgeons must pass to be board-certified. It passed the test, but has not yet been used on humans.
Fowler says that IREP’s dexterity in maneuvering around tissues and organs can be better for patients than the surgeons’ standard laparoscopic graspers and dissectors. It can also reduce the size and number of incisions in the more invasive surgeries.
As recently as a few years ago, there was little hope that people who were paralyzed would ever be able to do something as simple as pick up a bottle of water again. But as improbable as it may sound, paralyzed people can now control robotic arms with their thoughts.
Recently, several science teams have experimented with brain-computer interfaces, electronic devices that translate people’s intent to move in to robotic devices. But the experiments often required invasive methods: the electrodes that pick up neurons’ electrical activity have to be surgically implanted into the brain, and remain there.
In June 2013, professor Bin He and his team at the University of Minnesota showcased the first non-invasive brain-computer interface. They captured neurons’ impulses using the electroencephalogram method, which records brain activity from a person’s scalp by using skull caps outfitted with electrodes. Participants steered a toy quadcopter, a remote-control helicopter, around a room by imagining its complex movement in their heads. Their mental commands were at the helm.
The EEG approach hasn’t been practical because the brain produces a variety of brain waves and decoding that “noise” outside the brain was difficult. “The challenge was how to pick up these extremely weak signals of human “intention” buried among background brain waves and reliably interpret it for use in real-time control of a device,” He says. By amplifying a particular type of wave called sensorimotor rhythms—the rhythmical electrical impulses produced in the cortex of the brain when we imagine various actions, like moving the quadcopter to the right or up—the scientists were able to translate the brain waves into commands. The control signal decoded from the EEG was then sent via Wi-Fi to the quadcopter to direct its flight. “EEG electrodes alone are able to accomplish this complex task,” He says. The technology will allow paralyzed people to control robotic limbs without brain surgery. Will it one day allow just about anybody to don an electronic skull cap and fly a remote-controlled helicopter with his mind? Those would be scary thoughts.