5 Amazing Projects That Will Change the Future of Healthcare
Microneedle patches, handheld diagnostic machines, better sensing capabilities, and 3D bioprinting are just a few of the technologies coming to a doctor’s office near you — or maybe even into your home — in the next decade.
Even when it’s moving at a slow speed, Rohit Bhargava’s 3D printer in action is mesmerizing. As the pointed tip of the printer head moves, it extrudes a thin, shining tube of what looks like plastic. The nozzle moves away and draws out another tube. Then suddenly they’re connected; joined by other tubes to become a complex three-dimensional shape: A tiny, anatomically accurate replica of a heart.
The tubes aren’t plastic; they’re made of isomalt, a soluble material. And though the heart is impressive, Bhargava’s ultimate targets are much more subtle: ducts and vessels in the human body where cancer can take root. These delicate filigrees are seeded with cells from the human body, then enclosed in wobbly cylinders of collagen where the isomalt dissolves. What remains are models of real human anatomies made of living cells: a 3D platform to study disease as though you’re within the body itself.
As the head of the University of Illinois Urbana-Champaign’s innovative Cancer Center, Bhargava has been plugging away at injecting more advanced engineering solutions into medical problems. The freeform 3D printer is one of the first futuristic achievements of that effort.
But Bhargava’s project is just one of a wave of technologies that stand to transform medicine and healthcare as we know it; to make them faster, more accurate, and hopefully, drastically more affordable. Microneedle patches, handheld diagnostic machines, and better sensing capabilities, as well as 3D bioprinting, are just a few of the technologies coming to a doctor’s office near you — or maybe even into your home — in the next decade.
“Something fundamental has to change in healthcare. Policy is only part of it,” Bhargava said. “Look at phones and laptops, which used to be so much more expensive but have gotten cheaper as the technology has gotten better. If we bring engineering into healthcare, taking basic knowledge and converting it into usable solutions, we have a chance to reduce costs and increase quality in a similar way.”
3D Printing the Body
Driven by complex mathematical algorithms and capable of printing tubes as tiny as 10 microns across — a fifth of the size of a human hair — Bhargava’s printer differs from standard 3D printers in that it doesn’t deposit one layer at a time. The hollow filaments it extrudes can all be interconnected, creating highly complex frameworks on which cells can grow and through which bodily fluids can pass.
A target anatomy — say, a breast duct or lymphatic vessel — can be replicated in the tens or hundreds or even thousands, making experiments highly and quickly reproducible. By introducing tumor cells to each sample, researchers can zero in on the behavior and responses of an individual person’s cancer to various treatments and body environments. This approach would make it easier to study and understand the differences between healthy and diseased tissue.
This 3D-printing technology, along with high-powered, machine-learning-driven infrared microscopes that can image the unique chemical environment of an individual’s disease (and are also developed by Bhargava’s research group), are helping bespoke clinical care become a reality.
“It’s not just the cells, but the blood, the chemistry, the molecular environment, the tumor — everything present in the tissue,” Bhargava said. “What this will eventually allow us to do is to really personalize diagnoses by considering the entirety of the person’s tissue.”
At the University of Minnesota, Michael McAlpine has also been focused on 3D biologics, but with a kick.
“Do you have to replace biology with biology? Typically, you don’t,” McAlpine said. “We replace knee cartilage with titanium or a heart with a pacemaker — so do you need to replace a liver with a 3D-printed liver that’s made of the same cells as the original liver? Maybe you can print a better liver based on polymers with electronics.”
One of his lab’s early successes was a printed bionic ear, a rosy pink shell of cartilage with an embedded coil of silver nanoparticles. Though it was ridiculed at the time for being crude and simplistic, the ear was nonetheless able to detect radio frequencies beyond the natural range of human hearing. And it was produced with an off-the-shelf printer.
“It was one cell type with simple electronics, and the engineering community was using words like ‘direct-write’ and ‘additive manufacturing’ because they felt ‘3D printing’ wasn’t a good term,” McAlpine said. “But it broke the barrier. 3D-printed bionics are everywhere now.”
What McAlpine is working toward is a killer app for 3D printers: a single machine capable of handling different types of materials at once, able to lay down biologics alongside electronics in a quick and seamless fashion.
Though we’re not yet to the point where prosthetic ears with superhuman abilities are readily available, we’re also not too far away, thanks to McAlpine’s continued work in bioprinting. And he hasn’t stopped at ears — his group recently produced a bionic eye (pictured) and is also working on producing bionic skin and regenerated spinal cords.
“No one wants to go out and buy 3D printers now because they only print hard plastic knick-knacks for your desk,” McAlpine said. “Expanding the capability of 3D printers to use materials like soft polymers, with complete electronic and biological functionality, in one printer: That is the transformative advance.”
At the University of Texas at Dallas, Jeremiah J. Gassensmith’s research group is using 3D printing to improve a widely reviled medical experience: injections.
“Hypodermic needles don’t have any friends,” laughed Ron Smaldone, a chemist at UT-Dallas and one of Gassensmith’s collaborators. Along with graduate students Danielle Berry and Michael Luzuriaga, Gassensmith (pictured below) and Smaldone have developed a 3D-printed microneedle patch — a bit like a scrap of Velcro, but one loaded with medications or vaccines.
Identified by Johns Hopkins University as one of 15 promising technologies for averting or avoiding future disease pandemics, microneedle patches are exactly what they sound like: a grid of microscopic needles that painlessly pierce the upper layer of the skin to deliver a drug or vaccine payload. Currently, microneedle arrays are produced in expensive factory clean-rooms via plastic injection molds or on stainless steel templates through lithography. The ability to 3D print such arrays in biodegradable plastic could drastically reduce the price of microneedle patches, as well as make it possible to produce them anywhere with a power supply.
Gassensmith’s team used an off-the-shelf LulzBot printer and PLA polymer — a compostable, biocompatible plastic made from lactic acid — to produce a small grid of pegs that was then bathed in a potassium solution that etched the tips of the pegs into micron-sized needles. In pig skin, between 84 and 92 percent of the needles broke off, dissolved, and delivered the test dye, compared with a roughly 75 percent success rate for conventional designs.
In the future, Gassensmith’s group will explore ways of integrating proteins into the polymer matrix in a way that will let them survive the high-heat printing process. This is a key hurdle to overcome in making cheap, disposable microneedle patches a viable technology.
“Microarrays let you get around the need for trained medical professionals to give injections, since you’re not getting into the vasculature or generating biohazardous waste,” Gassensmith said. “It also democratizes medicine. It hacks the convention that you need these high-end manufacturing facilities to produce therapies.”
Hakan Ceylan has ambitious goals: He aims for nothing less than to eradicate the need for surgery. And how does he propose to do such a thing? With cell-sized swimming robots, or microswimmers.
“Surgery is very invasive and traumatic. Many people die because of post-operative infections,” said Ceylan, a research scientist at the Max Planck Institute for Intelligent Systems in Stuttgart, Germany.
The microswimmers are 3D-printed via two-photon polymerization (lasers), their double-helix hydrogel forms infusing with magnetic nanoparticles. These microswimmers are semi-autonomous, since they’re guided through the “body” (water, in lab tests) with an external magnetic current, but they’re also designed to respond automatically to certain environmental or chemical signals they encounter while inside the body.
Ceylan’s current prototypes swell in the presence of the enzyme MMP-2, which is produced by breast cancer cells. This releases the robot’s payload of magnetic nanoparticles, coated in an antibody that attaches them to the cancerous cells. The magnetic microswimmer was able to tag 40 percent of cells in tests — four times better than conventional cell-tagging technology.
The thinking is that if rogue cells can be detected and tagged throughout the body, they can also be targeted for destruction at the cellular level — thus eliminating the need for a surgeon with a scalpel or toxic chemotherapies.
Consider glioblastomas, or complex, branched tumors that invade the brain. Because the surgeries to excise them also necessarily remove some amount of brain tissue, patients are rarely the same afterward. Survival rates are low.
“If surgeons could remove these tumors in a neat and clean way with microswimmers, then you drastically reduce the invasiveness of the operation,” Ceylan said. “There’s no need to open the whole skull — just an injection at a small location.”
Ceylan concedes that it may be a decade or more for the first “realistic use” of such microswimmers, as there are many problems still to solve with steering the bots, imaging where they are in the body, and different methods for triggering marker or drug releases from the hydrogel.
Better Sensors Everywhere
In his office in San Diego, Erik Viirre goes over a few touchstones on his desk. A replica of an original Star Trek tricorder, a fictional handheld medical device featured prominently on the show. A silver rupee from a 1701 shipwreck discovered by none other than Arthur C. Clarke. A snapshot of Viirre with the author at his home in Sri Lanka.
Viirre’s day job at the University of California San Diego is studying brains, particularly how some people’s brains cause them to have migraines, tinnitus, vertigo, and other balance disorders. His research has involved the use of virtual reality to help treat some of those conditions.
But he’s also on staff at the university’s Clarke Center for Human Imagination, which gives the rupee extra significance — a personal connection to the science-fiction master. These objets d’art remind Viirre that despite the medical and technological advances we’ve made, some of the most powerful visions of the future have yet to be fulfilled.
“We have these inspirations, and we still have lots of problems, but at least we’re able to see the problems now,” Viirre said. “We joke about Siri and Alexa getting it wrong, but they do pretty darn good jobs. Sure, we get cynical, but it’s a hedonic adaptation” — in other words, we happily integrate tech into our lives, but we always want it to be better and fast.
Hence Viirre’s role in shepherding several once-fictional technologies into the now: handheld sensing (Viirre was the medical and technical advisor for the Tricorder XPrize competition) as well as artificial intelligence applications in medicine, particularly chatbots and AI diagnosis. But the AI beast requires data, and the data of the future is coming from better, smarter sensors.
An acoustic analysis project Viirre is involved in aims to screen for — and perhaps eventually diagnose — tuberculosis, as well as other serious respiratory diseases. The tool? Better microphones and electronics in cell phones that can tune in to the characteristic sounds of TB-infected lungs. An upcoming pilot program in Mozambique, where tuberculosis is endemic, will collect data from TB clinics to improve the screening tool.
Viirre is also eager for the promise of video analysis, particularly for diagnosis of melanoma. Making this possible are bigger, better data clouds and cheaper hyperspectral sensors able to make high-res images in infrared and ultraviolet as well as visible spectra. And the UK company Owlstone, a 2015 finalist in the Nokia Sensing XChallenge, recently released a system for detecting volatile organic compounds in breath — chemical markers that can indicate the presence of a variety of maladies, from infections to metabolic disease and even cancer.
Clarke’s 1962 book Profiles of the Future probed the possibilities of science and technology, including the prediction of global telecommunications. Viirre suggested that continuing to ask questions and push limits, as Clarke did, is key to unlocking the next ripple of life-saving innovations.
“All the features we can gather are now nuances in data that will help us hunt down disease, and we’re excited that sensors like these will make things like the Star Trek tricorder a reality,” Viirre said. “Thirty years out of med school, and this has been the most exciting year in medical treatment in my entire career.”
This story originally appeared in the PCMag Digital Edition.