Could lab-grown bones replace tissue grafts and multiple painful
surgeries? Nina Tandon is the CEO and co-founder of EpiBone, a
Brooklyn-based biotech company that was chosen as one of the World
Economic Forum's 2015 Technology Pioneers. Tandon is also a World
Economic Forum Young Scientist who will be speaking at the Annual
Meeting of the New Champions in Tianjin, China, from June 26 to 28.
[An edited transcript of the interview follows.]
What do you do?
We grow bones from stem cells to hopefully help people who need skeletal reconstruction.
How do you do that?
We take two things from the patient. One is a sample of their fat
tissue, from which we extract stem cells. The other is a CT scan, which
is like a three-dimensional X-ray of the bone we want to engineer. We
use this to make the perfect shape, what we call a scaffold. This
scaffold can be made out of protein and collagen from animal bones, or
it can be made from synthetic materials. We infuse the cells into this
puzzle-piece shape, this scaffold, and over about three weeks the cells
mature into a piece of bone that's ready for implantation.
What's the advantage over conventional bone transplants or synthetic transplants?
The current gold standard for reconstructive procedures is called
autograft, where we cut a piece of bone out of one part of the body and
put it in another. That works quite well for where you need the bone,
but it can cause other problems, because there's no piece of bone that's
not really necessary in the body. For example, my fiancé had surgery to
reconstruct his ankle. They took a piece of his hipbone, and his
abdomen even now hurts as much as his ankle does.
Synthetic implants only last a certain amount of time, and people are
living longer and longer. If you get injured at 15 and live to 115, the
idea that your implant only lasts 10-15 years is becoming
unsustainable. So we need new solutions for skeletal repair.
We're also hoping that with our approach there won't be any need for
immunosuppressant drugs because there would be a recognition that it's
the body's own, since it's your own DNA.
How far along are you with your research?
We're currently doing animal experiments, and we think we're about 18 months away from human trials.
In terms of taking this to the market, we're looking at 2022 or 2023.
This is not a sprint, it's a marathon. You can reprogram a chip and
immediately it takes on a different behavior, but it takes three weeks
to grow a bone. Our technology is moving quickly, but the cells
themselves can't be rushed, and medical research can't be rushed.
We've made friends with a lot of surgeons over the years, and they're
in desperate need of things like this. They have patients who they want
to treat. We get emails every day from people who want to volunteer.
But first we need to make sure it's all safe.
Who will benefit from this?
Right now we're focusing on bones above the neck, for cancer, trauma,
congenital defects and dental surgery. In this area, about 100,000
procedures are performed every year in the U.S. alone. After blood, bone
is the most transplanted tissue.
Could you grow bigger bones, too?
In theory, yes, but the materials of our scaffolds dictate some of our
limitations. So we are closely watching any progress in material science
that implies we can grow bigger, stronger bones.
How about growing a whole leg, or an arm?
We can all see a future in which our approach can be used for
regenerating a whole limb, but that will be much further along because
there are many tissues that go into a limb. There's skin, neurons,
muscle, bone, tendons, ligaments, and you grow all of those things in
different micro-environments. The state of the art right now is to grow
two kinds of tissue together—bone and cartilage, or muscle and nerve—and
that's already hard. But we're hoping to lay the groundwork for this
future technology.
What are your other challenges?
Our main challenge is translating the work from the lab into the clinic,
[and then] into humans. We have to keep our heads down and do a really
good job with the science, so we can get to the clinic and help people.
And what are your long-term goals?
I'd like to be able to say that if you're born with congenital defects,
you don't have to be consigned to a lifetime of disfigurement, that you
can have your face restored. More broadly, I love the idea that we can
look at our own body as a source of healing, as opposed to pills and
machines.
In a way it's an agricultural and ecological view of the body,
combined with 3D fabrication. It's so old that it's new. This idea that
we can cultivate natural systems has its roots in pre-history, with the
domestication of animals. But it's being re-envisioned now as, "Can we
repair our bodies using our own cells?"
You originally trained as an electrical engineer. How did you move from programming chips to growing bones?
In the early 2000s I was working in telecommunications and I started
taking a physiology class at night in the local community college.
Reading about DNA and realizing that it was much more powerful than a
binary storage device, that was a strong analogy for me. I ended up
going to MIT to study neural interfaces. I helped spin EpiBone out of my
PhD supervisor's lab together with another post-doc, Sarindr
Bhumiratana. I was growing cardiac and neural tissue, and he was growing
bone and cartilage. So this is certainly a team effort.
As someone who is passionate about science, how would you
encourage more women to enter the STEM (science, technology, engineering
and math) fields?
As little kids, we are all into science, but then we have to narrow our
studies in our teen years. That's when we start to lose our girls, but
also many boys, so let's make sure we find ways for them to stay
engaged. Toys are a great gateway, and there are some brilliant
innovators in that field, like Ayah Bdeir of littleBits, and Debbie
Sterling of GoldieBlox. Remembering that learning is about play, and
careers can also be about play, all those are ways of making sure we
have a diverse set of contributors.