Museum of Modern Art acquires human organs-on-chip

Samples of the Wyss Institute’s Human Organs-on-Chips were formally acquired by the Museum of Modern Art (MoMA) of New York City on March 2, 2015, and are on display in MoMA’s latest Architecture and Design Exhibition, “This Is For Everyone: Design For The Common Good”, until January 2016.

The human organs-on-chips were recognized by Paola Antonelli, the museum’s senior curator in the Department of Architecture and Design, for their state-ofthe- art design and rendering which allows them to emulate complex human organ structures and functions using a combination of living cells and mechanical components encased in a flexible translucent polymer fabricated using computer microchip manufacturing methods.

The organs-on-chips devices are made of clear, silicone rubber and contain hollow channels that are lined by living cells and fed with flowing nutrient–rich fluids and liquid blood substitutes. The tissues mimic blood flow, air movements and physical distortion of internal organs, such as those caused by breathing motions and peristalsis, by application of cyclic vacuum through adjacent microchannels.

Scientists at the Wyss Institute led by the Institute’s Founding Director Donald Ingber, M.D., Ph.D., and former Wyss Technology Department Fellow Dan Dongeun Huh, Ph.D, first developed a living breathing lung-on-a-chip that was published in Science in 2010. The Wyss team also leveraged this design to create various kinds of organs-on-chips to represent different organs in the human body. They can be utilized on each’s own for the study of one specific organ, or their vascular, flowing channels can be connected to link different organs using a stream of fluid, mimicking the blood and nutrient movement through the human body’s vascular system. This feature allows scientists to replicate a human “body” on chips to see how drugs or chemicals impact each organ as the body metabolizes different compounds.

The design of organs-on-chips is highly effective at mimicking the function of real human organs because it contains cultures of living cells from different types of tissues, including blood capillaries, that make up living organs, and because the chips replicate the physical motions and flow seen in the human body that are crucial for organ function.

From the numerous different organs-onchips created by Ingber and his team, the human lung-on-a-chip, gut-on-a-chip, and liver-on-a-chip have been selected for display at MoMA. Their installation in the exhibition, “This Is For Everyone: Design Experiments for the Common Good” opened to the public on February 14, 2015 and will remain on display until January 2016.

The exhibition explores contemporary design in the digital age and takes its name from a 2012 tweet by Tim Berners-Lee, the British computer scientist who invented the World Wide Web in 1989. His message, This Is for Everyone, lit up the stadium at the Olympics Opening Ceremony during the 2012 games in London, and celebrated how the Internet has created limitless possibilities for information sharing and knowledge expansion.

“As design is absolutely key to everything we do at the Wyss Institute, and it has been a guiding light for me personally from the start of my career, it’s a thrill and an honour to see the organs-on-chips technology find a home amongst MoMA’s collection of world-renowned designs,” said Ingber, who is a founder of the emerging field of biologically inspired engineering. “I have always felt that great scientists are closer to artists than any other profession, and great advances come from crossing the boundary between these disciplines. So it’s exciting to see MoMA’s curators embrace the subtlety and simplicity of our microscale design, and communicate the power of bridging the artscience interface to the public.”

Human organs-on-chips represent a powerful alternative to animal testing models by mimicking human organs for purposes such as: testing of drugs, cosmetics, chemicals and toxins; understanding infections and inherited diseases; and creating replicas of personalized organs or organs of genetically related sub-populations to advance precision medicine.  


WHO condemns attack on health facility in Syria

The WHO has expressed deep concern over damages to health facilities due to conflict in the Syrian Arab Republic and the far-reaching implications on all Syrians, especially those in dire need of medical attention.

The statement was provoked by incident in March at Aisha Hospital in Alboukamal city in Deir ez-Zor governorate, which resulted in the death of two women and three newborns who were in incubators at the time of the strike. Critical hospital equipment was also destroyed including incubators, electrocardiography machines and the laboratory.

Of the seven public hospitals and 103 health centres in Deir ez-Zor, only one hospital and eight health centres are currently fully functional. There are only 27 female doctors and 339 male doctors for 794,000 people in need.

“At a time when the few health facilities are overwhelmed with patients, it is important that their functionality be protected and health workers and humanitarian aiders allowed to provide required health services and humanitarian aid” says Elizabeth Hoff, WHO Representative to Syria.

Hoff laments that over 50% of hospitals in the Syrian Arab Republic have ceased to function due to damages arising from the conflict.

The WHO Representative reiterated the obligations under the international humanitarian law and Geneva Conventions for the protection of civilians, health facilities and health professionals during conflict.

“Health facilities must be treated as neutral premises and never exploited for military purposes. It is in the interest of all parties involved in the conflict to preserve the neutrality and functionality of health infrastructures, personnel and civilians”, she stressed.


Why some people with diabetes can’t buy insulin in the US

Many patients with diabetes have lapses in medication that can lead to serious complications requiring hospitalization. A generic version of insulin, the lifesaving diabetes drug used by six million people in the United States, has never been available there because drug companies have made incremental improvements that kept insulin under patent from 1923 to 2014.

As a result, say two Johns Hopkins internist- researchers, many who need insulin to control diabetes can’t afford it, and some end up hospitalized with life-threatening complications, such as kidney failure and diabetic coma.

In a study published on March 19, 2015, in the New England Journal of Medicine, authors Jeremy Greene, MD, Ph.D, and Kevin Riggs, MD, MPH, describe the history of insulin as an example of “evergreening,” in which pharmaceutical companies make a series of improvements to important medications that extend their patents for many decades.

This keeps older versions off the generic market, the authors say, because generic manufacturers have less incentive to make a version of insulin that doctors perceived as obsolete.

Newer versions are somewhat better for patients who can afford them, say the authors, but those who can’t suffer painful, costly complications.

“We see generic drugs as a rare success story, providing better quality at a cheaper price,” says Greene, an associate professor of the history of medicine at the Johns Hopkins University School of Medicine and a practicing internist. “And we see the progression from patented drug to generic drug as almost automatic. But the history of insulin highlights the limits of generic competition as a framework for protecting the public health.”

More than 20 million Americans have diabetes, in which the body fails to properly use sugar from food due to insufficient insulin, a hormone produced in the pancreas. Diabetes can often be managed without drugs or with oral medications, but some patients need daily insulin injections. The drug can often cost from $120 to $400 per month without prescription drug insurance.

“Insulin is an inconvenient medicine even for people who can afford it,” says Riggs, a research fellow in general internal medicine and the Berman Institute of Bioethics at Johns Hopkins. “When people can’t afford it, they often stop taking it altogether.”

Patients with diabetes who are not taking prescribed insulin come to Riggs’ and Greene’s Baltimore-area clinics complaining of blurred vision, weight loss and intolerable thirst – symptoms of uncontrolled diabetes, which can lead to blindness, kidney failure, gangrene and loss of limbs.
The two doctors decided to find out why no-one makes generic insulin. A University of Toronto medical team discovered insulin in 1921, and in 1923, the university, which held the first patent, gave drug companies the right to manufacture it and patent any improvements. In the 1930s and 1940s, pharmaceutical companies developed longacting forms that allowed most patients to take a single daily injection.

In the 1970s and 1980s, manufacturers improved the purity of cow- and pig-extracted insulin. Since then, several companies have developed synthetic analogs.

When these insulins come on the market, they may cost just 20 to 40 percent less than the patented versions, Riggs and Greene write.


WHO highlights serious threat posed by exposure to recreational noise

Some 1.1 billion teenagers and young adults are at risk of hearing loss due to the unsafe use of personal audio devices, including smartphones, and exposure to damaging levels of sound at noisy entertainment venues such as nightclubs, bars and sporting events, according to the WHO.

Hearing loss has potentially devastating consequences for physical and mental health, education and employment. Data from studies in middle- and highincome countries analysed by WHO indicate that among teenagers and young adults aged 12-35 years, nearly 50% are exposed to unsafe levels of sound from the use of personal audio devices and around 40% are exposed to potentially damaging levels of sound at entertainment venues. Unsafe levels of sounds can be, for example, exposure to in excess of 85 decibels (dB) for eight hours or 100dB for 15 minutes.

“As they go about their daily lives doing what they enjoy, more and more young people are placing themselves at risk of hearing loss,” notes Dr Etienne Krug, WHO Director for the Department for Management of Non-communicable Diseases, Disability, Violence and Injury Prevention. “They should be aware that once you lose your hearing, it won’t come back. Taking simple preventive actions will allow people to continue to enjoy themselves without putting their hearing at risk.”

Safe listening depends on the intensity or loudness of sound, and the duration and frequency of listening. Exposure to loud sounds can result in temporary hearing loss or tinnitus which is a ringing sensation in the ear. When the exposure is particularly loud, regular or prolonged, it can lead to permanent damage of the ear’s sensory cells, resulting in irreversible hearing loss.

WHO recommends that the highest permissible level of noise exposure in the workplace is 85 dB up to a maximum of eight hours per day. Many patrons of nightclubs, bars and sporting events are often exposed to even higher levels of sound, and should therefore considerably reduce the duration of exposure. For example, exposure to noise levels of 100 dB, which is typical in such venues, is safe for no more than 15 minutes.

Teenagers and young people can better protect their hearing by keeping the volume down on personal audio devices, wearing earplugs when visiting noisy venues, and using carefully fitted, and, if possible, noise-cancelling earphones/headphones. They can also limit the time spent engaged in noisy activities by taking short listening breaks and restricting the daily use of personal audio devices to less than one hour.

With the help of smartphone apps, they can monitor safe listening levels. In addition they should heed the warning signs of hearing loss and get regular hearing check-ups.

Governments also have a role to play by developing and enforcing strict legislation on recreational noise, and by raising awareness of the risks of hearing loss through public information campaigns. Parents, teachers and physicians can educate young people about safe listening, while managers of entertainment venues can respect the safe noise levels set by their respective venues, use sound limiters, and offer earplugs and “chill out” rooms to patrons. Manufacturers can design personal audio devices with safety features and display information about safe listening on products and packaging.

To mark International Ear Care Day, celebrated each year on 3 March WHO launched the “Make Listening Safe” initiative to draw attention to the dangers of unsafe listening and promote safer practices. Worldwide, 360 million people have moderate to profound hearing loss due to causes such as noise, genetic conditions, complications at birth, infectious diseases, chronic ear infections, the use of particular drugs and ageing. It is estimated that half of all cases of hearing loss are avoidable.


NIH announces $41.5 million in funding for the human placenta project

Geared to improving health of mothers and children, the National Institutes of Health has dedicated $41.5 million for an initiative to understand and monitor the development of the human placenta during pregnancy.

“The placenta is a lifeline that gives us our start in the world,” said Alan E. Guttmacher, M.D., director of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, which is leading the research effort. “It influences the health of mother and child not just during pregnancy, but for the rest of their lives. However, despite its important role, the placenta has received comparatively little attention.”

The placenta is a temporary organ that ferries oxygen and nutrients from the mother to her foetus while at the same time removing potentially toxic substances like carbon dioxide. It also produces hormones to help maintain pregnancy and perform the unique immunologic function of allowing the mother and foetus to co-exist.

Problems with the placenta may lead to negative pregnancy outcomes for mother or foetus, such as pre-eclampsia (a disorder of high blood pressure in pregnancy), gestational diabetes, pre-term birth, and stillbirth. Placental problems have also been linked to a higher risk of heart disease later in life, for both mother and child.

“If we can develop technologies to monitor placental health during pregnancy, we should be able to prevent some of these problems from happening,” said Dr Guttmacher. “We hope this funding opportunity will attract a broad range of researchers and clinicians to help -- placental biologists, obstetricians, and experts in imaging, bio-engineering, and other arenas.”

Until now, most studies of the placenta have been limited to ultrasound exams, blood tests, and the examination of placental tissue after delivery. These studies have provided important foundational knowledge, Guttmacher said, but many questions remain about normal placental development and function and the organ’s role in health and disease.

The initiative seeks to spur new technologies or innovative applications of existing technologies, such as imaging tools or sensors, that would allow practitioners to safely track placental functioning during pregnancy. Such technologies might gauge how blood and oxygen flow through the placenta, how it attaches to the uterine wall, and how it conveys nutrients to the foetus.

“Advances in imaging and bioengineering hold terrific promise for the study of the placenta,” said Roderic Pettigrew, Ph.D., M.D., director of NIH’s National Institute of Biomedical Imaging and Bioengineering, which is co-sponsoring the Human Placenta Project’s latest initiative. “We expect that the technologies resulting from this initiative will also translate to other organs and open new avenues of study that will benefit human health.”

The latest funding announcement for the Human Placenta Project, its third and largest to date, also requires applicants to address the effects of environmental factors -- such as air pollution, medications, and maternal diet -- on the placenta during pregnancy.

“The placenta is a fascinating organ, but it’s one of the least understood,” said Guttmacher. “For researchers who want to apply their skills in an area of medicine that isn’t being looked at as much as both scientific opportunity and human health warrant, this is a wonderful chance.”


WHO issues its first hepatitis B treatment guidelines

WHO today issued its first-ever guidance for the treatment of chronic hepatitis B, a viral infection which is spread through blood and body fluids, attacking the liver and resulting in an estimated 650,000 deaths each year – most of them in lowand middle-income countries.

Worldwide, some 240 million people have chronic hepatitis B virus with the highest rates of infection in Africa and Asia. People with chronic hepatitis B infection are at increased risk of dying from cirrhosis and liver cancer.

Effective medicines exist that can prevent people developing these conditions so they live longer. But most people who need these medicines are unable to access them or can only obtain substandard treatment. One reason for this is the lack of clear evidence-based guidance for countries (especially low- and middle-income countries) as to who should be treated and what medicines to use.

“Deciding who needs treatment for hepatitis B depends on a number of factors,” says Dr Stefan Wiktor, who leads WHO’s Global Hepatitis Programme. “These new guidelines, which give treatment recommendations that rely on simple, inexpensive tests, will help clinicians make the right decisions.”

The “WHO guidelines for the prevention, care and treatment of persons living with chronic hepatitis B infection” lay out a simplified approach to the care of people living with chronic hepatitis B, particularly in settings with limited resources. The guidance covers the full spectrum of care from determining who needs treatment, to what medicines to use, and how to monitor people long-term.

Key recommendations include: • the use of a few simple non-invasive tests to assess the stage of liver disease to help identify who needs treatment; • prioritizing treatment for those with cirrhosis - the most advanced stage of liver disease; • the use of two safe and highly effective medicines, tenofovir or entecavir, for the treatment of chronic hepatitis B; and • regular monitoring using simple tests for early detection of liver cancer, to assess whether treatment is working, and if treatment can be stopped.

The special needs of specific populations, such as people co-infected with HIV, as well as children and adolescents, and pregnant women are also considered. The two recommended medicines are already available in many countries as generics, and thus are relatively inexpensive, costing as little as US$5 per person per month. “Because for so many people treatment is lifelong, it is important that patients can access these medicines at the lowest possible price” says Dr Wiktor. A number of countries are beginning to develop hepatitis B treatment programmes, and the newly-released document also provide guidance on how to organize hepatitis care and treatment services.

“For example, countries need to think about ways to improve access to medicines and how best to deliver quality care that builds on existing health services and staff,” says Dr Philippa Easterbrook, from the WHO Global Hepatitis Programme. Treatment can prolong life for people already infected with hepatitis B, but it is also important to focus on preventing new infections. WHO recommends that all children are vaccinated against hepatitis B, with a first dose given at birth.

Some countries, particularly in Asia, have reduced the rates of childhood hepatitis B infection through universal childhood vaccination. The challenge now is to scale up efforts to ensure that all children worldwide are protected from the virus.

Another route of infection is through the re-use of medical equipment, in particular of syringes. WHO has recently launched a new policy on injection safety that will also help prevent new hepatitis B infections. The policy calls for the worldwide use of “smart” syringes to prevent the re-use of syringes or needles.

The new guidelines on treating hepatitis B follow on from the publication last year by WHO of its first-ever guidelines on treating hepatitis C.


Nibib launches ‘Want to be a bioengineer?’ game app

How do you keep an artificial limb attached to the body? What lab-grown organ have scientists successfully transplanted into patients? You can find the answer to these questions and many more while playing Want to Be a Bioengineer?, a game for middle and high school students, designed by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of the National Institutes of Health.

The game introduces students to real-life examples of how bioengineers are improving people’s lives, from helping paralyzed individuals stand, to re-growing fingertips, to finding new ways to see inside the body. During the game, students answer a series of multiple choice questions pertaining to subjects in rehabilitation engineering, regenerative medicine, and biomedical imaging. At the end, a score is generated based on how many questions are answered correctly.

“It is truly an exciting time to be entering the field of bioengineering. Yet, students don’t often know what it means to be a bioengineer,” said NIBIB Director Roderic Pettigrew, Ph.D., M.D. “The bio-engineers we support are building bio-artifical kidneys, growing functional cartilage, and developing implantable sensors that can detect real-time changes in biochemistry. They are coming up with ways to make tumours glow, supercool organs so that they can stay outside the body longer for transplantation, and store vaccines so they don’t require refrigeration. They are making biomedical technologies better, faster, cheaper, and smaller and, in doing so, are profoundly changing health care in the US and around the world.”

“This game is a fun and easy way to introduce a younger generation to the exciting possibilities of bio-engineering. It plants the seed that if you’re interested in science and technology, enjoy being creative, and have a desire to help people, you might consider becoming a bio-engineer,” said Pettigrew.

The game can be played on the NIBIB website at or downloaded for free to your phone or tablet from the iTunes App store.


New big data portal aims to speed up Alsheimer’s drug discovery

A National Institutes of Health-led public-private partnership to transform and accelerate drug development achieved a significant milestone recently with the launch of a new Alzheimer’s Big Data portal – including delivery of the first wave of data – for use by the research community. The new data sharing and analysis resource is part of the Accelerating Medicines Partnership (AMP), an unprecedented venture bringing together NIH, the US Food and Drug Administration, industry and academic scientists from a variety of disciplines to translate knowledge faster and more successfully into new therapies.

The opening of the AMP-AD Knowledge Portal and release of the first wave of data will enable sharing and analyses of large and complex biomedical datasets. Researchers believe this approach will ramp up the development of predictive models of Alzheimer’s disease and enable the selection of novel targets that drive the changes in molecular networks leading to the clinical signs and symptoms of the disease.

“We are determined to reduce the cost and time it takes to discover viable therapeutic targets and bring new diagnostics and effective therapies to people with Alzheimer’s. That demands a new way of doing business,” said NIH Director Francis S. Collins, M.D., Ph.D. “The AD initiative of AMP is one way we can revolutionize Alzheimer’s research and drug development by applying the principles of open science to the use and analysis of large and complex human data sets.”

Developed by Sage Bionetworks a Seattle-based non-profit organization promoting open science, the portal will house several waves of Big Data to be generated over the five years of the AMP-AD Target Discovery and Preclinical Validation Project by multi-disciplinary academic groups. The academic teams, in collaboration with Sage Bionetworks data scientists and industry bioinformatics and drug discovery experts, will work collectively to apply cutting-edge analytical approaches to integrate molecular and clinical data from over 2 000 post-mortem brain samples.

The National Institute on Aging (NIA) at NIH supports and co-ordinates the multidisciplinary groups contributing data to the portal. The AMP Steering Committee for the Alzheimer’s Disease Project is composed of NIA and the National Institute of Neurological Disorders and Stroke, both of NIH, the US Food and Drug Administration, four pharmaceutical companies (AbbVie, Biogen Idec, GlaxoSmithKline and Lilly) and four non-profit groups (Alzheimer’s Association, Alzheimer’s Drug Discovery Foundation, Geoffrey Beene Foundation and US Against Alzheimer’s) and is managed through the Foundation for the NIH.

Because no publication embargo is imposed on the use of the data once they are posted to the AMP-AD Knowledge Portal, it increases the transparency, reproducibility and tran


                                  
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