February 3, 2023 – As a child, I watched syndicated episodes of the unique series Star TrekOf course I used to be fascinated by space travel, but in addition by medical technology.
A conveyable “Tricorder” recognized diseases, while an intramuscular injector (“Hypospray”) could treat them. Infirmary “Organic beds“ came with real-time health monitors that looked futuristic at the time but seem primitive today.
Such visions inspired many of us children to become interested in science. We had no idea what advances many of us would experience in our lifetime.
Artificial intelligence helps detect diseases, robots perform surgeries, even video calls between doctor and patient – all of this once sounded like a fantasy, but is now practiced in clinical care.
Now, in the 23rd year of the 21st century, you might not believe what we will be capable of next. Three particularly wild examples are approaching clinical reality.
Human hibernation
Captain America, Han Solo, and Star Trek villain Khan have all been preserved at low temperatures and then revived, only to wake up alive and well months, decades, or centuries later. While these are fictional examples, the science they're based on is real.
Rare cases of accidental hypothermia prove that full recovery is possible even after cardiac arrest. The drop in body temperature slows down the metabolism and reduces oxygen demand, thereby stopping brain damage for an hour or more. (In an extreme casea mountaineer survived after almost 9 hours of resuscitation attempts.)
Useful for a space traveler? Maybe not. But for someone with life-threatening injuries from a car accident or a gunshot wound, it could be of great use.
That is the idea behind a groundbreaking procedure that was developed after decades of research on pigs and dogs and is now being tested in a clinical study. The idea: A person with massive blood loss, whose heart has stopped beating, is injected with an ice-cold liquid that cools them from the inside to around 50 degrees. F.
After cardiac arrest and during surgery on the aortic arch (the main artery that carries blood away from the heart), doctors already perform more moderate hypothermia to protect the brain and other organs.
But this experimental procedure – called emergency preservation and resuscitation (EPR) – goes far beyond that and “dramatically reduces the's need for oxygen and blood flow,” says Samuel Tisherman, MD, trauma surgeon on the University of Maryland Medical Center and the lead researcher of the studyThis puts the patient in a state of limbo, which “could give surgeons time to stop the bleeding and thus save more of these patients.”
The technique was applied at the least to six patientsalthough there are reports that none survived. The trial is anticipated to incorporate 20 people by the point it's accomplished in December, based on the list on the US Clinical Trials DatabaseHowever, given the stringent requirements for candidates (victims of emergency trauma with no likelihood of survival), one cannot really depend on a hard and fast timetable.
Still, the technology is promising. Experts predict that someday we may even have the ability to make use of it to maintain patients suspended for months or years, allowing astronauts to survive decades-long space flights or delaying the death of sick patients awaiting a cure.
Artificial uterus
Another science fiction classic: the expansion of human babies outside the womb. Think of the fetal fields of The Matrixor the frozen embryos in Alien: Covenant.
In 1923, the British biologist JBS Haldane coined a term for this – Ectogenesis. He predicted that by 2074, 70% of all pregnancies – from conception to birth – would happen in artificial wombs. That many seems unlikely, however the timeline is on the right track.
The development of an embryo outside the uterus is already routine in in vitro Fertilization. And technology allows premature babies to survive much of the second half of pregnancy. A traditional human pregnancy lasts 40 weeks and TThe youngest premature baby ever to survive was 21 weeks and 1 day old, only just a few days younger than some others who were still alive.
The biggest obstacle for younger babies is lung function. Mechanical ventilation can damage the lungs and result in a chronic (and sometimes fatal) lung disease called bronchopulmonary dysplasia. To avoid this, one would want to search out a method to maintain fetal circulation – the complex system that carries oxygen-rich blood from the placenta through the umbilical cord to the fetus. Researchers at Children's Hospital of Philadelphia (CHOP) have achieved this using a fetal lamb.
The key to their invention is a surrogate placenta: an oxygen device connected to the lamb's umbilical cord. Tubes inserted through the umbilical vein and arteries carry oxygen-rich blood from the “placenta” to the fetus and oxygen-poor blood out again. The lamb is kept in a man-made, fluid-filled amniotic sac until its lungs and other organs are developed.
Fertility treatments could also profit from this. “An artificial womb can be used in situations where a surrogate mother is indicated,” says Paula AmatoMD, professor of obstetrics and gynecology at Oregon Health and Science University. (Amato shouldn't be involved in CHOP research.) For example: If the mother lacks a uterus or cannot safely carry a pregnancy to term.
There isn't any date for clinical trials yet. But based on Researchthe fundamental difference between humans and lambs could also be size. A lamb's umbilical vessels are larger, so feeding via a tube is less complicated. Given today's advances in miniaturizing surgical methods, this appears to be a challenge that scientists can overcome.
Messenger RNA therapeutics
Back to Star Trek. The contents of the hypospray injector could cure virtually any disease, even one just discovered on an alien planet. This shouldn't be unlike messenger RNA (mRNA) technology, a breakthrough that allowed scientists to quickly develop among the first COVID-19 vaccines.
But vaccines are just the start of what this technology can do.
An entire field of immunotherapy is emerging that uses mRNA to deliver instructions for making chimeric antigen receptor-modified immune cells (CAR-modified immune cells). These cells are engineered to attack diseased cells and tissues, comparable to Cancer cells and harmful fibroblasts (scar tissue) that promote fibrosis, for instance within the Heart and lungs.
There is currently loads of research being done in rodents on this area and clinical trials have begun to treat some advanced cancers.
It might be years before these drugs are literally utilized in the clinic, but when all goes well, they may help treat and even cure probably the most fundamental medical problems facing humanity. We're talking about cancer, heart disease and neurodegenerative diseases. One therapy could be transformed into one other by simply changing the “nucleotide sequence” of the mRNA, the blueprint that comprises the instructions on what to do and what disease to fight.
As this technology matures, we may begin to feel like we're truly on the Star Trekwhere Dr. Leonard “Bones” McCoy uses the identical device to treat virtually any illness or injury.