WEBVTT 00:00:11.853 --> 00:00:14.206 For the past 12 years, 00:00:14.211 --> 00:00:18.707 I have been a researcher in the field of regenerative medicine. 00:00:18.713 --> 00:00:20.633 As a doctor of neuroscience, 00:00:20.638 --> 00:00:23.936 my work investigates whether or not we can use stem cells 00:00:23.937 --> 00:00:27.962 to help children who have had brain injury or adults with spinal cord injury. 00:00:29.541 --> 00:00:31.683 Today, I am going to speak with you 00:00:31.693 --> 00:00:35.684 about how we are changing the future with stem cells. 00:00:37.266 --> 00:00:42.081 I believe that stem cells are the new Internet. 00:00:42.656 --> 00:00:44.903 Think about it. 00:00:45.255 --> 00:00:51.742 Think about how the Internet completely changed the way that we communicate, 00:00:52.045 --> 00:00:53.958 the way that we do business, 00:00:53.972 --> 00:00:57.698 and even the way that we gather data and information. 00:00:58.305 --> 00:01:05.205 Similarly, I believe that stem cells have the power to revolutionize 00:01:05.230 --> 00:01:08.274 the whole concept of healthcare. 00:01:09.074 --> 00:01:12.404 So to start, let's have a little audience participation. 00:01:12.419 --> 00:01:15.975 Put your hand up: how many of you have heard of the term "stem cells"? 00:01:16.032 --> 00:01:20.194 Now leave your hand up if you can tell me what they are. 00:01:21.769 --> 00:01:27.304 This illustrates a very important part of my work in science communications. 00:01:27.324 --> 00:01:30.105 Most of us have heard of the term stem cells 00:01:30.116 --> 00:01:32.797 either through the media or through our friends, 00:01:32.828 --> 00:01:35.919 but very few of us actually know what they are, 00:01:35.944 --> 00:01:39.994 what they can do, and, importantly, what they can't do. 00:01:40.267 --> 00:01:43.551 So, today, we're going to speak a little about what stem cells are, 00:01:43.563 --> 00:01:46.445 we're going to look at what they're currently being used for, 00:01:46.457 --> 00:01:49.136 and where the future of the field lies. 00:01:50.287 --> 00:01:54.750 So, you can't be expected to understand about stem cell treatments 00:01:54.776 --> 00:01:57.550 if you don't understand what stem cells are to begin with. 00:01:57.563 --> 00:02:00.936 This is something that I like to call "Stem Cells: 101". 00:02:01.896 --> 00:02:05.252 We all know that the hundreds of cells in the human body 00:02:05.276 --> 00:02:08.008 all originate from one fertilized egg. 00:02:08.392 --> 00:02:11.544 If you think of this as a ball rolling down a hill: 00:02:11.669 --> 00:02:16.576 at the top of the hill, the ball can go to any number of destinations downhill, 00:02:16.887 --> 00:02:21.342 but as it rolls down guided by gravity, it hits a series of forks in the road. 00:02:21.347 --> 00:02:24.998 After which it must make a decision to go one way or the other, 00:02:25.216 --> 00:02:29.480 and that restricts its potential outcomes. 00:02:29.746 --> 00:02:34.000 Similarly, stem cells during the process of differentiation 00:02:34.020 --> 00:02:36.243 face a series of fate decisions 00:02:36.254 --> 00:02:40.451 where they must choose which cell type to specialize into, 00:02:40.459 --> 00:02:42.074 and they cannot go back. 00:02:42.707 --> 00:02:46.404 Near the top of the hill, you see pluripotent stem cells: 00:02:46.429 --> 00:02:49.338 "pluri-" meaning "many"; "potent", "potencies". 00:02:49.930 --> 00:02:52.637 Embryonic pluripotent stem cells 00:02:52.650 --> 00:02:57.416 are the type of stem cell that people most often associate with the word. 00:02:57.431 --> 00:03:02.566 However, in reality, these cells are virtually never used 00:03:02.573 --> 00:03:04.226 in transplant paradigms. 00:03:04.233 --> 00:03:09.063 Instead, we differentiate the cell down into multipotent progenitors 00:03:09.199 --> 00:03:12.453 that are very specialized for the type of tissue that we want to get. 00:03:12.918 --> 00:03:16.897 It's important to note that one type of multipotent cell 00:03:16.903 --> 00:03:19.334 cannot make adult cells of another type. 00:03:19.346 --> 00:03:24.090 For example, fat stem cells cannot make cells of the brain or the eye, 00:03:24.094 --> 00:03:25.520 and vice versa. 00:03:26.879 --> 00:03:29.087 So, you might ask, 00:03:29.101 --> 00:03:32.892 if pluripotent stem cells can turn into any cell in the body, 00:03:32.905 --> 00:03:35.023 why don't we just inject those? 00:03:35.029 --> 00:03:37.045 You know, they could go to the site, 00:03:37.051 --> 00:03:39.544 they could travel to the site of whatever is injured 00:03:39.555 --> 00:03:41.870 and turn into the cells that we need. 00:03:42.872 --> 00:03:43.895 Right? 00:03:43.901 --> 00:03:44.926 Wrong! 00:03:44.937 --> 00:03:47.459 Because they could turn into something like this. 00:03:47.466 --> 00:03:49.521 This is called a teratoma. 00:03:50.157 --> 00:03:53.324 The problem is once we put stem cells in, 00:03:53.360 --> 00:03:57.228 we cannot control where they go or what cells they turn into. 00:03:57.242 --> 00:04:00.344 They could turn into all of the cells in the body 00:04:00.357 --> 00:04:02.631 all at once, all in the same place. 00:04:03.349 --> 00:04:08.940 Here you can see hair, fat, tooth, gut, bone - 00:04:09.559 --> 00:04:13.981 imagine if this were in your brain or your eye. 00:04:14.649 --> 00:04:17.308 This is why we must differentiate cells 00:04:17.313 --> 00:04:20.127 into the specific progenitors as much as possible 00:04:20.132 --> 00:04:22.330 before we're thinking of transplanting them in. 00:04:23.459 --> 00:04:29.107 Now, all of our adult tissue has its own multipotent cells within it, 00:04:29.120 --> 00:04:33.876 that's what helps us to grow or when we're repairing injury, 00:04:34.350 --> 00:04:36.398 and these can be harvested in many tissues, 00:04:36.405 --> 00:04:39.896 and grown in the lab for transplanting paradigms. 00:04:40.193 --> 00:04:44.124 However, there are some tissues that you can't harvest. 00:04:44.566 --> 00:04:47.444 Think about the brain or the heart or the eye. 00:04:47.448 --> 00:04:49.897 Going in there to get cells could kill you. 00:04:50.330 --> 00:04:54.564 So we have to think of other alternative cell sources for these cells. 00:04:55.195 --> 00:04:58.134 And this is where pluripotent cells come in. 00:04:58.140 --> 00:05:02.826 Now, up until now, embryonic drive cells have been differentiated down the hill 00:05:02.839 --> 00:05:07.030 into the stem cell types that we need. 00:05:07.568 --> 00:05:11.108 Recently, induced pluripotent stem cells were developed 00:05:11.119 --> 00:05:14.906 where you can take adult skin samples, your own consenting adult, 00:05:15.316 --> 00:05:18.059 push them back up the hill using four chemical factors, 00:05:18.072 --> 00:05:20.980 and then differentiate them down to the cell type you need. 00:05:21.278 --> 00:05:23.910 This was discovered recently by Shinya Yamanaka, 00:05:23.916 --> 00:05:26.075 who went on to win the Nobel Prize. 00:05:26.085 --> 00:05:29.658 The good thing about this is it uses non embryonic sources, 00:05:29.661 --> 00:05:32.793 and it's your own tissue, so your body is not likely to reject it. 00:05:33.399 --> 00:05:38.845 Alternatively, direct lineage reprogramming - there we go - 00:05:39.040 --> 00:05:40.753 takes you from A to B 00:05:40.764 --> 00:05:43.052 without this intermediate step up the hill. 00:05:43.269 --> 00:05:45.610 You can take adult skin samples 00:05:45.616 --> 00:05:48.793 and differentiate them directly into the cell type you choose 00:05:48.803 --> 00:05:50.501 using different chemical triggers. 00:05:50.827 --> 00:05:54.793 Now, this is only in the lab phases, it's very new, 00:05:54.802 --> 00:05:57.193 but it represents a very interesting direction 00:05:57.199 --> 00:05:58.901 into where the field is heading. 00:06:01.234 --> 00:06:04.211 So, what we are we doing with stem cells? 00:06:04.212 --> 00:06:06.032 Here's another audience participation. 00:06:06.343 --> 00:06:11.071 How many of you are affected by, or know someone who has been affected by, 00:06:11.089 --> 00:06:12.402 any of these diseases? 00:06:12.403 --> 00:06:13.610 Put up your hands. 00:06:13.620 --> 00:06:17.279 Stroke, burns, diabetes, injuries to joints. 00:06:18.132 --> 00:06:19.739 Now look around. 00:06:21.185 --> 00:06:26.590 Every single one of us is affected by diseases 00:06:26.592 --> 00:06:30.724 that stem cells could potentially one day help treat. 00:06:33.404 --> 00:06:38.120 Just because we are putting stem cells into the first person in the first trial 00:06:38.293 --> 00:06:39.967 doesn't mean these are a treatment, 00:06:39.987 --> 00:06:42.580 doesn't mean it's a regular accepted treatment. 00:06:42.704 --> 00:06:44.135 As you can see here, 00:06:44.144 --> 00:06:47.387 it can take up to ten years or over 00:06:47.391 --> 00:06:49.546 to get through the clinical trials pipeline. 00:06:49.897 --> 00:06:52.475 Science is incremental, 00:06:53.309 --> 00:06:56.352 but the good news is we have a lot of treatments 00:06:56.362 --> 00:06:58.547 that have been in the pipeline for many years, 00:06:58.554 --> 00:07:00.945 that are just now starting to come out. 00:07:01.921 --> 00:07:05.460 Furthermore, now more than ever before, 00:07:05.473 --> 00:07:09.948 scientists, clinicians, members of the public, policymakers, 00:07:09.965 --> 00:07:14.564 are all working together to streamline this process. 00:07:14.598 --> 00:07:17.717 That means we can get the best stem cell treatments out 00:07:17.726 --> 00:07:21.596 to the people who need them the most in the shortest amount of time. 00:07:22.108 --> 00:07:24.583 So here you see these diseases are colour-coded 00:07:24.585 --> 00:07:26.532 based on where they are on the pipeline. 00:07:26.537 --> 00:07:30.132 You can see that we have two current treatments using stem cells 00:07:30.147 --> 00:07:31.593 here in green. 00:07:31.611 --> 00:07:34.357 The first for bone and blood cancer 00:07:34.384 --> 00:07:37.505 you might know of as a bone marrow transplant. 00:07:37.506 --> 00:07:39.506 Been used for decades. 00:07:39.510 --> 00:07:43.564 The next stem cell product to come out of the pipeline 00:07:43.577 --> 00:07:45.338 is for burns and wound healing. 00:07:45.356 --> 00:07:51.227 This uses skin tissue and helps with vision burns as well. 00:07:52.126 --> 00:07:54.521 Today we're going to focus on two major areas 00:07:54.533 --> 00:07:56.158 that we're using stem cells in. 00:07:56.159 --> 00:07:57.573 The first is stroke. 00:07:58.281 --> 00:08:00.755 This is my work in childhood brain injury. 00:08:01.753 --> 00:08:06.710 Did you know that cerebral palsy is more common 00:08:06.723 --> 00:08:11.984 than juvenile AIDS, childhood leukaemia, muscular dystrophy, 00:08:11.999 --> 00:08:15.081 and juvenile diabetes combined. 00:08:15.926 --> 00:08:19.316 Cerebral palsy, which means problems sending signals 00:08:19.326 --> 00:08:22.391 from the brain to the muscles creating movement 00:08:22.403 --> 00:08:25.824 is the most common neurodevelopmental disability. 00:08:26.827 --> 00:08:28.411 What my work does, 00:08:28.429 --> 00:08:31.044 is we inject stem cells into the brain 00:08:31.298 --> 00:08:35.635 which are able to incorporate and turn into the site types of cells 00:08:35.639 --> 00:08:38.287 that are lost in the most common forms of brain injury. 00:08:38.486 --> 00:08:41.089 They can enhance function and restore brain tissue. 00:08:41.308 --> 00:08:44.399 And what my work in particular has been able to show 00:08:44.415 --> 00:08:48.939 is that we are able to functionally double the signal speed 00:08:48.955 --> 00:08:50.691 in the brains of animals. 00:08:50.891 --> 00:08:53.693 What could this mean for a child with cerebral palsy? 00:08:53.806 --> 00:08:57.126 This could mean the potential for normal movement, 00:08:57.401 --> 00:09:01.067 the ability to go out and run and jump, to play with their friends. 00:09:01.144 --> 00:09:03.019 Very exciting stuff. 00:09:03.212 --> 00:09:07.693 Right now, these cells are being used in clinical trials only. 00:09:08.250 --> 00:09:11.399 There are trials in adults looking at stroke, 00:09:11.410 --> 00:09:14.349 and there are adult trials looking in spinal cord injury. 00:09:14.968 --> 00:09:18.270 The same cells are lost in these models. 00:09:18.276 --> 00:09:22.437 Importantly, the first clinical trial using these types of cells 00:09:22.442 --> 00:09:24.262 has now started in children. 00:09:26.716 --> 00:09:30.929 Next, I want to focus on a very interesting area 00:09:30.940 --> 00:09:35.027 that's combining 3D bioprinting with stem cell regenerative medicine. 00:09:35.037 --> 00:09:38.236 This is in red, because it is only in the early stages, 00:09:38.237 --> 00:09:41.008 but I think it represents a very exciting avenue 00:09:41.022 --> 00:09:43.091 through which the field is heading. 00:09:43.905 --> 00:09:47.205 With improvements in imaging software and technology, 00:09:47.231 --> 00:09:51.738 we are now able to make accurate 3D images 00:09:51.743 --> 00:09:55.336 and take scans of body structures inside the body. 00:09:56.247 --> 00:09:58.947 Using AutoCAD and 3D software, 00:09:58.948 --> 00:10:04.676 we are able to make CAD designs which can be printed using 3D bioprinters. 00:10:04.973 --> 00:10:08.384 These bioprinters are kind of like the printers you have at home, 00:10:08.538 --> 00:10:12.034 only, instead of using ink, they use special biogels 00:10:12.043 --> 00:10:15.215 to create the structures that you have in the body. 00:10:15.567 --> 00:10:19.639 After that, you can seed them with stem cells. 00:10:19.780 --> 00:10:22.519 Here you see a heart valve being printed 00:10:22.542 --> 00:10:26.416 which can then later be seeded, possibly with your own stem cells. 00:10:26.800 --> 00:10:29.596 There's an image on the inset of the heart valve. 00:10:29.605 --> 00:10:33.639 There's also an image of an ear being seeded with stem cells 00:10:33.650 --> 00:10:35.047 which can be your own. 00:10:35.061 --> 00:10:38.439 Underneath, you see a 3D printed image of a trachea. 00:10:38.457 --> 00:10:43.119 On the bottom right, you see an interview that I recently did with CTV national news 00:10:43.131 --> 00:10:47.635 on the youngest ever transplant recipient of a trachea 00:10:47.637 --> 00:10:49.337 seeded with her own stem cells. 00:10:50.392 --> 00:10:54.954 It's important to note that while this is very exciting, 00:10:54.966 --> 00:10:56.579 it is still in its infancy. 00:10:56.583 --> 00:11:00.452 We cannot make complicated structures with multiple cell types, 00:11:00.815 --> 00:11:04.340 and right now, it is just very basic. 00:11:04.356 --> 00:11:06.168 But think about where this can head. 00:11:06.675 --> 00:11:10.805 Think about whether we could use it in the future 00:11:10.822 --> 00:11:14.879 to print structures in the body and use our own cells for transplant. 00:11:16.398 --> 00:11:19.348 So this is a very exciting field, 00:11:19.359 --> 00:11:23.445 but as with every potentially game-changing technology, 00:11:23.455 --> 00:11:24.903 there are challenges. 00:11:25.130 --> 00:11:28.954 This used to centre around the use of embryonic drive stem cells, 00:11:28.967 --> 00:11:32.567 but, recently, with the advent of the induced pluripotent stem cells 00:11:32.568 --> 00:11:34.473 and direct lineage reprogramming, 00:11:34.484 --> 00:11:38.576 which can use your own adult consenting tissues, 00:11:38.591 --> 00:11:41.759 this conversation has become less and less relevant. 00:11:42.535 --> 00:11:44.553 What we see, 00:11:44.573 --> 00:11:49.909 especially with the the increase of treatments coming out of the pipeline, 00:11:49.932 --> 00:11:54.111 is misrepresentation of stem cell strategies. 00:11:55.271 --> 00:12:02.233 Here, some doctors are offering unproven treatments using stem cells 00:12:02.241 --> 00:12:03.659 for profit. 00:12:04.587 --> 00:12:09.426 Unproven - that means a) not proven to work, 00:12:09.452 --> 00:12:12.818 and b) not proven to be safe. 00:12:13.744 --> 00:12:16.933 Recently, "Scientific American" had an article 00:12:16.949 --> 00:12:21.790 about a woman who went to a very fancy clinic in Beverly Hills 00:12:21.811 --> 00:12:26.480 and got the latest stem cell facelift that they were offering. 00:12:27.285 --> 00:12:33.226 The doctors took advantage of a loophole in the law, 00:12:33.640 --> 00:12:37.308 sucked out her fat, and put the stem cells in her face 00:12:37.317 --> 00:12:41.157 to make her rejuvenated, or healthier or something. 00:12:41.462 --> 00:12:45.396 And while they were under the hood, they gave her dermal filler. 00:12:45.955 --> 00:12:49.774 What the doctors didn't take into account 00:12:49.935 --> 00:12:51.965 is that dermal filler 00:12:51.972 --> 00:12:56.683 differentiates fat stem cells 00:12:56.684 --> 00:12:59.528 into bone. 00:13:00.150 --> 00:13:05.400 So this woman was left with bone fragments in her eyelids. 00:13:06.801 --> 00:13:13.716 This is why we need clinical trials to make sure that treatments are safe. 00:13:14.376 --> 00:13:18.226 If you were to take a drug, and you had a bad side effect, 00:13:18.237 --> 00:13:22.201 you could stop taking the drug, and that side effect would go away. 00:13:22.215 --> 00:13:24.966 But it's not the case with stem cells. 00:13:24.980 --> 00:13:29.335 Once stem cells are put in, they can never be taken back out. 00:13:30.147 --> 00:13:32.922 Furthermore, going to an unregulated clinic 00:13:32.955 --> 00:13:36.069 can exclude you from future legitimate trials. 00:13:36.091 --> 00:13:39.704 So, how do you know whether or not what you're looking at 00:13:39.721 --> 00:13:44.311 is a real stem cell treatment or misrepresentation? 00:13:44.370 --> 00:13:47.979 Here are some hints that can help you, it's a difficult field to navigate. 00:13:48.032 --> 00:13:51.423 The first: look at how many cell types per injury. 00:13:51.476 --> 00:13:56.540 We mentioned that cell types need to be very specific to replace damaged tissue, 00:13:56.576 --> 00:14:00.712 and one stem cell type cannot turn into cells of another. 00:14:00.899 --> 00:14:02.975 So it's very important if someone's saying 00:14:02.983 --> 00:14:05.315 they're going to suck out one type of stem cell 00:14:05.321 --> 00:14:07.740 and use it for 12 different indications, 00:14:07.747 --> 00:14:09.898 it's likely something you should question. 00:14:10.028 --> 00:14:13.107 Second of all: you can check out their preclinical track record; 00:14:13.131 --> 00:14:16.134 clinicaltrials. gov is a comprehensive database 00:14:16.135 --> 00:14:20.266 of all of the clinical trials if they want to get FDA approval. 00:14:20.596 --> 00:14:23.254 And the third and most important thing that you can do 00:14:23.266 --> 00:14:25.065 is to be knowledgeable. 00:14:25.543 --> 00:14:29.232 Do your research and get consensus. 00:14:30.095 --> 00:14:34.967 Ask your doctors, all of them, because they are here to help you. 00:14:36.808 --> 00:14:43.157 So, overall stem cells have the potential 00:14:43.171 --> 00:14:47.279 to change life as we know it. 00:14:48.150 --> 00:14:52.689 Every single one of us is affected by diseases 00:14:52.717 --> 00:14:57.234 which stem cells could potentially help to treat in the future. 00:14:58.344 --> 00:15:02.647 And now that you have the knowledge, you have the power. 00:15:02.672 --> 00:15:06.560 It is up to you to spread the word about stem cells 00:15:06.586 --> 00:15:09.494 and to support reputable clinical trials, 00:15:09.503 --> 00:15:12.718 so that we can work hard to get the best treatments out 00:15:12.731 --> 00:15:17.433 to the people who need them the most in the shortest possible amount of time. 00:15:18.161 --> 00:15:23.184 Right now, there are many - more than ever before - treatments 00:15:23.184 --> 00:15:25.305 in the pipeline, ready to come out. 00:15:25.323 --> 00:15:29.332 And the field of regenerative medicine is at critical mass. 00:15:29.991 --> 00:15:33.621 So I ask you to come join me on this journey. 00:15:33.888 --> 00:15:40.229 Come with me as newly-minted purveyors of stem cell knowledge 00:15:40.609 --> 00:15:44.966 as we turn science fiction into science fact. 00:15:45.160 --> 00:15:46.389 Thank you. 00:15:46.389 --> 00:15:47.953 (Applause)