0:00:11.743,0:00:14.206 For the past 12 years, 0:00:14.211,0:00:18.707 I have been a researcher[br]in the field of regenerative medicine. 0:00:18.713,0:00:20.633 As a doctor of neuroscience, 0:00:20.638,0:00:23.936 my work investigates[br]whether or not we can use stem cells 0:00:23.937,0:00:27.962 to help children who have had brain injury[br]or adults with spinal cord injury. 0:00:29.541,0:00:31.683 Today, I am going to speak with you 0:00:31.693,0:00:35.684 about how we are changing[br]the future with stem cells. 0:00:37.266,0:00:42.081 I believe that stem cells[br]are the new Internet. 0:00:42.656,0:00:44.903 Think about it. 0:00:45.255,0:00:51.742 Think about how the Internet completely[br]changed the way that we communicate, 0:00:52.045,0:00:53.958 the way that we do business, 0:00:53.972,0:00:57.698 and even the way[br]that we gather data and information. 0:00:58.305,0:01:05.205 Similarly, I believe that stem cells[br]have the power to revolutionize 0:01:05.230,0:01:08.274 the whole concept of healthcare. 0:01:09.074,0:01:12.404 So to start, let's have[br]a little audience participation. 0:01:12.419,0:01:15.975 Put your hand up: how many of you[br]have heard of the term "stem cells"? 0:01:16.032,0:01:20.194 Now leave your hand up[br]if you can tell me what they are. 0:01:21.769,0:01:27.304 This illustrates a very important part[br]of my work in science communications. 0:01:27.324,0:01:30.105 Most of us have heard[br]of the term stem cells 0:01:30.116,0:01:32.797 either through the media[br]or through our friends, 0:01:32.828,0:01:35.919 but very few of us[br]actually know what they are, 0:01:35.944,0:01:39.994 what they can do,[br]and, importantly, what they can't do. 0:01:40.267,0:01:43.551 So, today, we're going to speak[br]a little about what stem cells are, 0:01:43.563,0:01:46.445 we're going to look[br]at what they're currently being used for, 0:01:46.457,0:01:49.136 and where the future of the field lies. 0:01:50.287,0:01:54.750 So, you can't be expected to understand[br]about stem cell treatments 0:01:54.776,0:01:57.550 if you don't understand[br]what stem cells are to begin with. 0:01:57.563,0:02:00.936 This is something[br]that I like to call "Stem Cells: 101". 0:02:01.896,0:02:05.252 We all know that the hundreds of cells[br]in the human body 0:02:05.276,0:02:08.008 all originate from one fertilized egg. 0:02:08.392,0:02:11.544 If you think of this[br]as a ball rolling down a hill: 0:02:11.669,0:02:16.576 at the top of the hill, the ball can go[br]to any number of destinations downhill, 0:02:16.887,0:02:21.342 but as it rolls down guided by gravity,[br]it hits a series of forks in the road. 0:02:21.347,0:02:24.998 After which it must make a decision[br]to go one way or the other, 0:02:25.216,0:02:29.480 and that restricts its potential outcomes. 0:02:29.746,0:02:34.000 Similarly, stem cells[br]during the process of differentiation 0:02:34.020,0:02:36.243 face a series of fate decisions 0:02:36.254,0:02:40.451 where they must choose[br]which cell type to specialize into, 0:02:40.459,0:02:42.074 and they cannot go back. 0:02:42.707,0:02:46.404 Near the top of the hill,[br]you see pluripotent stem cells: 0:02:46.429,0:02:49.338 "pluri-" meaning "many";[br]"potent", "potencies". 0:02:49.930,0:02:52.637 Embryonic pluripotent stem cells 0:02:52.650,0:02:57.416 are the type of stem cell that people[br]most often associate with the word. 0:02:57.431,0:03:02.566 However, in reality, these cells[br]are virtually never used 0:03:02.573,0:03:04.226 in transplant paradigms. 0:03:04.233,0:03:09.063 Instead, we differentiate the cell down[br]into multipotent progenitors 0:03:09.199,0:03:12.453 that are very specialized for the type[br]of tissue that we want to get. 0:03:12.918,0:03:16.897 It's important to note[br]that one type of multipotent cell 0:03:16.903,0:03:19.334 cannot make adult cells of another type. 0:03:19.346,0:03:24.090 For example, fat stem cells[br]cannot make cells of the brain or the eye, 0:03:24.094,0:03:25.520 and vice versa. 0:03:26.879,0:03:29.087 So, you might ask, 0:03:29.101,0:03:32.892 if pluripotent stem cells can turn[br]into any cell in the body, 0:03:32.905,0:03:35.023 why don't we just inject those? 0:03:35.029,0:03:37.045 You know, they could go to the site, 0:03:37.051,0:03:39.544 they could travel to the site[br]of whatever is injured 0:03:39.555,0:03:41.870 and turn into the cells that we need. 0:03:42.872,0:03:43.895 Right? 0:03:43.901,0:03:44.926 Wrong! 0:03:44.937,0:03:47.459 Because they could turn[br]into something like this. 0:03:47.466,0:03:49.521 This is called a teratoma. 0:03:50.157,0:03:53.324 The problem is once we put stem cells in, 0:03:53.360,0:03:57.228 we cannot control where they go[br]or what cells they turn into. 0:03:57.242,0:04:00.344 They could turn[br]into all of the cells in the body 0:04:00.357,0:04:02.631 all at once, all in the same place. 0:04:03.349,0:04:08.940 Here you can see hair,[br]fat, tooth, gut, bone - 0:04:09.559,0:04:13.981 imagine if this were[br]in your brain or your eye. 0:04:14.649,0:04:17.308 This is why we must differentiate cells 0:04:17.313,0:04:20.127 into the specific progenitors[br]as much as possible 0:04:20.132,0:04:22.330 before we're thinking[br]of transplanting them in. 0:04:23.459,0:04:29.107 Now, all of our adult tissue has[br]its own multipotent cells within it, 0:04:29.120,0:04:33.876 that's what helps us to grow[br]or when we're repairing injury, 0:04:34.350,0:04:36.398 and these can be harvested[br]in many tissues, 0:04:36.405,0:04:39.896 and grown in the lab[br]for transplanting paradigms. 0:04:40.193,0:04:44.124 However, there are some tissues[br]that you can't harvest. 0:04:44.566,0:04:47.444 Think about the brain[br]or the heart or the eye. 0:04:47.448,0:04:49.897 Going in there to get cells[br]could kill you. 0:04:50.330,0:04:54.564 So we have to think of other alternative[br]cell sources for these cells. 0:04:55.195,0:04:58.134 And this is where[br]pluripotent cells come in. 0:04:58.140,0:05:02.826 Now, up until now, embryonic drive cells[br]have been differentiated down the hill 0:05:02.839,0:05:07.030 into the stem cell types that we need. 0:05:07.568,0:05:11.108 Recently, induced pluripotent[br]stem cells were developed 0:05:11.119,0:05:14.906 where you can take adult skin samples,[br]your own consenting adult, 0:05:15.316,0:05:18.059 push them back up the hill[br]using four chemical factors, 0:05:18.072,0:05:20.980 and then differentiate them down[br]to the cell type you need. 0:05:21.278,0:05:23.910 This was discovered recently[br]by Shinya Yamanaka, 0:05:23.916,0:05:26.075 who went on to win the Nobel Prize. 0:05:26.085,0:05:29.658 The good thing about this is[br]it uses non embryonic sources, 0:05:29.661,0:05:32.793 and it's your own tissue,[br]so your body is not likely to reject it. 0:05:33.399,0:05:38.845 Alternatively, direct lineage[br]reprogramming - there we go - 0:05:39.040,0:05:40.753 takes you from A to B 0:05:40.764,0:05:43.052 without this intermediate[br]step up the hill. 0:05:43.269,0:05:45.610 You can take adult skin samples 0:05:45.616,0:05:48.793 and differentiate them directly[br]into the cell type you choose 0:05:48.803,0:05:50.501 using different chemical triggers. 0:05:50.827,0:05:54.793 Now, this is only[br]in the lab phases, it's very new, 0:05:54.802,0:05:57.193 but it represents[br]a very interesting direction 0:05:57.199,0:05:58.901 into where the field is heading. 0:06:01.234,0:06:04.211 So, what we are we doing with stem cells? 0:06:04.212,0:06:06.032 Here's another audience participation. 0:06:06.343,0:06:11.071 How many of you are affected by,[br]or know someone who has been affected by, 0:06:11.089,0:06:12.402 any of these diseases? 0:06:12.403,0:06:13.610 Put up your hands. 0:06:13.620,0:06:17.279 Stroke, burns, diabetes,[br]injuries to joints. 0:06:18.132,0:06:19.739 Now look around. 0:06:21.185,0:06:26.590 Every single one of us[br]is affected by diseases 0:06:26.592,0:06:30.724 that stem cells could potentially[br]one day help treat. 0:06:33.404,0:06:38.120 Just because we are putting stem cells[br]into the first person in the first trial 0:06:38.293,0:06:39.967 doesn't mean these are a treatment, 0:06:39.987,0:06:42.580 doesn't mean it's[br]a regular accepted treatment. 0:06:42.704,0:06:44.135 As you can see here, 0:06:44.144,0:06:47.387 it can take up to ten years or over 0:06:47.391,0:06:49.546 to get through[br]the clinical trials pipeline. 0:06:49.897,0:06:52.475 Science is incremental, 0:06:53.309,0:06:56.352 but the good news is[br]we have a lot of treatments 0:06:56.362,0:06:58.547 that have been in the pipeline[br]for many years, 0:06:58.554,0:07:00.945 that are just now starting to come out. 0:07:01.921,0:07:05.460 Furthermore, now more than ever before, 0:07:05.473,0:07:09.948 scientists, clinicians,[br]members of the public, policymakers, 0:07:09.965,0:07:14.564 are all working together[br]to streamline this process. 0:07:14.598,0:07:17.717 That means we can get[br]the best stem cell treatments out 0:07:17.726,0:07:21.596 to the people who need them the most[br]in the shortest amount of time. 0:07:22.108,0:07:24.583 So here you see these diseases[br]are colour-coded 0:07:24.585,0:07:26.532 based on where they are on the pipeline. 0:07:26.537,0:07:30.132 You can see that we have[br]two current treatments using stem cells 0:07:30.147,0:07:31.593 here in green. 0:07:31.611,0:07:34.357 The first for bone and blood cancer 0:07:34.384,0:07:37.505 you might know of[br]as a bone marrow transplant. 0:07:37.506,0:07:39.506 Been used for decades. 0:07:39.510,0:07:43.564 The next stem cell product[br]to come out of the pipeline 0:07:43.577,0:07:45.338 is for burns and wound healing. 0:07:45.356,0:07:51.227 This uses skin tissue[br]and helps with vision burns as well. 0:07:52.126,0:07:54.521 Today we're going to focus[br]on two major areas 0:07:54.533,0:07:56.158 that we're using stem cells in. 0:07:56.159,0:07:57.573 The first is stroke. 0:07:58.281,0:08:00.755 This is my work in childhood brain injury. 0:08:01.753,0:08:06.710 Did you know that cerebral palsy[br]is more common 0:08:06.723,0:08:11.984 than juvenile AIDS, childhood leukaemia,[br]muscular dystrophy, 0:08:11.999,0:08:15.081 and juvenile diabetes combined. 0:08:15.926,0:08:19.316 Cerebral palsy, which means[br]problems sending signals 0:08:19.326,0:08:22.391 from the brain to the muscles[br]creating movement 0:08:22.403,0:08:25.824 is the most common[br]neurodevelopmental disability. 0:08:26.827,0:08:28.411 What my work does, 0:08:28.429,0:08:31.044 is we inject stem cells into the brain 0:08:31.298,0:08:35.635 which are able to incorporate[br]and turn into the site types of cells 0:08:35.639,0:08:38.287 that are lost in the most[br]common forms of brain injury. 0:08:38.486,0:08:41.089 They can enhance function[br]and restore brain tissue. 0:08:41.308,0:08:44.399 And what my work in particular[br]has been able to show 0:08:44.415,0:08:48.939 is that we are able to functionally[br]double the signal speed 0:08:48.955,0:08:50.691 in the brains of animals. 0:08:50.891,0:08:53.693 What could this mean for a child[br]with cerebral palsy? 0:08:53.806,0:08:57.126 This could mean the potential[br]for normal movement, 0:08:57.401,0:09:01.067 the ability to go out and run and jump,[br]to play with their friends. 0:09:01.144,0:09:03.019 Very exciting stuff. 0:09:03.212,0:09:07.693 Right now, these cells are being used[br]in clinical trials only. 0:09:08.250,0:09:11.399 There are trials in adults[br]looking at stroke, 0:09:11.410,0:09:14.349 and there are adult trials[br]looking in spinal cord injury. 0:09:14.968,0:09:18.270 The same cells are lost in these models. 0:09:18.276,0:09:22.437 Importantly, the first clinical trial[br]using these types of cells 0:09:22.442,0:09:24.262 has now started in children. 0:09:26.716,0:09:30.929 Next, I want to focus[br]on a very interesting area 0:09:30.940,0:09:35.027 that's combining 3D bioprinting[br]with stem cell regenerative medicine. 0:09:35.037,0:09:38.236 This is in red, because it is[br]only in the early stages, 0:09:38.237,0:09:41.008 but I think it represents[br]a very exciting avenue 0:09:41.022,0:09:43.091 through which the field is heading. 0:09:43.905,0:09:47.205 With improvements[br]in imaging software and technology, 0:09:47.231,0:09:51.738 we are now able to make accurate 3D images 0:09:51.743,0:09:55.336 and take scans of body structures[br]inside the body. 0:09:56.247,0:09:58.947 Using AutoCAD and 3D software, 0:09:58.948,0:10:04.676 we are able to make CAD designs[br]which can be printed using 3D bioprinters. 0:10:04.973,0:10:08.384 These bioprinters are kind of like[br]the printers you have at home, 0:10:08.538,0:10:12.034 only, instead of using ink,[br]they use special biogels 0:10:12.043,0:10:15.215 to create the structures[br]that you have in the body. 0:10:15.567,0:10:19.639 After that, you can seed them[br]with stem cells. 0:10:19.780,0:10:22.519 Here you see a heart valve being printed 0:10:22.542,0:10:26.416 which can then later be seeded,[br]possibly with your own stem cells. 0:10:26.800,0:10:29.596 There's an image on the inset[br]of the heart valve. 0:10:29.605,0:10:33.639 There's also an image of an ear[br]being seeded with stem cells 0:10:33.650,0:10:35.047 which can be your own. 0:10:35.061,0:10:38.439 Underneath, you see[br]a 3D printed image of a trachea. 0:10:38.457,0:10:43.119 On the bottom right, you see an interview[br]that I recently did with CTV national news 0:10:43.131,0:10:47.635 on the youngest ever[br]transplant recipient of a trachea 0:10:47.637,0:10:49.337 seeded with her own stem cells. 0:10:50.392,0:10:54.954 It's important to note[br]that while this is very exciting, 0:10:54.966,0:10:56.579 it is still in its infancy. 0:10:56.583,0:11:00.452 We cannot make complicated structures[br]with multiple cell types, 0:11:00.815,0:11:04.340 and right now, it is just very basic. 0:11:04.356,0:11:06.168 But think about where this can head. 0:11:06.675,0:11:10.805 Think about whether we could[br]use it in the future 0:11:10.822,0:11:14.879 to print structures in the body[br]and use our own cells for transplant. 0:11:16.398,0:11:19.348 So this is a very exciting field, 0:11:19.359,0:11:23.445 but as with every potentially[br]game-changing technology, 0:11:23.455,0:11:24.903 there are challenges. 0:11:25.130,0:11:28.954 This used to centre around the use[br]of embryonic drive stem cells, 0:11:28.967,0:11:32.567 but, recently, with the advent[br]of the induced pluripotent stem cells 0:11:32.568,0:11:34.473 and direct lineage reprogramming, 0:11:34.484,0:11:38.576 which can use your own adult[br]consenting tissues, 0:11:38.591,0:11:41.759 this conversation has become[br]less and less relevant. 0:11:42.535,0:11:44.553 What we see, 0:11:44.573,0:11:49.909 especially with the the increase[br]of treatments coming out of the pipeline, 0:11:49.932,0:11:54.111 is misrepresentation[br]of stem cell strategies. 0:11:55.271,0:12:02.233 Here, some doctors are offering[br]unproven treatments using stem cells 0:12:02.241,0:12:03.659 for profit. 0:12:04.587,0:12:09.426 Unproven - that means[br]a) not proven to work, 0:12:09.452,0:12:12.818 and b) not proven to be safe. 0:12:13.744,0:12:16.933 Recently, "Scientific American"[br]had an article 0:12:16.949,0:12:21.790 about a woman who went[br]to a very fancy clinic in Beverly Hills 0:12:21.811,0:12:26.480 and got the latest stem cell facelift[br]that they were offering. 0:12:27.285,0:12:33.226 The doctors took advantage[br]of a loophole in the law, 0:12:33.640,0:12:37.308 sucked out her fat,[br]and put the stem cells in her face 0:12:37.317,0:12:41.157 to make her rejuvenated,[br]or healthier or something. 0:12:41.462,0:12:45.396 And while they were under the hood,[br]they gave her dermal filler. 0:12:45.955,0:12:49.774 What the doctors didn't take into account 0:12:49.935,0:12:51.965 is that dermal filler 0:12:51.972,0:12:56.683 differentiates fat stem cells 0:12:56.684,0:12:59.528 into bone. 0:13:00.150,0:13:05.400 So this woman was left[br]with bone fragments in her eyelids. 0:13:06.801,0:13:13.716 This is why we need clinical trials[br]to make sure that treatments are safe. 0:13:14.376,0:13:18.226 If you were to take a drug,[br]and you had a bad side effect, 0:13:18.237,0:13:22.201 you could stop taking the drug,[br]and that side effect would go away. 0:13:22.215,0:13:24.966 But it's not the case with stem cells. 0:13:24.980,0:13:29.335 Once stem cells are put in,[br]they can never be taken back out. 0:13:30.147,0:13:32.922 Furthermore, going[br]to an unregulated clinic 0:13:32.955,0:13:36.069 can exclude you[br]from future legitimate trials. 0:13:36.091,0:13:39.704 So, how do you know [br]whether or not what you're looking at 0:13:39.721,0:13:44.311 is a real stem cell treatment[br]or misrepresentation? 0:13:44.370,0:13:47.979 Here are some hints that can help you,[br]it's a difficult field to navigate. 0:13:48.032,0:13:51.423 The first: look at [br]how many cell types per injury. 0:13:51.476,0:13:56.540 We mentioned that cell types need to be[br]very specific to replace damaged tissue, 0:13:56.576,0:14:00.712 and one stem cell type[br]cannot turn into cells of another. 0:14:00.899,0:14:02.975 So it's very important if someone's saying 0:14:02.983,0:14:05.315 they're going to suck out[br]one type of stem cell 0:14:05.321,0:14:07.740 and use it for 12 different indications, 0:14:07.747,0:14:09.898 it's likely something you should question. 0:14:10.028,0:14:13.107 Second of all: you can check out[br]their preclinical track record; 0:14:13.131,0:14:16.134 clinicaltrials. gov[br]is a comprehensive database 0:14:16.135,0:14:20.266 of all of the clinical trials[br]if they want to get FDA approval. 0:14:20.596,0:14:23.254 And the third and most important[br]thing that you can do 0:14:23.266,0:14:25.065 is to be knowledgeable. 0:14:25.543,0:14:29.232 Do your research and get consensus. 0:14:30.095,0:14:34.967 Ask your doctors, all of them,[br]because they are here to help you. 0:14:36.808,0:14:43.157 So, overall stem cells have the potential 0:14:43.171,0:14:47.279 to change life as we know it. 0:14:48.150,0:14:52.689 Every single one of us[br]is affected by diseases 0:14:52.717,0:14:57.234 which stem cells could potentially[br]help to treat in the future. 0:14:58.344,0:15:02.647 And now that you have the knowledge,[br]you have the power. 0:15:02.672,0:15:06.560 It is up to you to spread[br]the word about stem cells 0:15:06.586,0:15:09.494 and to support reputable clinical trials, 0:15:09.503,0:15:12.718 so that we can work hard[br]to get the best treatments out 0:15:12.731,0:15:17.433 to the people who need them the most[br]in the shortest possible amount of time. 0:15:18.161,0:15:23.184 Right now, there are [br]many - more than ever before - treatments 0:15:23.184,0:15:25.305 in the pipeline, ready to come out. 0:15:25.323,0:15:29.332 And the field of regenerative medicine[br]is at critical mass. 0:15:29.991,0:15:33.621 So I ask you to come join me[br]on this journey. 0:15:33.888,0:15:40.229 Come with me as newly-minted purveyors[br]of stem cell knowledge 0:15:40.609,0:15:44.966 as we turn science fiction[br]into science fact. 0:15:45.160,0:15:46.389 Thank you. 0:15:46.389,0:15:47.953 (Applause)