The Union of Engineering & Medicine
The union of engineering and medicine is creating new opportunities for innovations in human health. A recent study published in the Open Journal of Engineering in Medicine and Biology identifies several research areas in which biomedical engineering is poised to impact both engineering and medicine. These include: precision medicine, immuno-engineering, the engineering of cells and genomes, developing systems for human function augmentation, and “Exo-Brain,” that is, engineering the brain, including with AI.
Precision Medicine
We’re quickly approaching a time when precise, personalized medical treatment is a reality. Some ways this could manifest include the engineering of organs and tissue from a patient’s own cells, the development of hyper-personalized organ-on-a-chip technology, personalized physiology avatars, and more.
On-demand Tissue and Organ Engineering
According to the US Health Resources and Services Association, there are currently more than 100,000 people on organ transplant waiting lists, and an estimated 17 people per day die waiting for transplant organs.
The ability to produce, on demand, organs and tissues from a patient’s own cells could mean a faster road to needed transplants, and a lower rate of rejection for transplanted organs. This technology is in sight, but will require further advancements in stem cell engineering and manufacturing, as well as gene editing, to become reality.
Another exciting development is “organ-on-a-chip” technology. An organ-on-a-chip (OOC) is a multi-channel 3-D microfluidic cell culture integrated circuit that can be used to simulate the activities, mechanics and physiological response of an entire organ or an organ system. At this point, OOC technology is in its infancy. However, it’s not difficult to imagine a future with personalised OOCs made from a patient’s own cells, which could be used for targeted, individualized diagnosis and treatment.
Personalized Physiology Avatars
Manufacturing uses digital twins–virtual representations of physical products–for the simulation, integration, testing, and monitoring of those products. In addition to the products themselves, digital twins integrate sensor data to provide snapshots of product performance at any given instance.
A personalized physiology avatar is similar. Today’s medicine employs a variety of data collection technologies, including medical wearables, which produce an immense amount of patient data. It’s becoming increasingly possible to use this data to develop a model of the physiology of a given patient–an avatar–which can help practitioners to diagnose, predict risk, and treat patients in a more personalized and targeted way than ever.
Engineering the Immune System for Health and Wellness
The success of immunotherapies in the treatment of some diseases, for example the use of the BCG vaccine in the treatment of bladder cancer, is evidence of the promise of engineering the human immune system to combat disease. Innovations in the engineering of protein, genomes, and epigenomes, as well as nanomedicine and other technologies mean that we will become increasingly able to engineer the immune system in novel ways, including engineered therapies and devices.
One challenge to developing this technology will be increasing our knowledge of the immune system itself. Although our knowledge has grown from the original understanding of a single immune cell to encompass an entire repertoire of different immune cells, there is still a lot to learn. In addition, challenges still exist in understanding the effects of environment and personal experience on immune system function.
Cell and Genome Engineering
Cells and genomes hold the key to many diseases, as well as to the treatment and prevention of those diseases.
We have already made remarkable advances in engineering cells to fight disease, for example the creation of cell-based therapies using engineered human T-cells. Future goals include repurposing cells to be ‘living drugs.’
Aberrations in the genome and its execution are at the center of a number of diseases. Repressing, activating, or perturbing different genetic targets can affect changes that drugs fail to affect. However, we still lack adequate understanding of the plasticity of the human genome as well as epigenetic regulation, which limits our understanding of genome aberrations. In addition, constraints on efficacious in vivo delivery tools, their delivery, and manufacture of these tools limits the capability of these tools, and makes them very expensive at this time.
The Smart Human: Developing Systems to Augment Human Function
The study identifies several systems currently in development that aim to augment the function of the human body: stem cells, tissue fabrication, imaging and biomarker technology, and microphysiological platforms. In addition, systems are currently under development which will ultimately be able to replace the function of certain parts of the body.
Stem cells
Developing technologies for the large-scale production, manufacturing, storage, and distribution of consistent, high-quality stem cells will increase our ability to treat disease.
Tissue Fabrication
The goal of regenerating complex multi-tissue structures and whole organs will require engineering design and fabrication technologies, which may include 3D bio-printing and bioreactor technologies.
Imaging and Biomarker Technologies
Well developed imaging technologies will be necessary to evaluate the quality of engineered tissues.
Microphysiological Platforms
Establishing microphysiological platforms consisting of linked micro-sized human tissues will require sophisticated technologies, as well.
Replacement Parts
Devices, like dialysis machines and the artificial heart can temporarily fulfill the function of vital organs, but research is currently underway into devices that could be permanently implanted or worn. Examples include local drug delivery devices, integrated prosthetic limbs, and more.
The Exo-Brain: Engineering Advanced Brain Interface Systems
Exciting developments in brain engineering and interfacing are on the horizon. These include brain-computer interfaces, neural modeling, neural sensing, modulation, and control; rehabilitative technologies, electrode technologies, and the use of AI-powered data science.
Brain-computer interfaces for continuous neurosensing of electrical hemodynamic, and molecular signatures of brain function are paving the way for engineering of brain systems. Neural modeling and the simulation of axon tracts in peripheral nerves is already helping to improve the design and targeting of electrodes. Control systems technologies are helping to develop effective intervention for neurological disorders, new technologies are helping to measure outcomes and adjust neurological interventions by means of a real-time simulation, and emerging electrode technologies are allowing new kinds of interfacing.
Rehabilitative technologies are emerging, allowing neural interfaces to work together with traditional rehabilitation techniques to improve recovery from strokes and brain trauma, as well as to improve outcomes for people with neurodegenerative diseases.
Finally, machine learning and artificial intelligence are helping to process the immense amount of nervous system data, so that practitioners can better understand, evaluate, and treat their patients.