Renowned futurist Ray Kurzweil has made some eye-popping predictions about the future of human longevity. For example, by 2030 he predicts average lifespans will grow by one annum per annum. This progress will accelerate rapidly and not too long after, the average person can expect to live for 1,000 years. Now, if having a swarm of nanobots floating around your body repairing cells and damaged DNA seems a little far fetched, it may be comforting to learn that in the meantime, biomaterials innovators have some tricks up their sleeve to help our aging population better heal from disease, trauma, and wear-and-tear. Advanced materials have long played a role in western medicine with ubiquitous products such as cardiac stents, artificial joints, hemodialysis membranes, and artificial heart valves. But biomaterials innovation is accelerating just as pharmaceutical innovation struggles in the context of high technical risk, long timelines, and pushback on ever-increasing treatment costs. As healthcare budgets are increasingly constrained, will these biomaterial innovations turn us all into the Six Million Dollar Man (as seen on the television show about a former astronaut filled with implants, which aired four decades ago) or are they a potential savior to a healthcare system under strain? Let’s take a look at where biomaterials have a big role to play:
The modern operating room is capable of some magical things. Nevertheless, hospital derived infections and surgical complications can have a huge impact on patient outcomes and post-operative treatment costs after the magic is done. Better diagnostics and less invasive surgical techniques are all advancing, in many cases due to advanced materials such as the CZT-based radiation sensors being produced by our portfolio company Redlen Technologies. But new advanced biomaterials such as antimicrobial coatings and surgical sealants are also a critical part of the toolkit.
And technology is not standing still. As one example, the antimicrobial efficacy of catheters was increased from a few days to almost a month by Pangaea portfolio company Semprus Biosciences, which was sold to Teleflex a few years ago. Lately, we have seen new fibrin sealants functionalized with drugs or biologics that promote healing, greatly improving the ability to seal dura mater damaged during brain or spine surgery. Resorbable and biocompatible, electro-spun meshes are promising for use in burn and diabetic wound care applications. My guess is that the body is much more welcoming to these innovative approaches, at least compared to the polypropylene meshes as an example. They have caused major suffering and countless lawsuits from genealogical surgery patients over the last decade. Surgery will never be pleasant but biomaterials innovation is definitely playing its part to reduce the risks.
Bones have a miraculous ability to repair themselves. Take as an example cycling star Alberto Contador, who broke his tibia in July at the 2014 Tour de France but took victory at the equally demanding Vuelta a Espana less than two months later. But more complicated fractures sometimes need help. The gold standard of care, bone graft surgery, takes bone from the hip and implants it into the defect bone. While generally effective, the need for multiple surgeries, significant pain, and lengthy healing time increase the overall cost and exacerbate the patient experience of this procedure.
One alternative, inspired by the fact that an implanted bovine bone will over time be replaced by human bone, starts with decellularized bovine bone as a substrate, which is implanted with the patient’s stem cells. The idea is that a strong, highly compatible bone can be inserted into the target area with the promise of significantly higher success rate and reduced complications. Other techniques may be even simpler, and we have seen biomimetic enzymes that help bind the mineral constituents of bone. Ceramic 3D printing is a little behind metal and polymers but printed ceramic bones are the home run market that researchers have their eyes on.
Unfortunately, cartilage regeneration is not as easy as bone repair. Growth is constrained by lack of blood vessels that deliver the nutrients required for repair. When undue stress causes irreversible damage, the eventual solution is joint replacement. The average cost for a knee replacement in the United States is close to $50,000, and over 700,000 are performed annually (just in the US). This is a major invasive surgery with high device costs, recovery times, and complication rates. No wonder orthopedic surgeons face one of the healthcare industry’s highest insurance costs. But what if a simple orthoscopic procedure taking only a few minutes can provide a mechanically stable and porous hydrogel scaffold that enables cartilage to do what other tissues like muscle, vessels, and skin already do? Data from one Dutch start-up shows the knees of worn out racehorses improving drastically in only a few months. Stryker and Johnson & Johnson might very well be shaking at their own knees.
Transplant surgeons have become experts at replacing major organs such as the kidney, liver, heart, and even the lung. These surgeries can have a transformational impact on a patient’s life and on their healthcare costs. The cost of hemodialysis for a patient with late stage renal failure in the US can be close to $100,000 annually, 4-10X the cost of an actual kidney transplant. Unfortunately the availability of suitable organs means that transplant wait times can be five years or more. But what if the patient’s own tissue could be used to 3D print the patient a model 2.0? Well, that is the dream of companies like Organovo. Sure, kidneys are complicated organs and printed versions are a long way off, but there is a clear line of sight to the printing of simpler organs such as blood vessels or trachea. Printed liver tissue for pharmaceutical toxicology screening is perhaps even closer to becoming mainstream. At the end of the day, the strength of additive manufacturing is customization, and what application could require any more customization than replacing body parts?
The world of biomaterials has obviously evolved since the airing of The Six Million Dollar Man. Implants, surgeries, and tissue repair will always have costs and risks, but biomaterials innovation is doing some heavy lifting to bring both down. Innovation in traditional therapeutics and pharmaceuticals is stagnating, while costs continue to go up. We are excited to see biomaterials innovation increasingly picking up the slack, and we're making bold plans to help these biomaterials entrepreneurs make our world a better place.