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Facing health challenges with science and technology
Antonio Carlos Campos de Carvalho
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STATING THE PROBLEM
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AGING RATE IS GREATER IN LESS DEVELPED REGIONS
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AGING IN THE WORLD
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AGING AND CHRONIC DISEASES
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Order Men % Women %
1 Homicide & violence 11,3 Ischemic Heart dis. 10,9
2 Ischemic heart dis. 10,1 Stroke 10,7
3 Transit accident 7,2 Diabetes mellitus 6,3
4 Stroke 7,0 Lung infections 4,9
5 Lung infections 3,9 Breast cancer 3,5
6 Diabetes mellitus 3,3 Hypertension 3,2
7Cirrhosis – alcohol & other
3,1 COPD 2,7
8 COPD 2,3 Transit accident 2,4
9 HIV/AIDS 2,2 Uterine cancer 2,3
10 Hypertension 2,1 Lung cancer 1,9
Distribution of YLL for ten main causes, by sex in Brazil
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Order Men % Women %
1 Alcohol abuse & dep. 9,6 Depression 22,3
2 Depression 8,3 Bipolar disease 4,9
3 Bipolar disease 6,4Alzheimer &other dementias
4,7
4 Diabetes mellitus 6,0 Diabetes mellitus 4,2
5 COPD 5,1 COPD 4,0
6 Asthma 3,6 Asthma 3,5
7 Ischemic heart dis. 3,1 Ischemic heart dis. 3,4
8Alzheimer & other dementias
2,7 Osteoarthritis 2,6
9 Schizophrenia 2,2 Alcohol abuse & dep. 1,7
10 Epilepsy 2,1 Anemia by iron deficiency 1,7
Distribution of YLD for ten main causes, by sex in Brazil
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WHY DO WE NEED MORE SCIENCE AND TECHNOLOGY IN THE HEALTH SECTOR?
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HOW CAN WE IMPROVE THIS SCENARIO?
• WE NEED BETTER DISEASE MODELS• WE NEED TO IMPROVE DRUG SCREENING• WE NEED AFFORDABLE PERSONALISED MEDICINE• WE NEED NEW THERAPIES FOR INCURABLE DISEASES
IS THIS ACHIEVABLE?
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INDUCIBLE PLURIPOTENT STEM CELLS - iPS
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LQTS?
DNA
sequence
PBMC
5 mLPoint mutation
Cardiac
characteriza
tion
Cardiac differentiationiPSC characterizationiPSC
generation
D-12 D0 D21- 30 D90 D120 D140
CD36+ CD71+
(over 70%)
TRANSDUCTION
Karyotype analysis, RT-PCR, Flow
Cytometry, Genotype analysis,
spontaneous differentiation
D97
Electrophysiology analysis,
MEA, patch clamp,
Immunofluorescence
First beating
cells
USING iPS FOR DISEASE MODELLING
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Embryoid Bodies (EB)
EB 2 days in suspension EB post differentiation
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Troponin TDAPI
iPS DERIVED CARDIOMYOCYTES
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CONTROL (iBM1.2) PAC1 Cl9 PAC2 Cl11 iBM_CRISPR_Cl12
c.1600C>T
c.1600C>T
c.1600C>T
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ACTION POTENTIAL DURATION AFTER DIFFERENTITATION
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BETTER DRUG SCREENING
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BETTER DRUG SCREENING
INTESTINAL ORGANOID
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THE OLD MODEL THE NEW MODEL
PERSONALISED MEDICINE
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Haruhisa Inoue et al. EMBO J. 2014;33:409-417
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CELL THERAPIES FOR INCURABLE DISEASES
n engl j med 376;11 nejm.org March 16, 2017
Clinical trial to start in 2019 in Japan
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GENE THERAPIES FOR INCURABLE DISEASES
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HOW TO DEAL WITH THE SHORTAGE OF ORGAN TRANSPLANTS
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HEART TRANSPLANTS IN BRAZIL
DEMAND IS 1600
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BIOENGINEERING ORGANS AND TISSUES
3D PRINTING
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BIOENGINEERING ORGANS AND TISSUES
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USING BIOREACTOR-ANIMALS AS A SOURCE
1. GENE EDIT THE EMBRYODelete Pdx1
2. GROW TO BLASTOCIST STAGE
3. INJECT HUMAN iPS
4. IMPLANT THE CHIMERICEMBRYO
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6. HARVEST THE HUMAN PANCREAS
5. ALLOW CHIMERIC EMBRYO TO DEVELOP
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Taís
Adriana Regina
JorgeFernando Glauber
Fernanda