Here is the full transcript of sports medicine doctor Anthony Galea’s talk titled “Get Your Body To Heal Itself” at TEDxIUM 2014 conference.
Listen to the audio version here:
TRANSCRIPT:
I haven’t rehearsed this part of my TED talk, and you’ll know why in a second. I’m going to take this needle, and I’m going to stab my finger. And I’m going to take this tiny drop of blood and place it on this slide. What you’ll see, even though this drop of blood is extremely small, within it exists an entire universe.
Our blood is made up of a wide variety of cells, ranging from red blood cells that carry oxygen to the working muscle, the white blood cells that protect us from infection, to the platelets that heal our wounds, and the plasma which carry these important cells, as well as nutrients, proteins, and hormones, along a complex highway of blood vessels to every tissue in our body.
I am a sports medicine physician, and I try to bring physical change to reality. Over the last 25 years, I’ve dealt with a wide variety of sport and recreational injuries. 25 years ago, as a young physician, the treatment focused around what is known as the RICE formula, standing for rest, ice, compression, and elevation. We also had certain medications at our disposal, such as the anti-inflammatory drugs, homeopathics, and injections like cortisone.
It perplexed me that these therapists had this magic spray that would cure all injuries on contact with the skin, which I never could get my hands on. However, the results were short-lived, and the side effects of the medications ranged from bleeding stomach ulcers to ruptured tendons.
The Birth of Regenerative Medicine
Due to the pressure from my athletes, both professional and recreational, children, their parents, coaches, who just wanted another way to heal and another way to get back to what they love to do.
What if there was another way, an alternative way? A way which would utilize the power of our own bodies to heal? A way which would minimize the use of medications and improve recovery time?
Could we, you and I, make our own medication? Can we become our own pharmaceutical company? Thus, the birth of a new field known as regenerative medicine, based on the three fundamental pillars, the messengers of signaling proteins, scaffolds, and stem cells.
Due to the pressure from my athletes to find an alternative way, in early 2000, I started taking a little bit of blood, and I would put it in a centrifuge for a small amount of time, and at a certain speed, in order to concentrate these healing cells known as platelets. I then would take the super-concentrated load of platelets and inject it into the damaged tissue, such as muscle, tendon, and ligaments.
These messenger proteins, or signaling proteins, are also known as growth factors, cytokines, and hormones. They’re produced by blood cells and exist within the plasma. But collectively, they work like a construction crew. Some are plumbers, electricians, bricklayers. In response to injury, they go to work repairing damaged muscle, tendon, and ligaments. They would also control the inflammatory process itself.
Successful Results and Limitations
The results were quite interesting. I got healing in half the time. Minimal scarring. Earlier return to play, with minimal side effects. I was obtaining results with this form of treatment that I never did with any other form of treatment. In the above example, we see one of the world’s top figure skaters. In 2009, just before the Winter Olympic Games, he sustained a small tear in his calf muscle, which you can see by the arrow behind me. Normally, such an injury would prevent the athlete from performing well at such a competition.
However, by taking a little bit of blood, extracting out the concentrated platelets, and you can see the needle marked X, injecting it into the tear, the muscle went on to heal, and he placed in the top five during those Olympic Games. However, the messengers, or the signaling proteins through the platelets, have limitations.
Anya Balbir, we heard this morning, was one of the world’s top ten mogul skaters. She now lives and works just outside the Monaco area. One of the injuries during her career was a tear of a tendon just below the kneecap, known as the patellar tendon. You can see a big black hole in her tendon. The question was, could I repair this tendon by using the platelets? Well, the answer, no.
The reason, if I took the platelet load and injected it into that hole, it would just keep going right through. There was nothing to hold it in place long enough to repair the tendon. I needed a scaffold of some sort. Something that would hold these workers in place long enough to repair the tendon.
The Role of Scaffolds and Stem Cells
By doing a little process known as a micro-liposuction, and taking a little bit of fat, processing that fat, and injecting it back into the tendon, I had my scaffold. So you can see here some live footage. The needle’s going in the hole, and I’m filling up the space with the fat. Then, I’m going to take my platelets, I’m going to inject it in the scaffold. That scaffold will hold the platelets in long enough to repair the tendon.
So this opened up a whole new world of possibilities that I was able to treat. Such as, this is a tear in the rotator cuff, a small tendon in the shoulder. I can now put a scaffold, seat it with the platelets, and repair that tendon. The third essential pillar for healing are stem cells. These small cells are undifferentiated, but have the ability to specialize into other forms of tissue, such as bone and cartilage, fat and muscle, heart, blood vessels, and nerve. They’re easily obtained from our bone marrow or fat that exists throughout the body.
However, these stem cells do other functions that many people don’t know about. According to Dr. Caplan, from Case Western Reserve University in Cleveland, Ohio, one of the foremost stem cell pioneers in the world, he states that these stem cells do other functions, that they’re powerful little pharmaceutical plants producing healing signaling proteins that direct the reparative process.
Where do these stem cells come from? Well, as I mentioned before, from bone marrow and fat. But according to Dr. Caplan, these mesenchymal stem cells also have their origins in another small cell, the pericyte. These are little cells that wrap around every blood vessel in our body. During times of injury, they come off and go right to the injured site. They create a wall.
On one side of the wall, they keep out harmful cells produced by our body that want to attack the injured site. Why? Because the breakdown of proteins is seen as foreign. On the other side of the wall, they produce these healing signals that direct the reparative process.
Mesenchymal Stem Cells (MSCs) and Their Powerful Potential
Dr. Caplan coined the term MSCs, which stands for mesenchymal stem cells. But he goes on to state that we should not only think of these cells for their stemness, but also as powerful medicinal signaling cells that direct the reparative process itself.
Now let’s go back to our moguls here, Anya. In her case, I took some stem cells from her bone marrow by drilling a small hole in the back of the hip. I concentrated these stem cells. I then took a little bit of fat for the scaffold. But we know now that there’s other functions within the fat, according to Dr. Caplan, that are actually healing cells.
I took messenger proteins and the signaling proteins from the platelets and injected them into the tendon. Just a footnote, this hairy knee here is not Anya’s. Her knee is much stronger and nicer to look at. Anya went on to do quite well over the next few years and competed successfully. With this powerful triad of signaling proteins, scaffolds, and stem cells, I was able to treat a whole new list of injuries. Soon I had some of the best athletes in the world asking me to help with their debilitating injuries. However, in my zeal to heal and being naive and careless about some of the regulatory issues in North America, I found myself in regulatory hot water. Over the next few years, they were very difficult. Accusations of healing by doping, criticism by my peers, the media, and my own professional colleagues swirled around me. It was becoming extremely difficult to maintain my focus.
A New Way to Heal: Human-Tailored Biologics
However, I continued to treat and observe the positive results. A new way to heal. I believed that this process would revolutionize the sports medicine treatment of the future to come. A new way to heal, which I call human-tailored biologics. You and I, all of us, one day will have the ability to heal many of our own ailments.
Big pharmaceutical companies and each and every one of us will become partners in a new direction, making medications for us, by us, to treat not just only sports medicine injuries, but a wide variety of disease states. Utilizing the power of our unique genetic programming and inherent ability to heal.
There will come a time when we can take stem cells out of us and deposit them into a bank account such as in Monaco. We’ll draw them in the future to help heal ourselves. As the good book says, “For the life of a creature is in the blood.” This is my small idea worth sharing. Thank you.