Imagine a scientist scraping some skin off your arm or the back of your leg and then changing those skin cells into complex heart cells - transforming them into tiny clusters of tissue that go thump, thump, thump under a microscope.
Consider the implications this genetic trick would have for heart disease, even life expectancy. Can science untap the legendary Fountain of Youth in a simple skin cell?
Researchers at the Medical University of South Carolina are trying to figure that out - and they're already halfway to an answer.
"We have skin cells that are beating in the lab," said MUSC physiologist Martin Morad, also the SmartState BlueCross BlueShield of South Carolina endowed chair for Cardiovascular Health. "We want to make a robust, tissue-based pacemaker."
The advantages would be groundbreaking - a $10 billion discovery, Morad estimates.
While artificial pacemakers already extend life expectancy for many patients with heart disease, the technology is imperfect. But a natural pacemaker, engineered in a lab with a patient's own cells, wouldn't need its batteries routinely changed. Its electrodes wouldn't break or corrode.
Also there's "no problem of rejection if it's your own (cells)," Morad said. "The old geezer suddenly becomes a young geezer. He looks old, but he acts young. This application has the potential to totally change your lifestyle."
The broad term for engineering with human cells in a lab, even one day growing full-size organs to treat a range of diseases, is called biofabrication or tissue engineering - a cutting-edge field of research where South Carolina scientists find themselves out front.
On Wednesday, the National Institutes of Health awarded Clemson University an $11 million grant to expand its bioengineering center in Greenville. Part of the grant also will be used to collaborate with MUSC researchers in Charleston. This is the latest in a string of awards totalling almost $40 million that MUSC, the University of South Carolina and Clemson University have received in nearly 10 years to study biofabrication.
Scientists at the universities work side-by-side. MUSC experts provide guidance to Clemson researchers. University of South Carolina students and Clemson faculty work inside MUSC labs in Charleston.
"There is plenty of work to do," said Michael Yost, MUSC's associate chairman of surgery for research. "It's very collaborative."
That work includes using a sophisticated 3D printer to pave layers on layers of cells with bioink - eventually maybe even whole organs - and fine-tuning a process to create molds, or scaffolding, that will help this lab-engineered tissue grow.
First, Yost said his team needs to figure out how to engineer microvascular networks - very tiny systems of arteries and veins, some of them no more than a cell's width in diameter, to feed the tissue.
Technically, researchers could "print" organs today - but printing an organ, even with human cells, doesn't necessarily mean the organ will function properly inside someone's body. If, for example, a lab-engineered kidney doesn't have the nutrition it needs, if it doesn't have the appropriate vascular network in place, it will die inside the patient's body, Yost said.
"We really don't want to print the kidney and stick it in you. What we want to do is take kidney tissue, engineer some augmentation to it so that when we put it in you, your body says, 'Oh. This is a kidney.' And it finishes it," Yost explained. "The more 'you' you are, the better off you are."
So they're not growing full-size organs yet.
Morad, whose lab is laying the groundwork for the tissue-based pacemaker, also believes science is still a few years off from this final step.
Meanwhile, Morad's lab is studying how these genetically modified skin cells learn to beat like heart cells - the mechanism that literally makes them tick. Morad believes it's the mitochondria, which creates energy inside a cell, that generates the heart beat. It's a new, potentially controversial theory.
There may be only five to 10 groups in the world working on this research right now, Morad estimates.
"It depends on money," he said. "If I had $50 million tomorrow, I think I could deliver this in a maximum five years."
Reach Lauren Sausser at 937-5598.