Millennium 2000: Medical Second ChancesAired January 2, 2000 - 6:13 p.m. ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JOIE CHEN, CNN ANCHOR: Imagine it, Wolf, human body parts grown from scratch, a bone, an ear, even a spinal cord.
WOLF BLITZER, CNN ANCHOR: Those are just some of the medical possibilities in the 21st century, as doctors learn more about gene therapy and its potential to improve and save lives.
CNN medical correspondent Eileen O'Connor begins our focus this hour on medical second chances. We should note: This report contains some graphic pictures of surgery.
UNIDENTIFIED MALE: Ladies and gentlemen, Dr. Michael DeBakey.
EILEEN O'CONNOR, CNN MEDICAL CORRESPONDENT (voice-over): Michael DeBakey is the force behind many of medicines' major breakthroughs this past century, which have given millions a second chance at life. Using sewing skills he learned as a child watching his mother, a seamstress, he developed the first dacron artificial graft to replace diseased arteries.
He was a pioneer in coronary bypass surgery. Advice from his old college roommate, an engineering major, led him to develop the roller pump that is still used in the heart-lung machine that keeps people alive through open heart surgery. DeBakey is ranked among the best medical minds of this millennium.
DR. MICHAEL DEBAKEY, BAYLOR COLLEGE OF MEDICINE: It's very nice, I mean, it's very nice to be in the same painting with Pasteur, for example, and Lister and Hypocrates.
O'CONNOR: At 90, at the start of a new millennium, he is again at the forefront of medical innovation at the Baylor College of Medicine. Using technology originally developed at NASA to pump rocket fuel, DeBakey has designed a device giving heart patients who were without hope, a second chance. It's called the ventricular assist device, or VAD.
DEBAKEY: In the United States alone, there are five million Americans in heart failure. The great majority of these patients of course will die of heart failure and usually within three years of the occurrence of the heart failure. But with this pump, you know, if their organs otherwise are in good condition, reasonably good condition, they should be able to lead a reasonably normal life.
O'CONNOR: For patients with heart failure, the only solution is a transplant. But waiting for the donor heart carries great risk. DeBakey hopes the VAD can serve as a kind of bridge to a transplant. It's already being tested in patients in Germany. It works like this: the diseased heart cannot pump enough blood, so the VAD, a tiny miniaturized pump, is attached to the ventricle, helping the diseased heart by pumping in excess of 10 liters of blood per minute.
DEBAKEY: You know, as we are sitting here, our hearts are putting out about six liters a minute. And so, most patients, if you can generate something on the order of, say, three to four or five liters, then you're giving them enough auxiliary support to their heart to be able to be viable.
O'CONNOR: The test results are so encouraging that DeBakey hopes this pump will be able to operate long term, enabling patients to forego a transplant altogether. Its not just DeBakey. Scientists, engineers and doctors like him are revolutionizing medicine, giving even more people second chances through the development of smaller and smaller microchips that can replace our broken parts, restoring function. At Johns Hopkins University, this technology is literally helping the blind to see.
HAROLD CHURCHEY, RETINAL IMPLANT PATIENT: My wife, my son, my grandson. He's 11 years old, and he's almost as tall as I am, and that's what I want to see first.
O'CONNOR: Harold Churchey is 72 years old. He's been completely blind in his right eye since birth from rhetinitus pigmantosis, the rest of his sight was lost gradually.
CHURCHEY: This thing didn't, bang, just like that, it was gone. It just gradually, gradually, like you take a light bulb, or a light that's going out dim, you know, getting dimmer and dimmer. That's how it happened, and it happened over a number of years.
O'CONNOR: Churchey agreed to help doctors at Duke and Johns Hopkins University's Wilmer Eye Institute to test a new device they have developed, called an intraocular retinal prosthesis. In layman's terms: a man-made retina. It works by using a tiny camera mounted on an eyeglass frame. The camera locks onto an image and converts what it sees into an electric signal. The signal is transmitted to a chip, implanted in the retina, which in turn deciphers the signals for the brain. Patients like Churchey have only had the chip placed there so far, not implanted. The results: partially restored vision that is nothing short of miraculous for Harold Churchey.
CHURCHEY: The doctor said, "Mr. Churchey, what do you see?" And I said, "Is it an H?" He said, I think he said, "Yes, it is," or something to that effect anyway. But he let me know that definitely that's what it was, and that's what I seen, I thank the Lord.
O'CONNOR: Singer-composer Stevie Wonder is hoping he too can be a candidate for the experimental treatment. Technology and man-made devices are just one way doctors are giving patients damaged by disease a second chance.
But what if doctors could harness the body's own natural powers of healing? Ten years ago, doctors first utilized that power when they discovered they could use partial liver transplants to save children with liver disease. Just 25 percent of the liver taken from a living adult donor could be put into a child, where it would regenerate itself, growing as the child did into a full-grown liver. Doctors noted the donor's liver grew back to normal as well. That gave surgeons another idea. A new vibrating scalpel that cuts risky blood loss meant doctors could try a similar surgery on adults.
In the past year, 400 recipients have received a partial liver transplant, 60 percent of the liver comes from a living donor. In four to six weeks, the recipient's new liver grew to full size. The donor's grew back in six to 12 weeks. Such success has prompted the transplant community to approve another life-saving liver transplant. In split-liver transplant, a child and an adult receive pieces of the same liver. This time from a cadaver, one liver saves two lives.
DR. JAMES WOLF, UNITED NETWORK FOR ORGAN SHARING: Seventy five percent of the livers that would be obtained could be split, and then, of course, more children could receive their transplants.
O'CONNOR: In 1997, only one third of people waiting for a liver transplant received one. These new surgeries mean more people will likely get that second chance a transplant offers. Even so, there are still not enough livers to go around.
If only doctors could figure out how our bodies formed a liver in the first place, in utero. To do that, doctors are studying the power behind our very essence, our genetic make-up, our DNA. Our DNA is composed of chemicals, the most important make-up genes, they tell our cells what to be, what to do, like grow into a blood vessel, or a skin cell. Some new drugs being developed using those genes are actually boosting the body's own ability to heal itself by showing it where to grow new vessels.
For Samuel Hart, a genetically-based drug is the miracle cure he was looking for. Hart's blood flow to the heart was so constricted, his muscles so weak, he and his doctors did not think he would survive another bypass or angioplasty to remove blockages.
SAMUEL HART, GENE THERAPY PATIENT: I had been completely refused. Three doctors refused to do anything -- operate on me. They sent me home.
O'CONNOR: Hart opted for an experimental procedure that injects into the heart a new drug made from the human gene that grows blood vessels. His physician, Dr. Douglas Lasardo, says doctors may be able to help patients like Hart grow the cells that are most needed by their bodies where they are needed.
DR. DOUGLAS LASARDO, ST. ELIZABETH HOSPITAL: We're capitalizing on the body's own natural ability to grow a bypass graft on its own. It's a natural bypass, all we're doing is taking the gene that we all make in response to a blocked artery and giving the patient a very large dose of that.
O'CONNOR: It's finding these working genes that takes up the time of scientists like William Haseltine, director of Human Genome Sciences.
WILLIAM HASELTINE, HUMAN GENOME SCIENCES: We're not looking to chemicals to be the medicine. We're not looking for plant extracts to be the medicine. We're looking to that most natural source of medicine, which comes from within, which is the genes and proteins we use to build our bodies and repair our bodies.
O'CONNOR: Hart is counting on this technology to give him a longer life.
HART: I hope it turns me back to where I was, before I had any sign of heart trouble at all.
O'CONNOR: But the use of genetically-engineered drugs is still in the early stage, and there are risks associated with such uncharted territory. Another approach that is also showing preliminary promise in giving patients a second chance, uses these tiny cells, called stem cells. Found in embryos, stem cells are so-called blank slates, capable of becoming any type of cell in the human body. Scientists believe eventually they will be able to replace diseased cells in the body with healthy ones, grown from these stem cells, and possibly cure diseases like Alzheimer's, Parkinson's, diabetes, and Lou Gehrig's disease.
The use of stem cells is already working for cancer patients like Patricia Kennedy. Diagnosed with a cancer of the bone marrow called multiple myeloma, Kennedy thought she wouldn't live to see her grandchildren grow up. She needed a bone marrow transplant. Such transplants carry the risk of a deadly side effect called graft vs. host disease, when fighter cells, called T-cells, from the donor's immune system attack the cells of the recipient.
Doctors at Johns Hopkins Oncology Center use stem cells to avoid graft versus host disease by tricking the recipient's immune system. First, they isolate stem cells from the bone marrow being donated. These stem cells then do what bone marrow does naturally, produce blood cells, but lots of them, in fact, all that the recipient will need. Since they are brand new cells, they don't remember the donor, so they accept the patient, the new owner.
DR. RICHARD JONES, JOHN HOPKINS ONCOLOGY CTR.: If you isolate the good stem cells, you're by that process depleting the T-cells that cause graft versus host disease.
O'CONNOR: This makes a big difference in the survival rate of patients like Kennedy.
JONES: I would say she has at least a 30 percent to 50 percent chance of being cured with this procedure.
O'CONNOR: For Kennedy it spelled hope.
PATRICIA KENNEDY, STEM CELL PATIENT: I think with the grace of God and the love from families and friends, and support from so many people, and medical science and technology, I believe I'm truly going to beat it.
O'CONNOR: Doctors believe this technology holds out similar hope for treating other disease. John Gearhart, one of the top experts in stem cell research, believes stem cells can help doctors with the ultimate angle on self-repair, giving patients another chance at replacing just about any damaged part, but this time naturally, by growing body parts from scratch. Scientists are calling this tissue engineering.
JOHN GEARHART, JOHN HOPKINS MEDICAL INST.: We may be more of gardeners than carpenters, which means that we would take stem cells of different populations that would form an organ and grow these stem cells on the lattices, or whatever, to actually form then the components of organs that would then be used in transplantation.
O'CONNOR: Dr. Charles Vacanti and his colleagues at the University of Massachusetts are among the masters of this new craft of building body parts, like this cow trachea.
DR. CHARLES VACANTI, UNIV. OF MASSACHUSETTS: This is actually a tissue-engineered trachea or windpipe.
O'CONNOR: Vacanti creates a body part by building a scaffold using coral or a naturally dissolving plastic. This is molded into the shape of the desired tissue, in this case an ear, then seeding the mold with stem cells and a growth factor to help them grow.
VACANTI: And over a period of time it maintains the shape, but the cells grow new tissue and the plastic disappears. So, what you have with time...
O'CONNOR (on camera): So this is -- it's springy just like tissue?
VACANTI: Yes, it's just like your ear.
O'CONNOR (voice-over): The use of plastic body parts, like artificial legs, may become a thing of the past. Vacanti has grown bone.
VACANTI: Made the scaffolding, injected it. In this case, we used more immature cells, injected them throughout the bone, or throughout the coral, put it under the skin, the skin was taken from his chest, and then this turned into new bone.
O'CONNOR (on camera): Wow. So you basically regenerated a thumb?
VACANTI: That's correct, his thumb bone.
O'CONNOR (voice-over): Vacanti says in 10 to 20 years any organ that's been damaged will probably be repairable with tissue engineering.
VACANTI: It may be the heart, it may be the brain, it may be the spinal cord, the liver, but if it's prematurely injured, using the patient's own cells on some type of scaffolding we will be able to reengineer a new tissue or organ.
O'CONNOR: They've already had success with spinal cord, as Vacanti reported at a British tissue engineering meeting recently.
VACANTI: We've been able to grow spinal cord that attaches to the spinal cord above the resected segment and below the resected segment and returned fairly good function to the animals, so the ability to walk and have normal sensation again.
O'CONNOR: Christopher Reeve and others like him with traumatic, life changing injuries are counting on this type of research for their second chance.
CHRISTOPHER REEVE, ACTOR: The future of a cure for spinal cord injuries, as well as Parkinson's, Alzheimer's and stroke is going to be stem cells.
O'CONNOR: But there is a downside, the best source of stem cells are human embryos, either aborted fetuses or left over embryos created from fertilizing eggs for use in in-vitro fertilization. Many question whether it is right to condone the loss of potential new life, for scientific research, even if it betters the life of another. Vacanti and his brother Martin believe they have an alternative.
VACANTI: Sometimes I'll just sit and look at these for hours.
O'CONNOR: They believe they have found adult stem cells in each kind of tissue in the body, nature's own source of spare parts.
VACANTI: We've found these cells in virtually every organ system. We've found them in the blood, in the spinal fluid, so they're probably associated with the repair of every system.
O'CONNOR: Vacanti believes stem cells from fetal tissue may not be necessary, that every one of us has our own supply, even in adulthood. While making organs through tissue engineering may mean there will never be a need for a waiting list for donated ones, stem cell research raises questions even more fundamental to human existence. Even its pioneers worry if man can generate organs and virtually every body tissue, what is to stop us from creating life? And whether it's tissue engineering, medical devices, gene therapy, or stem cells, this newfound power to treat diseases that used to kill us raises another set of questions for society. As in, "Just how many second chances -- and what kind of second chances -- should each of us be given?"
ARTHUR CAPLAN, CTR. FOR BIOETHICS, UNIV. OF PENNSYLVANIA: But it can be misused if we start using it for the purposes of vanity, for purposes of trying to improve our appearance, or improve the way we age. O'CONNOR: Michael DeBakey, the man who has extended so many lives that were thought beyond hope, believes these types of questions are inevitably raised by the use of any science.
DEBAKEY: I remember reading an article about when glasses were first developed many, many years ago, people would be able to see better. There were those who criticized that, saying God didn't prepare us for that, that we, you know, weren't supposed to wear glasses, because if had done that he'd -- we would have been born with glasses, you know, so, I mean, it's a ridiculous example of an issue, but you see, there it is. I think in time you learn how to deal with the issue, or the society does,
O'CONNOR: Eileen O'Connor, CNN, Washington.
CHEN: When we return here, more on gene therapy in-depth. The man considered the father of gene therapy, Dr. French Anderson will join us to explain how the science may change modern medicine. Stay with us.
ANNOUNCER: The oldest known medical handbook is a 5,000-year-old clay tablet.
BLITZER: Now, more on the issues and science behind gene therapy, from stem cell research to tissue engineering.
CHEN: For the next half hour, we'll talk to three specialists about the subject.
We begin with Dr. French Anderson, who is director of gene therapy laboratories at the University of Southern California School of Medicine. Dr. Anderson joins us this hour from Los Angeles. We appreciate you being with us, sir. Let's talk -- since you have been labeled the father of gene therapy, if you can give us a quick perspective on this, how close are we seeing -- to seeing a real product in use of gene therapy on a widespread basis?
DR. FRENCH ANDERSON, DIR., GENE THERAPY LABS, UNIV. OF S. CALIFORNIA: Well, widespread basis, that will probably be another five to 10 years. The first successful gene therapy clinical trials are taking place now, so probably five to 10 years.
CHEN: And where do you see the first greatest hope, the first widespread use in a broad basis, where do you see the best hope for that happening?
ANDERSON: Well, I think there are three areas now that look most promising: first is cardiovascular disease, building new blood vessels in heart and the limbs; secondly is the use of gene therapy for vaccines, for AIDS vaccines, vaccines for some types of cancer; and thirdly, some very exciting results in trials that are just beginning in several genetic diseases, specifically hemophilia. CHEN: Nine years ago, Dr. Anderson, you did the first gene therapy in a human. That was well recognized. It was a little girl who had a serious immune system disorder that you worked with. Had you expected in this last decade that you would see more of this happening, that things would have moved along faster?
ANDERSON: Well, we were correct at the beginning in that our feeling was that it would take gene therapy 10 or 15 years to get going, because the initial patient, Ashanti Desilva (ph), had a very special type of genetic disease that really had the most promise of being treatable by gene therapy. But then we all got a little excited over in the early '90s, because gene therapy looked so simple, and in tissue culture you can cure almost anything, and in mice you can cure things.
But when we started doing a large series of clinical trials -- and by we I mean the entire field of gene therapy -- we found out that the body is a lot more complex than we had given it credit for. Its defenses are a lot more powerful than we had thought. So there was really a depression for the field in the mid '90s, but now things are getting exciting again. It looks like that gene therapy is going to work. We just had to get our engineering better.
CHEN: Let me elaborate on that point, though, specifically. I mean, we have emphasized that gene therapy is using the natural parts of the body to help the body itself. Why would the body then reject these things really that come from itself and how does that make gene therapy so much more difficult?
ANDERSON: Well, the human body has been protecting itself from foreign genes for eons, from, you know, from the beginning of time, and so what we are trying to do is take -- fair enough, it is a natural gene, but nonetheless it isn't a gene that the body has in itself at the time, and so it's putting a -- from the body's point of view -- a foreign gene into itself and the body has defense mechanisms. Now, we don't understand what all those defense mechanisms are, but we certainly can see the results of it, and that is that it has been very difficult to get an adequate level of genes into enough cells in the right place in order to actually treat disease. Now, we are starting to see the ability to do it, but it has taken nearly 10 years.
CHEN: I want to talk quickly about the work that you are doing now, a lot of it focuses on gene therapy in utero, that is in the womb. What sort of diseases do you anticipate will be countered through this kind of therapy? What will be most effective here?
ANDERSON: Well, there are a number of diseases that cause irreversible damage before birth, and many of these like tesax (ph), and eleshanaya (ph), and the licodystrophies (ph), canaba (ph) disease, and so on, there is a whole series of them and they basically produce them in many cases brain damage, so that when a baby is born it is already too late. The disease has already had a major impact, so the idea is to attempt to get -- to treat genetic diseases in the womb before they cause symptoms. CHEN: I know we only have a little bit of time left to talk about this, and I do want to get into this question of the ethics. We have talked about the natural elements of gene therapy, but there are concerns, particularly about the possibility of a partial success in this therapy?
ANDERSON: Yes. Well, there is really two big issues with gene therapy. The first is, as soon as you have the ability to put a gene into a human patient to treat a disease, you have the ability to put a gene in for any other reason, and therefore, the whole scepter, the whole concern of designer babies is really very valid. We don't want a "Gattaca" type environment. So that is really the major ethical issue.
The second issue is the one you just mentioned and that is, what if we were to attempt to treat a genetic disease like alphaphalesemia (ph), for example, which causes death in utero, but we only partially treated it so that a -- an infant instead of being born healthy is born dying basically, and all we have done is prolong death rather than life. That is a big issue and one that we really have to take very seriously into account and be certain that our treatment will treat and not just prolong death.
CHEN: Dr. French Anderson, we appreciate your insight into these subjects, and I am sure we will hear more as the decade continues. Dr. Anderson is with the gene therapy laboratories at the University of Southern California. Thanks for being with us -- Wolf.
BLITZER: And as our coverage continues, it may sound too good to be true, but there is technology in development that may one day turn our old aging cells into new young cells. One man working on this kind of time machine is Michael West. We'll talk to him next.
BLITZER: Now how would we get a second chance on life and live much longer? The research here involves genes, stem cells and what's called therapeutic cloning.
To help us understand this fascinating science, Michael West, president and CEO of Advanced Cell Technology. He joins us now from Boston.
Dr. West, thank you so much for being with us.
Therapeutic cloning, tell us how that could potentially extend life?
MICHAEL WEST, ADVANCED CELL TECHNOLOGY: Well, one of the major problems an aging population has is literally cells and tissues wearing out over time. So as you know, if we lose heart muscle as a result of a heart attack or neurons in our brain as the result of a stroke or Parkinson's disease, we have there cells and tissues that cannot regenerate themselves.
And so the hope of medicine in the future is to develop a whole new arena we call regenerative medicine which would allow us to make new cells and tissues for an aging population. And the -- maybe the most exciting approach to doing that is therapeutic cloning.
BLITZER: And in practical terms, how far away are you and other scientists away in achieving that therapeutic cloning that specifically would benefit individuals getting older?
WEST: Well, where we're at today are just the first halting steps toward doing that. We're using the same techniques that have been used to clone animals like Dolly and the cows and many other animals that have now been cloned. But rather than using the technique to clone an animal or in this case a human being, we're using the techniques to make these stem cells you referred to earlier. And these stem cells do have the ability of regenerating cells and tissues that could be used to treat all these millions of people dying every year for a lack of a transplantable tissue.
BLITZER: And specifically it could regenerate, for example, skin. Is that something on your horizon?
WEST: Well, I think the exciting thing here is the power of this new technology platform. It's not just a new technique to treat skin problems, although indeed that's a very important area. You can imagine, for instance, even a young person with a large body burn. We need to develop a new technology of replacing, you know, large segments of skin, but these new technologies are very powerful and very broad in their application, and it's been said that there's not an area of medicine that they cannot potentially impact.
So whether it be kidney tissue or heart tissue, brain tissue, spinal cord regeneration, the concept is we can take a cell from an older person or any person in need of a tissue, put that cell back in this time machine we call nuclear transfer, or cloning, but rather than cloning a human being, making these cells that have total power to regenerate any cell and tissue to make cells and tissues for that patient that would be not rejected by that patient. They'd be accepted as cells.
BLITZER: And I know you're not engaged in cloning human beings but cloning parts of human beings, and the ethics as you see it involved here? What are the ethics?
WEST: Right, well there certainly is a lot of debate going on right now as we speak in the ethics community and with policymakers in Washington and so on of sorting the good from the bad here. And as you pointed out, the goal is not to clone human beings, it's to make cloned cells, to make stem cells for therapy.
But nevertheless, the first steps in this technique are essentially identical to the techniques that would be used to clone a human being, that is the nuclear transfer step, where we take a cell from the body, maybe a skin cell, for instance, and put it into an egg cell whose DNA has been removed.
I think, though, maybe the more challenging ethical questions are not the applications in medicine. Certainly there will be, I think, dramatic, profound changes in how we treat disease by using therapeutic cloning in the coming decades and there will be many ethical issues involved.
I think maybe the more profound ethical problems are associated with using the technique to clone human beings and using the technique as it interfaces with all this genetic technology you've been speaking about earlier, because cloning allows us to introduce genetic changes in the cells and tissues and could also be used to introduce genetic changes into human beings and to make genetically engineered human beings. And certainly that is an area that will preoccupy ethicists for several decades to come.
BLITZER: All right, as we enter this new millennium we'll be preoccupied. It's breathtaking technology. Thank you so much for sharing your thoughts on what's going on, Michael West, in Boston -- Joie.
CHEN: Still ahead here, creating spare parts for the human body using your very own genes. We'll talk to a doctor that's already doing just that next.
CHEN: More on the remarkable advances in gene therapy.
Now joining us from Boston this hour to explain how we may all get a second chance, maybe even more, through tissue engineering, is Dr. Anthony Atala.
Dr. Atala, we thank you for being with us. We know you're at the Children's Hospital in the tissue engineering lab, and I want to ask first where you have been most effective, where you've already been able to grow -- I don't know, create? -- an organ -- I don't know what verb you use to describe that -- in the tissue engineering lab.
DR. ANTHONY ATALA, CHILDREN'S HOSPITAL, BOSTON: That's right. We created a bladder in the laboratory.
CHEN: A human bladder?
ATALA: That's correct.
CHEN: Can you give us some idea of how long, how complicated, and why you would choose to start with the bladder?
ATALA: Well, in fact it's a fairly complex organ which is designed to expand at very low pressures. And we were working with this organ because there are millions of people around the world that require bladder tissue, and there's just none available. Currently, there are no choices for these patients. And it was a tissue which was in reality one of the simpler tissues to make. So that's why we tackled that first.
CHEN: When you say that you have been able to tackle that first, does this mean that any human organ could be used -- could be developed in the same way in the laboratory? ATALA: Pretty much the same way, using the same techniques. Now there are varieties in terms of the tissues that we use and the cells that we use, but, in fact, they're all the same principles in terms of building blocks and how to build these tissues into organs.
CHEN: What other organs are you working on now?
ATALA: Kidney, wind pipes, tracheas, cartilage, bone, heart tissue among others.
CHEN: This seems quite incredible to us. I mean, in terms of how this relates to how the human body would grow itself, is there something -- would it take longer -- I mean, does the human body grow in a six-week period a bladder in the same way in an embryonic form as you are able to do in a laboratory?
ATALA: Well, basically the technology relies on the patient's own cells. So what is done is that a small piece of tissue from that patient is taken, and then the cells can be expanded into very large quantities so that at about six weeks you have enough cells, basically, to create your organ.
CHEN: We've talked a bit about ethical questions in the scope of this sort of research. Do you think that that is an research for you in your laboratory and in the particular kind of work that you are doing?
ATALA: Not really, because with the technology that we're pursuing, which is tissue engineering, we're actually taking the cells from the same patient and putting them back into the same patient. So we are actually growing the organ for that specific individual who will eventually benefit from it.
CHEN: What do you -- What is your perspective about the long term, about when this will be used widely, when the products will be used widely in the course of gene therapy?
ATALA: Well, certainly even today there are some tissues which are being used clinically. For example, skin, as was mentioned earlier, is being used today for patients with burns. Same thing as with cartilage for knee replacement; for cells for conditions such as urinary incontinence and vescory (ph) reflux. So there are many conditions today which are already being -- which are already taking advantage of this technology. And certainly the list will grow as time goes on.
CHEN: Dr. Anthony Atatla, we appreciate your being with us. Dr. Atala is with Children's Hospital in Boston on the very cutting edge of this gene therapy work.
Thanks very much, sir.
ATALA: My pleasure.
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