[1] On 4 March 2025, the de-extinction company Colossal revealed its latest research: the Woolly Mouse. Unlike typical mice which have short, grey hair, this mouse has long, shaggy, tawny-toned hair, mimicking the hair of the Woolly Mammoth. To achieve this, the scientists used many gene-editing techniques to modify up to 7 different genes involved in lipid production, and hair type, both of which differ due to the Woolly Mammoth’s adaptations to surviving in the cold.
[3] Gene editing is the process of modifying DNA via deletion, addition or modification of different genes in different plants, bacteria and animals which can change their physical features like eye colour and disease risk. While the concept and techniques have been developed since the late 1900’s, recent developments of a tool called CRISPR/Cas9 have greatly advanced gene editing.
[2] Gene-editing research often takes place in animals as humans and animals share many genes. Mice are often used as they have a short gestation period of 20 and have well established methods for gene editing protocols, allowing rapid testing compared to other animals. While the findings in mice models are not fully translational to human genes or in this case to Woolly Mammoth genes, they can still be used for research and understanding the effect of different genes and different characteristics.
[3] The de-extinction of the Woolly Mammoth could have great effects on the Artic tundra and convert it back to grasslands seen in the ice age. This could then reduce CO2 released into the atmosphere. Other animals which played unique crucial roles in their habitat, like the passenger pigeon, could also have positive long-lasting effects if they were brought back. While true de-extinction involves different technologies, the use of genetic engineering may be able to create modern replica animals with desirable characteristics which could still bring positive environmental impact.
There are many arguments for not using gene editing for de-extinction. If we use small creatures like rats, then it is possible to lose track of them and they could infiltrate other ecosystems. It also raises ethical issues as even if we could bring back these species are people and people in power ready for this? There is no guarantee that once people can bring back a Woolly Mammoth that people wouldn’t monopolise the discovery and create zoos filled with de-extinct creatures or bring back other species purely for monetary gains. Therefore, new laws will need to be put in place to regulate the ethical use of gene editing for de-extinction. If this technology develops it could also lead to a wider acceptance of gene editing and the use of gene editing in humans which comes with another set of arguments.
Overall, the arrival of the Woolly Mouse highlights the innovative research continuing to be done in the field of gene editing. While the mouse is adorable, it highlights the potential ethical issues around gene editing and could start discussions around introducing laws to regulate the use of gene editing for de-extinction, to prevent a real-life Jurassic Park situation.
References:
[1] E. Callaway, “Meet the ‘woolly mouse’: why scientists doubt it’s a big step towards recreating mammoths,” Nature.com, Mar. 2025, doi: https://doi.org/10.1038/d41586-025-00684-1.
[2] R. Chen et al., “Multiplex-edited mice recapitulate woolly mammoth hair phenotypes,” bioRxiv (Cold Spring Harbor Laboratory), Mar. 2025, doi: https://doi.org/10.1101/2025.03.03.641227.
[3] D. Shultz, “Should we bring extinct species back from the dead?,” www.science.org, Sep. 26, 2016. https://www.science.org/content/article/should-we-bring-extinct-species-back-dead
The human body has a limited capacity to heal or regenerate compromised organs. Currently these are normally replaced via transplant from a compatible donor, but there can be complications with rejection when the immune system recognises the transplanted tissue as foreign and there is the initial issue of having enough donors within society to provide the organs needed for transplants everyday. Those of us in the UK should be especially aware of donor shortages, given we must opt out of the organ donor register per the Organ Donation Bill (2019) as consent for donation is automatically assumed otherwise.
A possible solution
Bio-printing uses common 3D printing techniques to construct organs or other bio-materials from base cells in a ‘bio-ink’. Potentially, those waiting for organs could have one purpose printed or their damaged organ repaired (with successful stem cell use demonstrated for both), cutting the risk of rejection and wait time.
Printers?, Ink?, Like a regular printer? Bio-inks are predominantly blends of alginate-gelatine that contain desired cells. The properties of this material must be specialised for its use and the method of printing involved, optimal cell growth and tissue integrity has to be maintained for the cell payload, print temperature and pressure can kill the cells during delivery if not set correctly. Simultaneously the gelatin must be viscous enough for delivery and yet achieve a balance of flexibility and sturdiness once in place to replicate organs as if grown in situ.
The printers involved vary, but most may be familiar, inkjet printers similar to the one on your desk (and possibly built by the same company e.g. Hewlett-Packard) heat the ink and eject it onto the build plate via an array of nozzles in the printhead. Stereolithography (already used by hobbyists like myself with non-bio photopolymers), targets UV or visible light onto a build plate, upon which the bio-ink undergoes a chain reaction from liquid gelatine to a solid scaffold for growth under light exposure.
Extrusion printers build a structure with supports layer by layer, the material is either pushed out of a syringe in liquid form under pressure via pneumatics, pistons or screws or fed into a controlled heated nozzle (called a hot end), liquified and deposited directly onto the structure, the latter being the same premise as for FDM (Fused Deposition Modelling) printers.
HP Inkjet bio-printerVisuals for how the processes work.
Bio-printing in fiction and societal views
Those of you who’ve read books such as Kiln People or Queen of Angels or watched Westworld know the concerns that can arise with bio-printing. Body modification, cloning and exploitation of humans made through bio-printing have been explored in our media, so what standards can we hold bio-printing to? I myself own two (non-bio)printers, they’re incredibly easy processes to pick up and find equipment for (there have been open source instructions to build your own bio-printer for under £400 from Carnegie Mellon University since 2018) and yet there is no sui generis regulatory body governing the entire process, only partial coverage for the biological material itself under the HTA for tissues and HFEA for stem cells.
My closing thoughts
The concerns above are significant, and yet it seems to me the industry might be getting ahead of being assessed and regulated. Although we’re nowhere near printing the hosts, if someone can inexpensively decide to make their own bio-printers, why don’t specific regulation bodies exist and how could they monitor such possibilities when the process can feasibly be completed in the comfort of your own home.
Westworld (tv series) opening- the park’s hosts are automatons with organic bodies.
Ong, C. S., Yesantharao, P., Huang, C. Y., Mattson, G., Boktor, J., Fukunishi, T., Zhang, H., & Hibino, N. (2018). 3D bioprinting using stem cells. Pediatric research, 83(1-2), 223–231. https://doi.org/10.1038/pr.2017.252
Murphy, S., Atala, A. (2014). 3D bioprinting of tissues and organs. Nat Biotechnol32, 773–785. https://doi.org/10.1038/nbt.2958
Chung J, Kapsa R. (2013) Bio-ink properties and printability for extrusion printing living cells. Biomaterials Science. http://dx.doi.org/10.1039/C3BM00012E
Kirillova A, Bushev S, Abubakirov A, Sukikh G. (2020) Bioethical and Legal Issues in 3D Bioprinting. Int J Bioprint; 6(3):272. doi: 10.18063/ijb.v6i3.272.
S. Vanaei, M.S. Parizi, S. Vanaei, F. Salemizadehparizi, H.R. Vanaei, (2021) An Overview on Materials and Techniques in 3D Bioprinting Toward Biomedical Application, Engineered Regeneration, Volume 2, https://doi.org/10.1016/j.engreg.2020.12.001.
Herzog, Josha & Franke, Lea & Lai, Yingyao & Rossi, Pablo & Sachtleben, Janina & Weuster-Botz, Dirk. (2024). 3D bioprinting of microorganisms: principles and applications. Bioprocess and Biosystems Engineering. 47. 1-19. doi: 10.1007/s00449-023-02965-3.
Neuroprosthetic devices make use of the nervous system to enhance their ability to efficiently restore function to a part of the body, usually after an injury has occurred [1].
Some examples are [2]:
Cochlear implants
Prosthetic limbs
Retinal implants
In this particular post I will concentrate on just these examples, explaining what they are and how they work, along with evaluating their risks and any ethical concerns surrounding their use.
Cochlear implants
What are cochlear implants?
Cochlear implants are devices used to allow someone who is deaf or extremely hard-of-hearing to have a sense of sound. Part of the implant is external and sits just behind the ear and the other part is internal and is placed under the skin [3]. The implant picks up sounds using the external part of the device which are then received by the receiver under the skin. These are then converted into electrical signals which can be used to stimulate the cochlear nerve and therefore be understood as sounds by the brain [4].
Figure 1: The cochlear implant. Left: The external part of the implant consisting of the transmitter, microphone and speech processor. Right: The internal part of the implant with the receiver under the skin and the electrode in the cochlear [5].
Risks and ethical concerns with cochlear implants
There are many benefits to this type of device which generally improve the patient’s quality of life. Adults tend to benefit from the implant immediately and could have the ability to understand speech without lip-reading, make telephone calls and even perceive different types of sounds [6].
However, there are also some drawbacks to the implant. It is invasive and requires surgery, which comes with various risks such as damage to the facial nerve, infection and leakage of fluids (cerebrospinal and perilymph) [6]. In addition to the surgical risks, there are also some general risks involved: any hearing that was remaining could be lost, the implant could fail and lifestyle changes will need to be made to prevent damage and interference with the implant [6].
There is also an ethical debate involving the use of cochlear implants in deaf/hard-of-hearing children. There was an interesting discussion I found about this topic in an article by Byrd et al. [7]. The article talked about how some people in the Deaf community are sceptical about the devices and feel that they are not worth the risks involved. Additionally, lots of parents in the Deaf community wish to also bring up their children in the community, so that they can share their language, culture and unique experiences. Because of this, some parents will choose to not put their Deaf children through the surgery. However, it has been shown that it’s beneficial for a child to have the implant before 24 months of age to allow better development of speech and language, so in some cases this has raised questions about whether not giving a child the surgery should be considered neglect.
I think that it’s a very complex situation and each case must be looked at individually to determine what’s best for the child in that particular scenario. I also think it’s important that the parents are well informed about the risks and benefits of cochlear implants so that they are able to make the right decision.
Prosthetic limbs
What are neuroprosthetic limbs?
Neuroprosthetic limbs are replacement limbs that are connected to the nervous system allowing the person to control the prosthesis with their brain. For example, in bionic legs, electrodes measure the nerve activity from the person’s intention to move their leg and then a computer in the neuroprosthetic device uses these signals to move the prosthesis [8].
Issues with neuroprosthetic limbs
Due to the type of data collected to train and use these devices, there needs to be an evaluation of the safety of this data to protect it from hacking [9]. Since AI is often involved with these devices, there is bias involved that should be taken into consideration [9].
In my opinion, although there are still some concerns surrounding the use of these devices, the potential benefits by far outweigh the risks, so more research in this area would be beneficial. And as technology improves, as will AI and the ability to protect data, so these concerns could be eliminated in the future.
Retinal implants
What are retinal implants?
Retinal implants are prosthetic devices that aim to restore some vision to those with vision loss by replacing the role of photoreceptors. They can be epiretinal (on the inner surface of the retina), subretinal (behind the retina) or suprachoroidal (between the choroid and the sclera) and they work by using direct electrical stimulation or by using photodiodes [10].
Figure 2: The structure of the retina showing the placement of epiretinal and subretinal implants [11].
Ethical concerns with retinal implants
In the article by Slattery [12], it is mentioned that from observing the data from clinical trials it is clear that visual accuracy cannot be guaranteed from the use of the implants, which can lead to misinterpretations that may affect a patient’s day-to-day life. In conclusion, this type of implant needs to be further researched to give people more confidence in its abilities.
Bibliography
[1] B. C. Eapen, D. P. Murphy, and D. X. Cifu, “Neuroprosthetics in amputee and brain injury rehabilitation,” Experimental Neurology, vol. 287, pp. 479–485, Jan. 2017, doi: https://doi.org/10.1016/j.expneurol.2016.08.004.
[5]“Cochlear implant in Singapore – Hearing Specialist & Audiologist in Singapore | D&S Audiology,” Dsaudiology.sg, 2022. https://dsaudiology.sg/implantable-devices/ (accessed Mar. 11, 2025).
[6] “Benefits and Risks of Cochlear Implants,” U.S. Food and Drug Administration, Feb. 09, 2021. https://www.fda.gov/medical-devices/cochlear-implants/benefits-and-risks-cochlear-implants (accessed Mar. 11, 2025).
[7] S. Byrd, A. G. Shuman, S. Kileny, and P. R. Kileny, “The right not to hear: The ethics of parental refusal of hearing rehabilitation,” The Laryngoscope, vol. 121, no. 8, pp. 1800–1804, Jul. 2011, doi: https://doi.org/10.1002/lary.21886.
[8] S. Ward, “People can move this bionic leg just by thinking about it,” MIT Technology Review, Jul. 2024. https://www.technologyreview.com/2024/07/01/1094459/bionic-leg-neural-prosthetic/ (accessed Mar. 12, 2025).
[9] Marcello Ienca, G. Valle, and Stanisa Raspopovic, “Clinical trials for implantable neural prostheses: understanding the ethical and technical requirements,” The Lancet Digital Health, Jan. 2025, doi: https://doi.org/10.1016/s2589-7500(24)00222-x.[10]
[10] L. N. Ayton et al., “An update on retinal prostheses,” Clinical Neurophysiology, vol. 131, no. 6, pp. 1383–1398, Jun. 2020, doi: https://doi.org/10.1016/j.clinph.2019.11.029.[12]
[12] M. Slattery, “The ethical future of bionic vision,” Pursuit, Dec. 05, 2017. https://pursuit.unimelb.edu.au/articles/the-ethical-future-of-bionic-vision (accessed Mar. 12, 2025).
In January 2023 two Democratic representatives, Judith Garcia and Carlos Gonzalez, proposed a bill that would offer prisoners in Massachusetts a new way to win not less than 60 and not more than 365-day reduction in their sentences by donating their bone marrow or vital organs. The legislators claimed that their proposal would respect the bodily autonomy of prisoners and would address racial disparities by helping to expand the pool of donors.
I must refute this claim. How is this a bill that was passed in TWENTY TWENTY-THREE – a mere two years ago? You’d think politicians would’ve learned by now. Consider the situation in which a prisoner was wrongfully committed and jailed. It is actually estimated that 1 percent of the US prison population, approximately 20,000 people, are falsely convicted. In this case, the punishment does not fit the crime because the crime was never even committed in the first place, and while this is true the bill should have never been passed.
In the instance the crime was committed, it simply doesn’t make sense that the sentence can be modified in anyway. Altering the sentence undermines the idea that it was appropriately determined in the first place which sets a dangerous precedent, suggesting that sentences are flexible rather than fitting the severity of the crime. It also opens the way for future modifications undermining the integrity of the legal system and its ability to deliver justice.
BUT this isn’t even the real problem here. Fundamentally, it does not matter what these prisoners have done – they arestillpeople. Human beings. There will never be real autonomy or true consent in this situation to ask them to give their bodies in exchange for freedom. It’s not a fair trade; it’s a blatant violation of human rights. It’s preying on vulnerable people who have little choice because the alternative – staying locked up for longer – is not really a choice, only the illusion of one.
This punishment will never fit the crime. Furthermore, Garcia and Gonzalez have walked back their proposal and are planning to introduce a version without the promise of a sentence reduction. This bill should never have been passed to allow this change in the first place. Bills passed in future need to focus on real reform—improving rehabilitation, ensuring fair sentencing, and expanding ethical organ donation programs by increasing public awareness and expanding donor registration programs.
Imagine a dragon regaining the ability to fly with a prosthetic tail. Now I’m not just talking about “Toothless” from the movie “How to train your dragon”, but this is a real emerging field in science where real animals in unfortunate situations get the chance to live a better life. As a pet owner myself, should something happen to my cats, I wouldn’t hesitate to provide them with the prostheses that they need to live comfortably again but is this really my choice to make? Are prosthetics for animals justifiable or are we just playing God?
Pivotal Events in Animal Prosthetics
Human prosthetics date back thousands of years but for animals, the idea emerged much more recently, evolving from rudimentary solutions to advanced personalised devices.
Timeline showing the evolution of animal prosthetics
High Profile Cases
“Winter”, a bottlenose dolphin who lost her tail after getting caught in a fishing net received a 3D-printed tail. She slowly regained mobility and could swim again at the Clearwater Marine aquarium (they even made a movie about her! Watch “Dolphin Tale” for her full story).
YouTube video of Winter getting fitted with her new tail
Other notable cases:
Mr. Stubbs the Alligator
First reptile to receive a prosthetic limb
Lost his tail after being illegally transported
Was fitted with a 3D-printed prosthetic one
Naki’o the Dog
Rescued from a frozen puddle as a puppy
Lost his paws and part of his tail due to frostbite
Was fitted with 4 prosthetic limbs (first dog to have 4 prosthetic limbs!)
Motala the Elephant
Lost her leg by stepping on a landmine
Received a prosthetic leg
A Deep Dive into Ethics
All these cases are inspiring, however the question of whether we should be altering an animal’s body remains an ethical dilemma. While I believe for the most part that prosthetics can help improve an animal’s life, some ethical issues are raised:
It’s not entirely clear if animals truly benefit from prosthetics long-term or if their suffering is simply prolonged.
Often, the need for animal prosthetics may be driven more by the human desire to “fix” things rather than the animal’s genuine needs.
In many cases, animals are given prosthetics for cosmetic reasons, to meet human expectations.
Animals can’t voice their opinions, so the decision lies in the hands of veterinarians, caretakers and pet owners.
Legal Boundaries of Animal Prosthetics
While there are general veterinary medical guidelines ensuring the safety and well-being of animals undergoing procedures, legal frameworks related to prosthetics are still developing.
There are no universal laws that protect animals from unnecessary prosthetic procedures.
The cost of the prosthetics can be substantial.
Insurance often doesn’t cover the procedures, as they are not always classified as medical necessities.
Pet owners are left to bear the financial burden.
A New Era of Compassion
In the past century, society’s perception of disabled animals has drastically shifted. Injured/disabled animals were often euthanised, due to few chances of recovery. Now, thanks to animal advocacy groups, the public has become more sympathetic toward animals with disabilities, many seeing prosthetics as a viable way to provide their furry companions with fuller, happier lives. Rehabilitation has also proven that animals with prosthetics can not only survive but thrive in their environment.
Final Thoughts
Some scepticism still exists about whether animals truly need prosthetics, or if they are merely a human desire. Ultimately, I firmly believe that the decision to fit an animal with a prosthetic should be made in the best interests of the animal and should involve careful consideration of the animal’s needs and physical and emotional state by professionals.
You must know Dolly?! The sensational sheep that was famously cloned in 1996. She’s been heavily reported in near every biology textbook and her story is eagerly recited by millions. She played a significant role in advancing our scientific knowledge. However, most are unaware of the work that led to her being a possibility and in almost three decades we have had major advancements! Did you know Dolly wasn’t even the first cloned animal?
Here is a brief history of cloning from the past and some of the controversial techniques availible today.
Photo of dolly the sheep from the natural history museum in Edinborough
What is cloning?
Cloning is the process of creating a genetically identical individual. Identical twins are natural clones. This concept is widely used as a plot line in media. You must have seen cloning in the movie Jurassic park! Perhaps the book Alex rider? Where an evil scientist creates clones of himself and uses them to try and achieve world domination.
The possibilities of cloning is exciting but clearly potentially problematic! More on that later…
Time line Towards Dolly
The early days 1885 – Embryonic cells were separated in the early stages of development of sea urchins.
1928 – The same method was used to clone salamanders but were not viable/fully formed
Nuclear transfer – 1950 – The first successful nuclear transfer on a tadpole!
A frog egg nucleus is removed and a the nucleus from another tadpole is added into the empty frog egg.
1958 – Nuclei from differentiated cells were found to result in development.
1970s- The first genetically identical mice was produced by splitting mouse embryos.
Dawn of Cloning – 1996 – Dolly the sheep, the first mammal from an adult somatic cell was created.
Cloning after Dolly
2001 -Endangered animals have been cloned.
2013 – Human embryonic stem cells are created using somatic cell nuclear transfer.
The successful cloning of Dolly led the way for vast improvements in our understanding of stem cells. For the first time it had been shown that a cell could be reprogramed after it had specialised and be used to form an organism. Important ethical issues were raised particularly surrounding human cloning and later the use of human embryos for stem cell research. Would you want your DNA used to create another being the same as you? On one hand it would be kind of amazing to have someone that thinks and acts inherently the same as me but at the same time I don’t think I could stand another one of me! Many had a moral apprehension around cloning and as such human cloning was immediately banned by UNESCO. The use of human embryos is also heavily regulated with the Warnock report restricting research on embryos up to 14 days old.
Nowadays there is a market for Pet cloning, yes you heard me right! Companies are providing the ability to have the DNA of your pet cloned to bring back your lost pup! I am flabbergasted that this is availible for purchase. My first thoughts were that this was pointless as it wouldn’t fully bring back your lost pet but after watching the video I am less sure. it did seem to bring solace to the pet owner, if its a harmless venture, why not?
Watch how cloning has been used to create Marley and Mabel!
Cloning can be hugely beneficial, such as producing live stock with desirable traits and the potential to study genetic diseases and develop cures, including bringing joy back after the loss of a beloved pet. However cloning also raises the concern of autonomy and individuality some argue that its unnatural and could lead to the exploitation and misuse. Additionally the technology required for cloning is expensive unavailable to most third world countries. Is it right to be benefiting from something that others cannot? What do you think?
Sciences (US), N.A. of et al. (2002) ‘Cloning: Definitions And Applications’, in Scientific and Medical Aspects of Human Reproductive Cloning. National Academies Press (US). Available at: https://www.ncbi.nlm.nih.gov/books/NBK223960/ (Accessed: 11 March 2025).
There are many accidents and events that lead to pain and suffering, but none greater than the minutes following stubbing your big toe on the corner of a coffee table (disclaimer – this is not fact, purely for comedic purposes).
However, severe pain in the Hallux (a fancy scientific name for ‘big toe’) is an every day reality for many. 1 in 40 people over the age of 50 suffer from big toe arthritis (Hallux Rigidus) and 16% of those suffering foot pain identified the Hallux as the centre of pain.
Potential treatments
Solutions for Hallux pain date back to the Egyptians, where replacements toes were found from about 1000 BC and in recent years, it has been favourable to fuse the bones at the affected joint, limiting pain and consequentially movement. But, focus has recently shifted, due to revolutionising joint replacement technologies, prioritising the maintenance of as much bone and cartilage as safe and viable.
Cartoon above by Tom Williams, showing a comedic representation of a hammer-toe ‘specialist’ who uses a hammer to treat the Hallux, also known as the hammer toe.
One example of this is Anika – a global joint preservation company, that is leading efforts to help people suffering from Hallux pain, particularly through their ToeMotion® and Toe HemiCAP® DF products. The video below providing an explanation of how this technology works (posted by Mason City Clinic).
Video transcript: Bones joint damage near toes can become debilitating and painful but relief is easier than you think. Osteoarthritis causes the bone and cartilage of the metatarsal the longest bone of the toe to wear down over time this causes pain and limits the toes effective range of motion. In more advanced cases both sides of the toe joint are damaged and a total resurfacing with implants on both sides of the joint may be necessary. The arthro surface toe motion total toe system is a simple procedure that can significantly reduce your pain while providing motion for a more active lifestyle. Here’s how it works. First your surgeon will insert a metal guide wire into the metatarsal bone ensuring that the implant itself will be inserted at exactly the right angle. Next the surgeon inserts a tapered screw designed for maximum strength, durability and fixation. Using a system unique to artho surface, the search and map several data points on your joint surface to figure out the curves of your damaged joint, ensuring that the implant will be a perfect fit. The surgeon then prepares the surface by means of a specialized reamer smoothing out the roughness caused by osteoarthritis and preparing the bone for the implant. Before placing the final implant on the metatarsal side, your surgeon will prepare the opposite side of the joint known as the phalangeal side similar to the technique for the metatarsal bone. The surgeon will begin by placing a metal guide wire, ensuring that the implant is inserted with the correct orientation. After shaping and preparing the bone for the implant, a metal base plate is screwed into place. The appropriate plastic implant is then locked into the base plate with the correct curve in thickness to match your joint. The phalangeal side implant is shaped like a cup and is designed to meet with the rounded metal implant on the metatarsal side. Once the plastic component is secured in place on the phalangeal side of the joint, the final metal implant is then locked into the screw on the metatarsal side, which completes the implantation. The final hem II cap implants are small, unobtrusive, strong and the only implants that have screw fixation on both sides of the joint. The implants are designed to match variations in patient anatomy so the surgeon can obtain a personalized fit at the time of surgery. With the procedure completed, the two sides of the joint moved smoothly against one another, simulating the movement of a toe joint. The toe motion procedure can be performed as an outpatient procedure, it’s minimally invasive, restores mobility and lets you enjoy an active lifestyle again.
Arthroplasty over Arthrodesis?
There are many arguments for why Arthroplasty is becoming more favourable than traditional Arthrodesis fusion methods (listed below), all of which are focused towards improving the patients care, recovery and experience with a toe joint replacement.
These arguments are supported by the successes of this medical advancement, which has helped people, at all levels, to get back on their feet. Furthermore, this technology is in line with the NICE joint replacement standards and actually seems to enhance them by giving patients more treatment options, preventing implant errors by removing less bone matter and improving rehabilitation with shorter recovery times.
Anna Lynch’s story: Anna feared she may never be able to walk pain free again, due to debilitating pain in her left big toe, but just months after her operation she trekked 10,000 feet up the Himalayas.
Despite overwhelming success, there is also still some drawbacks to this technology. For example it is fairly modern, so long term survival of the prosthetic cannot yet be disclosed with complete confidence and there is still lasting support for fusion as the more ‘reliable’ method of treatment. However, the benefits greatly outweigh the drawbacks (shown below).
Could this be BIGGER than the BIG toe?
There is also possibility to further this technology. Arthritis is now one of many disorders Hallux Arthroplasty can treat. Others include Hallux Vaglus (bunions), Osteonecrosis and unstable/painful MTP joints – making it a versatile treatment worth investing in.
The practises involved in this treatment have also been expanded to other areas of the body in hopes of achieving the same success, especially in places proven difficult to treat, such as the spine. This makes clear the significance of toe joint replacement technology and how the ideas and structures, e.g. replacement over fusion (shown in the image below), behind it, could revolutionise treatment for more difficult injuries, to allow greater movement and therefore quality of life for patients.
Article on the potential use of total joint replacement of the spine. Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC11265502/pdf/IJSS-18-01-8538.pdfX-ray images of spinal joint treatment – left image is a lumbar spinal fusion, right image is a artificial disk replacement. Right image from Mathur S, Jenis LG, An HS: Surgical Management of Chronic Low Back Pain: Arthrodesis, in Jenis LG, ed: Low Back Pain: Monograph Series Left image from Jenis LG: Surgical Management of Chronic Low Back Pain: Alternatives to Arthrodesis, in Jenis LG, ed: Low Back Pain: Monograph Series. Rosemont, IL, Amer Acad of Orthop Surg, 2005.
My thoughts…
Overall, it could be considered that there is BIG potential for this shift from fusion to joint replacement technology to help improve patient care and quality of life. Starting by improving motion of the BIG toe and hopefully towards future success in more complex regions and functions.
As a biologist who seeks to uncover the inner-workings of nature to better understand what makes organisms tick and potentially some day cure the seemingly incurable, the lecture I was most excited for in the UOSM2031 Module was that of the stem cell lecture. It’s among my greatest interests in science – a cell that can become any other, a tool to fit any screw, a piece to fit any puzzle, and I’ve been hotly interested in them ever since my biology lessons in my first year of secondary school. It was there that my biology teacher, Mr. Thomas (I wonder where he is now), stood in front of a class of generally apathetic and sleepless teenagers and spoke about a subset of cells called ESCs – Embryonic Stem Cells – which are pluripotent, unspecialized cells arising in the blastocyst (4-5 day old embryo) of a new organism, and have the miraculous ability to differentiate into whatever cell type the body requires, for the purpose of developing a complete body. These could also be cultured ex vivo in labs.
This was all covered in the lecture on the 3rd of February, but was not particularly new to me; what really piqued my interest that day was remembering an idea I had all those years ago. An idea that I took to the equally sleep-deprived Mr. Thomas after class and asked him, “Sir, what if we made hybridoma stem cells?”
A New Frontier of Immunology –
Now the idea was merely that, an idea. Very little deep thought was put into the logic and science of its functionality or practicality, but it was Albert Einstein who was thought to have said, “Innovation is not the product of logical thought, even though the final product is tied to a logical structure”. You have to start somewhere! Just the week prior we had been given a lecture on a type of cell culturing technology called Hybridomas, cell lines that would continually and rapidly produce monoclonal antibodies (mAbs) for the purpose of harvesting the antibodies for treatments, and these cells producing them would ideally never senesce (grow old and stop dividing). The reason for this? They were created from cancer cells. From the fusion of a designated B-lymphocyte immune cell taken from experimental animals and a myeloma (cancerous immune cell), a heterokaryon (cell with multiple nuclei) would be produced capable of unrestricted proliferation and antibody production – key elements of its constituent cells. Practically, it is a useful method of harvesting large amounts of dedicated antibodies towards a specific disease, and as old and low-complexity as it is, being a method originally developed in the 1970s, research is still conducted on it today, simultaneously to assess its viability alongside modern techniques.
Moraes et al., (2021) seek to compare hybridoma and mAb technologies with other emerging approaches, and discuss their benefits and limitations in this research paper.
To apply this idea to stem cells, what exactly was my approach? While I have done much research into hybridomas and stem cells over the years to better understand them, there is still much to figure out towards it being a working method, but the general concept is simple: combine a pluripotent stem cell with the endless proliferation of a cancer cell to yield a rapidly multiplying source of stem cells for fast and effective treatment. The challenges and difficulty are obvious concerning the use of cancer and ESCs to try and make a new cell line but I feel the benefits outweigh any costs. Almost like an axolotl is able to do, this may allow for the total repair/replacement of entire limbs, organs and tissue all from within the body itself, fully coinciding with the principle purpose of this academic module, Engineering Replacement Body Parts. It can go even further however; replacing neurons which is a most challenging aspect of medicine could be the key to eliminating neurodegenerative disorders like Alzheimer’s and Dementia, which I have experience with in my family and through my mother’s work in the NHS (always an inspiration of mine). So it is clear to see where my motivation for the idea strives from… but will ethics even allow this research?
Axolotls can replace entire limbs by distributing stem cells to the sites of regrowth. They can even do this with parts of their brain using Ependymoglial cells, which are like human neural stem cells. Imagine if we incorporated that? Image property of Julia Moore (2015), obtained from:https://medium.com/quarkmagazine/are-axolotl-the-key-to-everlasting-life-b4b35c9649a5
The Bane of Scientific Advancement? –
The reason for this whole retrospection of my hybridoma stem cell idea in the first place was because I attended a lecture recently that revisited these concepts, and then I had proceeded to have another lecture that revisited yet another aspect of cutting edge scientific development that holds great relevance in the realm of this discussion, only this one I’m slightly less excited about – the ethics of stem cell research. While I call it my least favourite part of the course, it’s not for lack of importance or interest in its discussion, but that it always seems to be the dampening factor on developing a lot of these ideas. On the 3rd of March, we discussed in lesson the ethical arguments surrounding using stem cells for research, and how in 1990, the Human Fertilization and Embryology Authority (HFEA) was set up to establish the guidelines for using them, in response to an enquiry headed by Dame Mary Warnock as to whether scientists should be allowed to freely experiment on the surplus embryos, not only for the reason of harvesting the ESCs from the embryos that would effectively be ‘destroying’ them. They eventually settled on the ‘14-day rule‘, where embryos could only be studied for 14 days at maximum in the lab, or until the ‘primitive streak‘ had appeared on the embryo (a division line of cells).
The main reasoning for this and the discussion as a whole is a whole host of moral/ethical arguments as to whether it is ‘inhumane’ to be treating these embryos like mere lab samples and whether stem cell research is effectively the termination of a potential life. Truth be told, I believe these ethical ‘dilemmas’ often get in the way of true scientific breakthrough for the simple reason that people are afraid of what they don’t understand, and things that seem unnatural or are otherwise unexplored frontiers are often viewed as taboo. I have to give Baroness Warnock some credit however, as she claimed the 14-day limit was more to “allay public anxiety” rather than be based on science, indicating the interest in its study was vital, and this was more to keep society ‘happy’. The embryos studied in question are usually excess embryos from fertility clinics that will get destroyed either way if unused, and to not use them for what is potentially life-saving research at the risk of ‘messing with life’ seems silly, and calls into question a very common argument those that are against commonly use: that an embryo is more valuable than a typical culture of cells. If so, would the life of someone with dementia who could greatly benefit from something like hybridoma stem cells be equal to that of an embryo that may very well never develop beyond a certain point? If morals are the standard, what authority decides a human life is any more valuable than any other animal? Obviously, it is an expansive and sensitive discussion that needs exploration well beyond this brief outline, but I only call it into question because it was the very Mr. Thomas himself – my biology teacher – who said “would people really accept the use of cancer and embryonic stem cells as a treatment if it meant ‘people had to die’ for it to work?” He was being metaphorical for the most part and said it mainly to promote thought, but it did make me think. I understand the hesitancy to destroy something as ‘valuable’ as embryos for science, and if this bothers people, what would they think of combining it with cancer, or even then implanting that in someone’s body? I don’t doubt an entirely new discussion and set of guidelines would arise to take control of this approach as well, and as it almost always about control, that is what bothers me. But perhaps I am sometimes too unsentimental and brazen about the issues – I only want to make the world a better place, and in my mind I see the trial and error using these sensitive resources a ‘necessary evil‘ for the betterment of humanity. These ethics are here for a reason after all, and a society without rules will collapse into anarchy, so perhaps this is a large part of my ‘grand’ idea that I have yet to fully explore; maybe research into the method will yield a better way for me to make it a reality, one that makes everyone happy.
ScienceDirect.com, 2014, Chapter 5 – B Cell Development, Activation and Effector Functions, Editor(s): Tak W. Mak, Mary E. Saunders, Bradley D. Jett, Primer to the Immune Response (Second Edition), Academic Cell, Pages 111-142, ISBN 9780123852458, Available at: https://doi.org/10.1016/B978-0-12-385245-8.00005-4
Moraes JZ, Hamaguchi B, Braggion C, Speciale ER, Cesar FBV, Soares GFDS, Osaki JH, Pereira TM, Aguiar RB. Hybridoma technology: is it still useful? Curr Res Immunol. 2021 Mar 22;2:32-40. doi: 10.1016/j.crimmu.2021.03.002. PMID: 35492397; PMCID: PMC9040095.
Le Bras, A. New insights into axolotl brain regeneration. Lab Anim51, 250 (2022). https://doi.org/10.1038/s41684-022-01063-3, Published 23rd September 2022.
Inspector gadget is the first thing that comes to my mind when thinking about this module. I’m exited to learn about the ‘gadgets’ that can be made to help people!
Hi! I am Leah Berry, a second year studying biology. I am really excited to start this module, especially the cochlear implants topic and the more practical, creative elements!
This is some example text.
Below is an image of the internal and external overview of how cochlear implants work.
This is a TED talk on cochlear implants that explores the significance of cochlear implants in improving the lives of those living with deafness.
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