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Monday, May 27, 2024

Power list interview: Medical research superstar Dr. Anthony Atala speaks with Nido Qubein

Dr. Anthony Atala joined High Point University President Nido Qubein in the Power List interview, a partnership
for discussions with some of the state’s most influential leaders. Interview videos are available at www.businessnc.com.

 


Anthony Atala is a superstar in North Carolina’s medical research community. The physician is director of the Wake Forest Institute for Regenerative Medicine. He’s edited 25 books, published 800 journal articles and received more than 250 patents. Scientific American named him one of the most influential people in global biotech. Time has cited his work twice among the Top 10 medical breakthroughs of the year.

Atala was born in Peru and grew up near Miami. He earned a medical degree at the University of Louisville and worked at Boston Children’s Hospital before moving to Wake Forest Baptist Medical Center in 2004. 

This story includes excerpts from Atala’s interview and was lightly edited for clarity.

How do you define regenerative medicine?

Regenerative medicine is really a field that takes in a lot of different aspects of science to basically help to regenerate your tissues and organs — to make them better — to make them healthier.  And that’s really, in a nutshell, the field.

Does regenerate mean recreate?

You’re really recreating what’s already there because your cells already have all the genetic information. Each cell in your body has the playbook of what it’s supposed to do. So, it’s really making sure you put them back in the same environment to let them do what they need to do.

We really need to take in that we’re not discovering anything. We’re rediscovering the wonders of what created us. God created this universe, and we’re just rediscovering the wonders that are there. It’s amazing to see how much information goes to make just one cell. And how do we make sure we can replicate what nature already does so we can make it better for generations to come?

So if my liver is in bad shape, there’s hope?

That is the goal of regenerative medicine. One thing to remember is nature made us with a 10-times reserve for pretty much all our organs. If you get chest pain, they rush you to the hospital, and find out that the blood vessel to your heart is over 90% obstructed. You did not get pain when that blood vessel was 80% obstructed. You only had the pain when it was over 90%. Same with your lungs. The question is, when that reserve starts giving out, how can we make sure that we refill the tank?

I would like my body to tell me at 20%.

That’s the key to the future of medicine. It’s about preventive medicine. You want to detect that problem when you’re at 50% or less to prevent it.

What does genetics play in predicting your health?

Features in your genes predetermine certain factors. If you’re born with a gene, for example, for cystic fibrosis, you’re going to be born with cystic fibrosis. Or you are born with a defective gene that prevents you from making a protein, that is going to be problematic for you to live long. But you are not dealing with single gene defects. You’re dealing with just abnormalities in your body that you need to overcome, and you can help to overcome them by living a healthier life.

How do you recreate a kidney or liver?  

We take a small sample of tissue of the organ that we want to regenerate. So, it’s your own cells. We take a sample of tissue, less than half the size of a postage stamp. We can then expand those cells outside the body into large quantities, and we can then use those cells to recreate the tissue ­— either by hand, or we can print them, or we can inject them. And, because we are using your own cells to create that tissue or organ, it will not reject. Your body will recognize it as its own. You are creating new structures for your body.

How many employees do you have?

At the Wake Forest Institute for Regenerative Medicine we have about 470 people. We have MDs, Ph.Ds, MD-Ph.Ds, masters students, scientists of all types. When you are creating a tissue or an organ, it’s not just cell biology. It’s cell biology, molecular biology, genetics, material sciences, engineering, nano-technology. It takes a village to get these tissues and organs into patients.

Does a 50-year-old have greater success with regenerative medicine than someone 85?   

Your cells keep producing no matter your age. There are so many factors. It’s the blood vessels that feed your cells, the nerves that feed your cells. So there are a lot of factors, but whether you’re 8 or 80, you’re still reproducing cells, but the backing for the tissue may be different. Your body does go through changes over age. But, your cells remain genetically the same, from the time you are born to the time you die.

Do you have faith in how the FDA operates?  

The FDA is there to protect the consumer, and they’re doing a good job. Look at the technologies out there and we see few problems compared to the past. The FDA has tried to modernize itself and tried to reinvent itself, so I think they’re on a good path. These technologies are available through clinical trials, but the average time for a drug to get approved and to the first patient is about 18 years.

What excites you about work?

We work on about 40 different technologies, and they’re affecting different types of diseases. And, you may say, ‘Well, this is more important than the other one.’ In reality, they’re not. If you’re the patient, that challenge is the most important thing for you. The importance of those technologies is equal.

How many other groups are working similarly?

There’s probably not a single university in the world that does research that is not involved in an area related to regenerative medicine, whether they are working with cell biology or material sciences or just delivery of therapies. And that’s good because it means that technologies are working and people are getting behind it. Knowledge is additive and it’s compounded. This January, we are at 501 active collaborations, of which about 440 are national and 60 are international.

Can you explain this in layman’s language?

I’ll make it simple. You’re taking cells from a patient. You’re expanding them, you’re creating a three-dimensional mold in the shape of the organ, and you’re coating the cells like you’re baking a layer cake. And then you put it in this oven-like device that has the same conditions as the human body, then you can take it out  and plant it back into the patient. I have to emphasize — that’s highly over simplified ­— but that’s really how it gets done.

What would say to a business audience?

Everybody wants to live longer, and that’s because we have so much more at our disposal now. The average life expectancy in 1900 was about 40. Today, it’s over 80. We’ve doubled our life expectancy in a century. The key is living longer, but with quality of life.

In some countries, life expectancy is still in the 40s?  

Absolutely. The quality of the water, the environment and nutrition. Think about the nutritional supplies we have today that we didn’t have before. Before, if you wanted something sweet, it was processed sugar. Now you have all these substitutes.

What you consume is one of the most important things in terms of longevity. And exercise. Eating well, exercising well and avoiding toxic agents is the way to assure the best outcome for you in the long term. 

Is moderate use of alcohol a toxic agent?

Studies have shown that a small consumption of alcohol daily is good for you. That’s about 4 to 8 ounces of wine. One glass of wine a day is a perfect thing for the body because it really has a lot of additive effects, even for your blood vessel disease, for Alzheimer’s, for many other conditions. The evidence is overwhelming.

Does living longer put pressure on health care?  

Absolutely.  Over a 10-year period, the number of patients on the transplant list went up tenfold, while the actual number of transplants went up less than 10%. And that has to do with us living longer. The longer we live, the more our organs tend to fail.

Does our more stressful world affect health?

Remember when we were in school and not learning about RNA synthesis until college?  Now, our children learn that in first grade. Information has grown enormously. There’s more pressure out there. Everything is more competitive. We live in a more stressful world. If COVID taught us anything, it taught us to take a break.

We live in a stressful world, yet we live longer. Is that because of medication?

I don’t think that that’s the relation. The relation has to do with better nutrition and better healthcare. Just a few decades ago, people didn’t realize the nutritional requirements that they needed. That’s still a challenge in parts of the world.  

What is your view of biotech in North Carolina?  

We are No. 3 in the biotech sector after California and Massachusetts. Biotechnology is a great commercial venue for the state because you have high-paying jobs, you’re attracting smart people, and the payback in terms of every dollar you spend in biotechnology, you’re spending at least equal amounts in other services. We’ve established this ecosystem of business entities that are in our backyard. So, biotechnology is a major driver for our economy, and attracting companies in this sector is also a positive.

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