I am Dr. Ennio Tasciotti, co-chair of The Department of Nanomedicine at the Houston Methodist Research Institute. AMA!

In relation to your 2010 paper "Engineering a Better Way to Heal Broken Bones", led by Matthew Murphy: What importance do you assign the physical environment in promoting MSC differentiation towards an osteogenic lineage, specifically on the nano and micro-scale level? That is, in relation to the chemical environment, how important is the physical or mechanical environment that the cell interacts with, ie. stiffness, smoothness, nano/micro-structure?

Also, is the fracture putty used clinically yet, and if not do you see that as a possibility? If scaffolds preloaded with cells perform significantly better, what sources would these cells be taken from?

This answer will be a little technical because of the question.

The physical environment is emerging as the new component able to induce stem cell differentiation and lineage commitment.

The cell can sense the mechanical properties of its surroundings and adjust accordingly through the activation of molecular pathways that transduce the mechanical signal into a chemical signal within the cytosol.

This ultimately triggers the activation of genes that direct cell specification toward the osteoclast lineage.

The fracture putty is not clinically available yet, as we are in the process of collecting all the information necessary to open an IND case with FDA. That may take 2 years.

Hello all. My name is David Bricker. I'm a science writer at Houston Methodist Hospital, and Dr. Ennio Tasciotti is sitting next to me. Ennio will start answering questions in a few minutes.

If you're the David Bricker I think you are, then might I say Go Blue! (Sorry, I creep super hard.)

(This is David) No worries! Did we go to grad school together? And Go Blue! /fist bump or whatever

What do you consider your biggest accomplishment so far?

The research I'm the most proud of is the Fracture Putty program that I run for the Defense Advanced Research Project Agency (DARPA) for the past 5 years.

This program has the objective of rebuliding the shattered bones of US Soldiers that would have never healed and led to the amputation of the limb.

I coordinated a team of more than 50 scientists from the best universities in the states and that resulted in preclinical success, as the materials developed by the team (BioNanoScaffolds) have shown incredible results in the preclinical setting.

What advice would you give an aspiring doctor that wants to be on the cutting edge of health research?

Come work for me! :) Jokes aside, I think it would be a great choice -- one that will be made by more and more doctors in the future -- to find a residency program in a hospital, like the one at Methodist, that has a joined clinician/scientist track, so that you can divide your time between the bedside and the bench.

There's an incredible need for the input of doctors in translational research. Without their help, a lot of our discoveries and technologies will remain in the laboratories and never reach the patients.

What's the most exciting research you are doing at the moment?

I'm working on the development of biomimetic materials that can imitate the chemical, biological and structural composition and structure of tissues in the body.

Such materials would allow us to bettter interact with the cells of the body in our quest to conquer several ongoing issues in medicine, from drug delivery to cancer to the regeneration of failing organs.

What is the most astounding fact you have learned through your years of expertise?

That most of the inventions and technologies today are based on observations and discoveries that were anticipated, postulated, or described in the past, often in very different fields of research.

In particular we're witnessing how natural and biological sciences are serving more and more the purpose of solving engineering problems by providing the amazing solutions that life has shown us through the course of evolution.

Cross-talking and interactions between different areas of science will be the way we'll solve problems in this century.

what are some of the most promising areas of research in cancer therapy or regenerative medicine in the near future?

I believe the future will bring incredible discoveries in both fields, mainly due to the better understanding of the way cells communicate with each other.

So far we've been learning that cells communicate through the secretion of single soluble messengers (molecules, metabolites, cytokines, growth factors, hormones, etc), but it's emerging that cells might have more complex ways of communicating with each other through packets of information transferred through exosomes, vesicles pinched off from the cell that contain chemical information.

I hope the understanding of these new forms of information transfer will open new avenues in research on cancer and the regeneration of tissues and organs.

What leaps and bounds do you think science will make in the next 15 years? Longer life spans? curing terminal diseases? less invasive surgeries?

All of the above, but with particular focus on robot-assisted surgeries and on adding quality to our lives. Keep in mind that one of the biggest challenges is not only to keep a healthy body but also to keep a functioning mind.

(This is David) Sadly, we are out of time. We are floored and grateful for the number of questions Dr. Tasciotti received, and are sad we didn't have time to answer every single one of them. Dr. Tasciotti may be able to come back later and answer a few, but now he must run to his next appointment. Thanks so much. We will be doing occasional AMAs with Methodist's best scientists in the future, and will always crosspost to r/science and/or r/medicine. Cheers and ciao!

Hello, I am an undergraduate student in Biochemistry (Senior) with my sights set on obtaining a PhD. Do you have any advice in choosing graduate schools, or for potential graduate students in general?

My advice for you is to pick a school that has integrated programs offering multidisciplinary research approaches.

The most interesting (and toughest) problems in the medical arena will be conquered only through teams of scientists with diverse backgrounds, so I encourage you to look into a school that has both basic and translational research but also an established practice in clinical research.

Also look at the departments at these schools and see if any of the faculty members are doing work similar or identical to what you want to do, and don't be shy about contacting them with questions. If they're excited enough about you, they may even be able to help you get into their graduate programs.

I read a fascinating article (many years ago now) about nanocryosurgery - using some kind of nanomolecular compound which would target cancer cells and freeze them solid, forming an iceball in a specific way that only targets the cancerous cells.

Do you have much experience with the field of nanocryosurgery?

That field did not really ever take off, but we do a lot of research in the area of hyperthermal therapy of cancer. One thing we are doing is concentrating gold nanorods and nanospheres at the site of the cancer. The nanoparticles are then activated by a harmless external force field (either magnetic waves or near-infrared light). This activation puts the nanoaprticles in motion. Their vibration generates heat that literally cooks the tumor. These nanoparticles have already been used in special experimental protocols in the treatment of glioblastomas in Germany for patients with incurable and inoperable brain tumors.

What do you think will happen with iPS cell lines now that Oregon had the success of nuclear transplant in embryos to develop embryonic stem cells? Is there even a need for them now? Link to abstract: http://www.cell.com/abstract/S0092-8674(13)00571-0 Human embryonic stem cells derived by somatic cell nuclear transfer Thanks for the AMA!!!

I have not read the paper, so I have not developed an opinion about the changes that this discovery will bring to the field.

I have already downloaded it and will read it carefully. Thanks for the heads up!

I was surprised to learn that corporations can contribute small portions to research at universities, and receive 100% of the patents yielded from that research. How is your research funded, and who gets the patents.

My research is mainly paid by grants from the NIH (cancer therapy) and the U.S. Department of Defense (tissue engineering), but I've also received a generous donation from a philanthropic fund to improve the regenerative medicine of the spinal cord. In all these cases the patents derived from my research belong to my insititution (Houston Methodist Research Institute), but we the inventors share 50% of the benefits in royalties and revenues, which is much better than what exists at the average American university. Another important aspect of our agreement is that scientists remain in control of how our technologies are used.

Hello Dr. Tasciotti,

Thank you so much for doing this AMA. I actually did tissue engineering/regenerative medicine for undergraduate research (Cartilage).

How long do you believe it will take to see tissue engineering/regenerative medicine relevant in an actual clinical setting, to the point where these tissue will actually implanted into a human body?

One of the reasons why I strayed away from doing tissue engineering for my upcoming masters is that I wanted to pursue a more industry related goal, and compared to that of pharmaceutical and orthopaedic implants tissue engineering/regenerative medicine seemed like it wouldn't be relevant in medical industry in a couple decades.

I think that in 10 years we will see standardized some of the regenerative medicine procedures now being tested in phase 1 and 2 clinical trials, especially for non-vital organs.

Approaches for the repair and regeneration of bone and cartilage are actually already approved and are based on materials able to trigger repair mechanism and increase healing time.

Dr. Ennio where are you from?

Roma/Rome, Italy. I studied in Pisa.

Do you believe the answer to curing cancer lies within nanotechnology?

I believe nanotechnology will be one of the areas of science that helps, but curing cancer will require the help of scientists form other disciplines (biology, chemistry and medicine, even physics) to accomplish this daunting task effectively.

Do you believe that we will ever be able to regenerate lost/damaged organs or limbs? If so, would it be done organically in the body, or externally in a lab?

I think we're closer than we might have ever dreamt a few years ago. The progress in supporting technologies and the broadening of our knowledge about how cells, tissues and organs are organized and interfaced between them should make that science fiction dream a reality within the next 20 years, we hope. If I had to bet, most of the work will be done by the body, the best bioreactor ever.

More promising stem cells: Adult or embryonic(edit)?

No need to touch embrionic stem cells -- we can do more than enough with the adults'.

have you done anything exciting with viral vectors? Ive read some awesome stuff about actually curing leukemia patients.

I got a Ph.D. in molecular medicine and the subject of my dissertation was on the use of AAV vectors for gene therapy.

I was deeply involved in viral vector research, but setbacks in the early 2000s due to the tragic deaths of the first patients enrolled in clinical trials slowed the field down. I moved on to something that could be translated to the clinic faster.

There's much hope in new generation viral vectors, though, both in terms of safety and efficacy. I believe the field will soon come back as one of the most prominent.

Do you believe that the first person to live 200 years is alive today?

I don't think we're close to extending human lifespans 3 times and get to a staggering 200 years of age, but I certainly think we will be able to improve quality of life in our later years.

I had a two-level acdf with allograft and titanium instrumentation in May 2013.

It's an imperfect solution which could cause new problems in future.

Considering the radical shifts in medical research these last two decades, will patients like me benefit from our new medical and health-research paradigm in the coming decades? How can we insure existing patients with "inelegant" surgical results are considered and included in research trials?

Thank you.

At some point, the new materials that we and many others are developing will replace metal implants all together.

These newer materials will be formulated so that they will be resorbed by the body during the process of tissue regeneration, ideally leaving the patients with no residual implant -- just the natural tissues.

How well are current nanoparticles being tested for health risks? I see socks with embedded nanoparticles and other casual uses. Are these adequately tested for possible health side effects?

The FDA has very tight controls over the use of nanotechnology in the biomedical arena. The caution with which nanomaterials, nanodrugs and nanodevices are treated is justified by the lack of data supporting the safety of their long term use.

The other important issue to consider is the route of administration of these materials or the type of exposure that we face.

Injecting a formulation of carbon nanotubes intravenously certainly poses more concerns than wearing fabric with embedded nanomaterials.

Last, nanoparticles can be produced by living beings and we've been naturally exposed to some of them with no apparent consequences.

My question is more of a general question about nanotechnology and it's implementation into medicine. The direction I see medicine ultimately going is through nanotechnology, machines capable of curing any disease and constantly repairing your body so you age slower. This could be just my fantasy but do you see nanotechnology heading in that direction? What is the most ground breaking nano tech in medicine currently being used?

Even if this had been the goal of nanomedicine from the beginning, we'd still be far away form the implementation of those ideas. We actually might never get there because we may find we don't need nanobots to repair our bodies -- just nanomaterials that trigger the inherent repair mechanisms that already exist in our bodies.

My father has progressing Parkinson's. I've heard some scuttlebutt that stem cell research may lead to some advances in Parkinson's treatment. Got any interesting information to offer me?

Regeneration of neuronal tissues, whether they are peripheral nerves or the brain, is still far away from being a clinical reality. That is actually one of the next big challenges of regenerative medicine, and possibly one of the most relevant, as a healthy, long-lasting body with no brain power would be completely useless…