Archive for 2016

Whilst you're reading this, hundreds of clinical studies are taking place to find the latest breakthrough drug in diabetes, heart, immunological or rare diseases that only affect a handful of people but are debilitating. The results of these trials are being published monthly in medical journals, most with positive results; but to what degree can a member of the public trust the results of clinical trials; particularly those sponsored by big pharmaceutical companies?

How much does the public trust clinical trials?

With the amount of work that is being done recently, public trust in clinical trials has been improving although not to the needed extent. In 2013, a public survey conducted by the Health Research Authority (HRA) for the NHS, respondents had less confidence in health research studies undertaken by the pharmaceutical industry.

In this survey, there were 1,295 adults aged 18 years or more from across England in 2013.

Only 27% of participants in the survey said that they had increased confidence in clinical studies when knowing that pharmaceutical companies work closely with the NHS, whereas this factor did not have an impact on the other 61% of respondents.

It’s well understood that pharmaceutical companies must make a big profit to ensure their company keeps on running and continuing to conduct a lot of clinical trials with amazing results that beat their competitors - which is why some members of the public feel that their results must be “too good to be true” and won't trust the results coming from a study conducted by a pharmaceutical company.

However it should be known that there are regulatory authorities such as the FDA (US) and the EMA (EU) who have full access to all data from clinical trials (the good and the bad) and they decide which drug can make it to the drug market depending on the results of the clinical study and the side effects associated with the drug.

Another reason for the lack of trust between the public and pharmaceutical clinical trials is partly due to the fact that there is a lack of understanding of what the results of the clinical trials mean and how they affect the public. This goes back to how science is communicated and who it’s communicated to.

A research paper published in 2011 discusses the need for research to be published to the public without restrictions; stating that the “interests of the patients must override commercial interests”. The paper also discusses several issues that the drug industry has when it comes to data sharing, sharing the data may not solve all problems but it can “demonstrate many of the hidden flaws in the research process”. Other “flaws” discussed in the 2011 paper is the issue of pharmaceutical companies comparing new drugs to placebo instead of comparing them to existing drugs on the market to achieve better results. Selective reporting has also been an issue with many clinical trials, the benefits of a number of drugs have been overrated whilst the harms have been underrated significantly, this has lead to serious and negative consequences in the past for patients and many lives have been lost due to hidden adverse events.

“For example, a class 1 anti-arrhythmic drug likely caused the premature death of about 50,000 Americans each year in the 1980s. An early trial found nine deaths on the drug and only one on placebo, but it was never published.”Gotzsche PC. 2011.

Therefore sharing data is absolutely beneficial so that everyone, including the public, is well informed about what the true harms and benefits of new drugs are leading to fewer harms within healthcare research. Not only that, data sharing also could reduce the amount of cheating in the industry and improve the efficiency of health care research and provide more reliable and meaningful data.

Again, one of the most important factors is communication. Every person/figure/authority has to be able to openly communicate all data, the positive and the negative so that there is transparency and everyone benefits from the data.

After all the issues I’ve discussed, it’s now time to discuss the solutions that have been implemented which aim to increase public trust in clinical studies.

Since 2005/2006 the World Health Organization (WHO) has aimed to create a global network of clinical trial registers and their goal is to “increase transparency and accountability on the part of companies and institutions that do clinical research, and, in turn, boost public trust and confidence in that research.”

Registering a clinical trial is the most important factor for the acceptance of a clinical study being published in a reputable journal. In response to the action that WHO have taken, the International Committee of Medical Journal Editors (ICMJE) agreed to not publish the results of any clinical study unless it has been registered in a public register before the enrolment of the first patient. Now the majority of trials are registered in Clinicaltrials.gov (this is one of main open clinical trials registers).

On 3^rd October 2016, ClinicalTrials.gov currently lists 226,788 studies with locations in all 50 States (USA) and in 191 countries.

Not only does registration allow the distribution of information among clinicians, researchers, and patients, it also acts as a reassurance blanket for clinical trial participants that their participation and their results will become part of the public record for public benefit.

Would a member of public participate in a clinical trial?

Going back to the survey results published by the HRA for the NHS:

33% of respondents would be very happy for their GP to access their patient records to see if they might be suitable to join a health research study
25% would be very happy for a hospital consultant to access their records
and 18% would be very happy for an NHS doctor who does not provide their care but is doing research to access their records
but 77% of all respondents would be confident about taking part in a health research study if they knew that it had been reviewed by a Research Ethics Committee.

So although there is a degree of hesitancy, this doesn’t prevent people from agreeing to participate in clinical studies.

To conclude this three-page blog post; even though previously there has been many issues which have resulted in public distrust in clinical trials, new initiatives and new rules and regulations are being implemented for public interest and well-being and to increase the transparency between pharmaceutical accompanies, institutions and the public.

Would you participate in a clinical trial/study?

Click here to download and read all of the papers I have used to write this essay blog post. :)

You may or may not have realised that there's been a bit of confusion around my blog over the weekend as I tried to move my blog over to wordpress.com (there's a big difference between wordpress.org and wordpress.com - will explain in depth below) but I wasn't completely successful and so I restored my blog back on blogger - my safe home. :)

Reasons why I wanted to move to WordPress:

It's a more professional
It's recommended that more bloggers should use it since it's more flexible and professional for blogging
The majority of science blogs are hosted on WordPress

How I tried to move over (and only partially succeeded)

I used the instructions from this website, and the coding to move to WordPress, I imported my files to my WordPress.com blog and I managed to set a redirect from my blogger blog to my WordPress blog that I had set up. But, this was only partly successful because I couldn't figure out how to set up a redirect for my individual posts - they only redirected to the home page, and this would confuse a lot of readers! Turns out, that they meant wordpress.org! *facepalm* So I ended up returning back to my Blogger blog.

What I learned from the process and you should know too...

You can't access any coding on wordpress.com, or add in any plugins other than the ones that are provided to you, so I couldn't create individual post redirects to my new website on wordpress.com
Blogger has more flexibility and options for free templates (which if you know me, I love changing templates!) - Wordpress does have an extensive variety of templates, but I didn't feel that they suited my blog or niche
To have access to coding you need to download and install WordPress.org (Note: To set up Wordpress.org you need to have purchased a domain name and have a host -like BlueHost or any other host which are recommended by WordPress). Wordpress.org is for those who are more experienced with coding and plugins and working with hosts

*A tip before you start blogging!*
Read around A LOT before you start blogging to choose where you want to host your blog (Blogger, WordPress, Medium, Wix or any of the other tools available online)

Whether it's stress or spending too much time focusing on computer/laptop screens we’re all susceptible to experiencing migraines and some people suffer from them even more than others; and we have heard many recommendations on how to prevent migraines, such as drinking plenty of water, but not the actual reasons why we get migraines. Researchers at Cincinnati Children's Hospital Medical Centre have found that a high percentage of children, teens and young adults with migraines appear to have mild deficiencies in vitamin D, riboflavin and coenzyme Q10. It’s possible that these deficiencies may play a role in the onset of migraines but this is still unclear, based on existing studies. In this study, the researchers’ trial drew from a database that looks at vitamin D, riboflavin and coenzyme Q10, all of which are all associated with migraines to some degree, and this has been reported in many previous research studies, some studies have even conflicted each other. Most of the study patients were put on preventative migraine medications and received vitamin supplements if their levels were low in the patient's bloodstream. Since a minority of the study population received vitamins alone, the researchers were unable to determine vitamin effectiveness in preventing migraines. Also, the researchers found that girls and young women were more likely than boys and young men to have coenzyme Q10 deficiencies at baseline. Boys and young men were more likely to have vitamin D deficiency but it’s unclear whether there were folate deficiencies. Patients with chronic migraines were more likely to have coenzyme Q10 and riboflavin deficiencies than those with episodic migraines. Many studies using vitamins to prevent migraines have been published but they have all had conflicting success, therefore more research, which doesn’t include the use of preventative migraine medications, is needed to determine the power that vitamins have on preventing migraines alone - and until research is no longer conflicting.

References: [1]

Researchers at Northwestern University, USA, have succeeded in finding a drug that can clear psoriasis in the body, almost completely and the great majority of the responses persist at least 60 weeks. The new drug called ixekizumab, tradename Taltz®, is a monoclonal antibody, prescribed to those with moderate to severe psoriasis. Research published in the prestigious journal, New England Journal of Medicine; reports the results of 3 large, long-term clinical trials which saw 80% of patients psoriasis completely or almost completely cleared.

Psoriasis affects 3% of the world population. It is an immune-mediated inflammatory disease and its most significant symptom is itchy, dry and red skin. Accompanying those uncomfortable symptoms, psoriasis is also associated with an increased risk of depression, heart disease, and diabetes.

What are Phase 3 trials? (Understanding the Drug Discovery Process- Compound Interest)

"Usually 1000-3000 people, gauges efficacy, dosage, and safety in a larger population. Also compares efficacy to existing treatments, as well as interactions with other drugs and effects of different dosages."

UNCOVER Phase III trials:

To test the drug's efficacy over time -- and to help clinicians determine whether its benefits outweigh any risks -- the three studies enrolled a total of 3,736 adult patients at more than 100 study sites in 21 countries. All participants had moderate to severe psoriasis, which is defined as covering 10 percent or more of the body. Patients were randomly assigned to receive injections of ixekizumab at various doses or a placebo over a period of more than a year.

What is ixekizumab?

It is a humanized monoclonal antibody which has been developed by the pharmaceutical company Eli Lilly and Co. A monoclonal antibody is an antibody produced by a single clone of cells or cell line and consisting of identical antibody molecules. Antibodies are produced by white blood cells in the body and they are used by the immune system to identify and neutralize pathogens such as bacteria and viruses.

How does it work?

Ixekizumab works by neutralizing a pathway in the immune system known to promote psoriasis. It binds to interleukin-17 receptors in the body to prevent an auto-immune response (the response which causes the skin to redden, itch and dry up). The new drug showed high rates of clinical response, particularly throughout week 12 and week 60. But every drug has side effects, in clinical trials, these are reported as "adverse events". The adverse events which were reported from the three clinical trials were: slightly higher rates of neutropenia (low white blood cell count), yeast infection and inflammatory bowel disease. A longer trial duration, lasting over several years, is needed to compare the benefits of this new drug and its adverse events to determine how safe this drug is for long term use.

Conclusions

So is Ixekizumab a wonder-drug? We can't be 100% sure but the results from the 3 UNCOVER clinical trials are very promising and is what awarded ixekizumab prescription approval by the FDA so doctors in the USA can prescribe ixekizumab to psoriasis patients. However, longer periods of trial research are needed to check the long-term safety effects of ixekizumab over time (years).

References: [1] [2] [3] [4] [5] [6]

Journal Reference:

Kenneth B. Gordon, Andrew Blauvelt, Kim A. Papp, Richard G. Langley, Thomas Luger, Mamitaro Ohtsuki, Kristian Reich, David Amato, Susan G. Ball, Daniel K. Braun, Gregory S. Cameron, Janelle Erickson, Robert J. Konrad, Talia M. Muram, Brian J. Nickoloff, Olawale O. Osuntokun, Roberta J. Secrest, Fangyi Zhao, Lotus Mallbris, Craig L. Leonardi.Phase 3 Trials of Ixekizumab in Moderate-to-Severe Plaque Psoriasis. New England Journal of Medicine, 2016; DOI:10.1056/NEJMoa1512711

New experiments conducted as a simulation of the human oesophagus and stomach, have shown that a tiny origami robot that can unfold itself from a swallowed capsule and, steered by external magnetic fields, crawl across the stomach wall to remove a swallowed button battery or patch a wound. Could we already be seeing the future in the technology of surgeries? This isn’t the first time that this type of technology has been introduced to the world. A predecessor was introduced last year at the International Conference on Robotics and Automation. Even though this years new robot is a successor to one reported at the same conference last year, the design of its body is significantly different. Like its predecessor, it can propel itself using what's called a "stick-slip" motion, in which its appendages stick to a surface through friction when it executes a move, but slip free again when its body flexes to change its weight distribution. Also like its predecessor -- and like several other origami robots from the Rus group -- the new robot consists of two layers of structural material sandwiching a material that shrinks when heated. A pattern of slits in the outer layers determines how the robot will fold when the middle layer contracts. It’s also possible to compress this robot into the size of a swallowable pill, and once in the stomach, the robot can fully unfold. The robot moves in the stomach in two ways: 1) A “stick-slip” motion (80% of the time) and 2) forward motion by propelling water/ stomach acid (20% of the time). This robot was essentially designed to extract swallowed button batteries. Every year, 3,500 swallowed button batteries are reported in the U.S. alone. Button batteries are digested normally, but if they come into prolonged contact with the tissue of the oesophagus or stomach, they can cause an electric current that produces hydroxide, which burns the tissue. This is a better way to extract unwanted objects which may have been swallowed in the body. Hopefully future research will be able to make robots that can carry out more complex operations in the stomach and oesophagus.

References: [1]

Paracetamol is the most common painkiller which we all rely on to treat our aches and pains, but it turns out that you might also be decreasing your empathy for both the physical and social pains that other people experience, a new study conducted at Ohio State University suggests.

It turns out that paracetamol may not only be a painkiller but also an emotion-killer. Researchers found that, for example, when participants in the study took paracetamol and were informed of the misfortunes of others they thought these individuals experienced less pain and suffering,when compared to those who took no painkiller.

"These findings suggest other people's pain doesn't seem as big of a deal to you when you've taken acetaminophen," said Dominik Mischkowski, co-author of the study and a former Ph.D. student at Ohio State, now at the National Institutes of Health.

"Acetaminophen can reduce empathy as well as serve as a painkiller."

This research was conducted at Ohio State University, USA and results were published online in the journal Social Cognitive and Affective Neuroscience.

"We don't know why acetaminophen is having these effects, but it is concerning," said Baldwin Way, the senior author of the study.

How the research was conducted...

The researchers conducted two experiments, the first involving 80 college students. In the start of the experiment, half of the students drank a liquid containing 1,000 mg of paracetamol while the other half drank a placebo solution that contained no drug- the students did not know which solution they were drinking. After waiting for one hour for the drug to take effect, the participants read eight short scenarios in which someone suffered some sort of pain. For example, one scenario was about a person who suffered a knife cut that went down to the bone and another was about a person experiencing the death of his father. Participants rated the pain each person in the scenarios experienced from 1 (no pain at all) to 5 (worst possible pain). They also rated how much the protagonists in the scenarios felt hurt, wounded and pained.

The participants which took 1000mg of paracetamol rated the pain of the people in the scenarios to be less severe than did those who took the placebo solution.

The second experiment...

Conducted with 114 college students. As in the first experiment, half took acetaminophen and half took the placebo. In one part of the experiment, the participants received four two-second blasts of white noise that ranged from 75 to 105 decibels. They then rated the noise blasts on a scale of 1 (not unpleasant at all) to 10 (extremely unpleasant). They were then asked to imagine how much pain the same noise blasts would cause in another anonymous study participant.

The participants in this experiment rated the noise blasts to be less distressing for themselves and they also rated the level of distress lower for others being subjected to the same noise blasts. Not only did paracetamol reduce the pain for themselves, but also reduced their empathy for others experiencing the same pain.

Previous research... putting the pieces of the puzzle together

In 2004, a study was conducted which scanned the brains of people as they were experiencing pain and while they were imagining other people feeling the same pain. Those results showed that the same part of the brain was activated in both cases. Since the part of the brain that experiences pain is the same as the part of the brain that experiences empathy, this could explain why paracetamol blocks physical and emotional pain together.

The researchers are now going to study ibuprofen to see, if, like paracetamol, it has a similar effect on physical and emotional pain.

References:

[1] [2]

We can buy common painkillers over-the-counter at a pharmacy or even be prescribed them in copious amounts for the treatment of difficult conditions such as colds, flu, pain, inflammation, and fever. However, all drugs come with side effects, such as increased blood pressure or an increased risk of ulcers. A new study has gathered all the information on each side effect of each common painkiller and its effect on patients with different health conditions (such as diabetes or heart-related diseases).

What you need to know about NSAIDs:

NSAIDs is an abbreviation for Nonsteroidal Anti-Inflammatory Drugs and is used to treat a wide range of diseases, in particular, disorders in the muscular and bone system, where the drug counteracts swelling, pain and limitations in movement associated with inflammation.
NSAIDs are not antibiotics and therefore do not help to fight infections caused by bacteria.
NSAIDs are in Denmark sold both in low doses (Ibuprofen 200 mg/tablet) without a prescription and in higher doses and other types with a prescription.

"It's been well-known for a number of years that newer types of NSAIDs -- what are known as COX-2 inhibitors, increase the risk of heart attacks. For this reason, a number of these newer types of NSAIDs have been taken off the market again. We can now see that some of the older NSAID types, particularly Diclofenac, are also associated with an increased risk of heart attack and apparently to the same extent as several of the types that were taken off the market," says Morten Schmidt, MD and PhD from Aarhus University, who is in charge of the research project. He adds:

"This is worrying because these older types of medicine are frequently used throughout the western world and in many countries available without prescription."

Every year, more than 15 percent of western populations are prescribed painkillers (NSAIDs) and this figure increases with patient age.

The study, which was carried out in collaboration between 14 European universities and hospitals, including a number of leading European heart specialists, was published in the European Heart Journal.

New Guidelines:

This study was conducted with the intention to find out the use of NSAIDs in patients with heart disease. Results from the survey that they gathered has now been used to compile a list of recommendations about what doctors should consider before prescribing painkillers to their patients.

"When doctors issue prescriptions for NSAIDs, they must in each individual case carry out a thorough assessment of the risk of heart complications and bleeding. NSAIDs should only be sold over the counter when it comes with an adequate warning about the associated cardiovascular risks. In general, NSAIDs are not be used in patients who have or are at high-risk of cardiovascular diseases," says another of the authors, Professor in cardiology Christian Torp-Pedersen, Aalborg University, Denmark.

We need to reduce the amount of painkillers being taken:

After seeing the results of this study, the researchers in Denmark have recommended that it would be better for patient safety that the amounts of painkillers prescribed and/or taken should be reduced, not just in Denmark but for all countries who consume more of these drugs. The Danish researchers have already been successful in reducing the consumption of Diclofenac in Denmark. Hopefully, this research will open the door for more research on NSAIDs and their effect on patients with other health conditions so that there will be more efficient guidelines on the prescription of painkillers.

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References:

Image: [1] Quotes: [1] Story: [1]

HIV is a virus that attacks the immune system and weakens your ability to fight incoming infections and diseases. The Human Immunodeficiency Virus currently has no cure but there are currently treatments which are able to help people with the virus to live a prolonged, healthy life. Since there is no cure for HIV, the best way to approach preventing the spread of the virus is by vaccination; enabling the body to fight off the virus before it attacks the immune system.

Researchers in the USA have been working on developing a vaccine capable of inducing "broadly neutralizing" antibodies that can prevent HIV infections. This new vaccine technique aims to immunize people with a series of different engineered HIV proteins as immunogens to "teach" the immune system to produce broadly neutralizing antibodies against HIV. This in turn, will prepare the immune system to fight off an incoming virus which carries similar proteins to the HIV proteins.

The group of researchers have found that the right precursor ("germline") cells for one kind of HIV broadly neutralizing antibody which is present in most people, and have described the design of an HIV vaccine germline-targeting immunogen capable of binding those B cells.

"We found that almost everybody has these broadly neutralizing antibody precursors, and that a precisely engineered protein can bind to these cells that have potential to develop into HIV broadly neutralizing antibody-producing cells, even in the presence of competition from other immune cells," said the study's lead author, William Schief, TSRI professor and director, Vaccine Design of the IAVI Neutralizing Antibody Center at TSRI, in whose lab the engineered HIV vaccine protein was developed.

The human immune system consists of a large variety of variating precursor B cells so that it is able to respond to a large variety of pathogens (viruses and bacteria). However, this also means that the precursor B cells able to recognize a specific feature on a virus surface are exceedingly rare within the total pool of B cells.

Our immune system is able to track and hunt down pathogens which carry markers (the proteins on the surface of the virus) for the HIV virus. This advance in research has lead to a phase 1 trial being initiated to clinical trial to test a nanoparticle version of the engineered HIV vaccine protein, the "eOD-GT8 60mer."

"The goal of the clinical study will be to test the safety and the ability of this engineered protein to elicit the desired immune response in humans that would look like the start of broadly neutralizing antibody development," Schief said. "Data from this new study was also important for designing the clinical trial, including the size and the methods of analysis."

In June 2015, researchers from TSRI, IAVI and The Rockefeller University reported that the eOD-GT8 60mer produced antibody responses in mice that showed some of the traits necessary to recognize and inhibit HIV. If the eOD-GT8 60mer performs similarly in humans, additional boost immunogens are thought to be needed to ultimately induce broadly neutralizing antibodies that can block HIV.

This new research has provided a new technique for researchers to determine if other new vaccine proteins can bind their intended precursor B cells. This technique is essential in manufacturing targeted and effective vaccines against HIV and AIDs.

This research was published in the March 25, 2016 issue of Science, published by AAAS. The paper, by J.G. Jardine at Scripps Research Institute in La Jolla, CA, and colleagues was titled, "HIV-1 broadly neutralizing antibody precursor B cells revealed by germline-targeting immunogen."

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References:

The Scripps Research Institute. "New findings in humans provide encouraging foundation for upcoming AIDS vaccine clinical trial." ScienceDaily. ScienceDaily, 24 March 2016.

https://www.sciencedaily.com/releases/2016/03/160324150047.htm

For any medical reason, sometimes artificial organs are required to take place instead of the real organ in the human body. But making artificial organs, which have complicated and intricate structures, aren't easy to make and there have been many methods which have been devised but don't work as efficiently. Leon Bellan is an assistant professor of mechanical engineering at Vanderbilt University, who has been working with candy floss machines, getting them to spin out networks of tiny threads similar in size, density and complexity to the patterns formed by capillaries - the minuscule, thin-walled vessels that deliver oxygen and nutrients to cells and carry away waste. His main aim has been to make fibre networks that can be used as templates to produce the capillary systems required to create full-scale artificial organs. This research has been published in the Advanced Healthcare Materials journal.

Bellan and his colleagues have been successful in using their new and really unusual technique to produce a 3D artificial capillary system that can keep living cells viable and functional for more than a week, which is a dramatic improvement over current methods. "Some people in the field think this approach is a little crazy," said Bellan, "But now we've shown we can use this simple technique to make microfluidic networks that mimic the three-dimensional capillary system in the human body in a cell-friendly fashion. Generally, it's not that difficult to make two-dimensional networks, but adding the third dimension is much harder; with this approach, we can make our system as three-dimensional as we like."

Researchers, like Bellan and his team, research a class of materials called hydrogels- water based gels- which should act as a scaffold to support cells within 3D artificial organs. Hydrogels are the top choice for material because their properties can be manipulated to closely mimic those of the natural extracellular matrix that surrounds cells in the body.

Contradictory to solid polymer scaffolds, hydrogels support diffusion of necessary soluble compounds; however, oxygen, nutrients and wastes can only diffuse a limited distance through the gel. Consequently, cells must be very close (within the width of human hair) to a source of nutrients and oxygen and a sink for the wastes they produce, or else they can starve or suffocate.

Therefore, to produce tissues that have the thickness of real organs and keep cells alive throughout the entire scaffold, the researchers had to create a network of channels that allow fluids to flow through the system, mimicking the natural capillary system.

To overcome the issues of previous artificial organ-producing techniques, Bellan used a top-down approach. In his report, Bellan says that his cotton-candy spinning method is successful in producing channels ranging from three to 55 microns, with a mean diameter of 35 microns. "The analogies everyone uses to describe electrospun fibers are that they look like silly string, or Cheese Whiz, or cotton candy," said Bellan. "So I decided to give the cotton candy machine a try. I went to Target and bought a cotton candy machine for about $40. It turned out that it formed threads that were about one-tenth the diameter of a human hair -- roughly the same size as capillaries -- so they could be used to make channel structures in other materials." But, getting from that point to creating artificial capillaries that work was not a simple matter. If you create a network of fibres using sugar, when you pour a hydrogel on it, the sugar dissolves away because the hydrogel is mostly water.

This demonstrates what Bellan describes as the "Catch-22" in creating such sacrificial structures. "First, the material has to be insoluble in water when you make the mold so it doesn't dissolve when you pour the gel. Then it must dissolve in water to create the microchannels because cells will only grow in aqueous environments," he explained. The researchers experimented with a range of different materials before they found one that worked. The essential material used is PNIPAM, Poly(N-isopropyl acrylamide), a polymer with the unusual property of being insoluble at temperatures above 32 degrees Celsius and soluble below that temperature. This material has also been used previously in various medical applications and has proven to be “cell-friendly”.

Initially, the researchers spun out a network of PNIPAM threads using a machine closely resembling a candy floss machine. Secondly, they prepared a solution of gelatine in water (a liquid at 37 degrees) and add human cells. Thirdly, they added an enzyme commonly used in the food industry (transglutaminase, a.k.a "meat glue") which caused the gelatine to irreversibly gel. This warm mixture was then poured over the PNIPAM structure and allowed to gel in an incubator at 37 degrees. Finally, the gel containing cells and fibres was removed from the incubator and allowed to cool to room temperature, at which point the embedded fibres dissolve, leaving behind an intricate network of microscale channels. Lastly, the researchers attached pumps to the network and then perfused them with cell culture media containing necessary chemicals and oxygen.

Since this technique has been proven through research by Bellan and his team, they will be perfect it to match the characteristics of the small vessel networks in different types of tissues, and exploring a variety of cell types in the near future.

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References:

1. Jung Bok Lee, Xintong Wang, Shannon Faley, Bradly Baer, Daniel A. Balikov, Hak-Joon Sung, Leon M. Bellan. Development of 3D Microvascular Networks Within Gelatin Hydrogels Using Thermoresponsive Sacrificial Microfibers. Advanced Healthcare Materials, 2016; DOI: 10.1002/adhm.201500792

2. Vanderbilt University. "Cotton candy machines may hold key for making artificial organs." ScienceDaily. www.sciencedaily.com/releases/2016/02/160208140723.htm (accessed February 12, 2016).
3. Image By Joseolgon (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

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