Can we repair injured nerves? | Massimo Hilliard | TEDxUQ

when I was a teenager I know it looks a

when I was a teenager I know it looks a long time ago now I then need you you’re

long time ago now I then need you you’re

long time ago now I then need you you’re my uncle

my uncle

my uncle while practicing judo and I broke my

while practicing judo and I broke my

while practicing judo and I broke my ankle I used to be hospitalized I have a

ankle I used to be hospitalized I have a

ankle I used to be hospitalized I have a small surgery with a long cast for two

small surgery with a long cast for two

small surgery with a long cast for two and a half months and then after

and a half months and then after

and a half months and then after physical therapy in about 4-5 months I

physical therapy in about 4-5 months I

physical therapy in about 4-5 months I was able to run and jump again like

was able to run and jump again like

was able to run and jump again like nothing had happened

nothing had happened

nothing had happened so despite the frustration the physical

so despite the frustration the physical

so despite the frustration the physical limitation and my mom’s desperation for

limitation and my mom’s desperation for

limitation and my mom’s desperation for that injury I knew that this was a

that injury I knew that this was a

that injury I knew that this was a temporary event and I with time I

temporary event and I with time I

temporary event and I with time I wouldn’t got a better unfortunately

wouldn’t got a better unfortunately

wouldn’t got a better unfortunately there are other kind of injuries like

there are other kind of injuries like

there are other kind of injuries like the ones that affect our nervous system

the ones that affect our nervous system

the ones that affect our nervous system there are not temporary I leave patients

there are not temporary I leave patients

there are not temporary I leave patients with the permanent and often severe

with the permanent and often severe

with the permanent and often severe disabilities so our nervous system is

disabilities so our nervous system is

disabilities so our nervous system is not very good the repair itself and

not very good the repair itself and

not very good the repair itself and despite this progress in medicine we

despite this progress in medicine we

despite this progress in medicine we still cannot have effective treatment to

still cannot have effective treatment to

still cannot have effective treatment to repair the nervous system when it’s

repair the nervous system when it’s

repair the nervous system when it’s damaged one of the reason for this is

damaged one of the reason for this is

damaged one of the reason for this is that we do not have a full understanding

that we do not have a full understanding

that we do not have a full understanding of the biology of nerve regeneration and

of the biology of nerve regeneration and

of the biology of nerve regeneration and degeneration so I would like to share

degeneration so I would like to share

degeneration so I would like to share with you today two entwines

with you today two entwines

with you today two entwines ideas one innovative approach that we

ideas one innovative approach that we

ideas one innovative approach that we might have that memorized flow in the

might have that memorized flow in the

might have that memorized flow in the future to treat nerve injuries and the

future to treat nerve injuries and the

future to treat nerve injuries and the other the enormous potential that arise

other the enormous potential that arise

other the enormous potential that arise when we look at nature in the most basic

when we look at nature in the most basic

when we look at nature in the most basic forms and how they have solved the

forms and how they have solved the

forms and how they have solved the biological problem that can inform us

biological problem that can inform us

biological problem that can inform us our new medical approaches so let me

our new medical approaches so let me

our new medical approaches so let me start with the metaphor imagine you

start with the metaphor imagine you

start with the metaphor imagine you build this beautiful electric circuit

build this beautiful electric circuit

build this beautiful electric circuit with very long cables that carry

with very long cables that carry

with very long cables that carry electricity to very distant villages and

electricity to very distant villages and

electricity to very distant villages and now imagine there is a storm and one of

now imagine there is a storm and one of

now imagine there is a storm and one of the cable gets severed and the villages

the cable gets severed and the villages

the cable gets severed and the villages without electricity

without electricity

without electricity you have two options one

you have two options one

you have two options one get a brand-new cable from the circuit

get a brand-new cable from the circuit

get a brand-new cable from the circuit down to the village

down to the village

down to the village she’s very time-consuming and in the

she’s very time-consuming and in the

she’s very time-consuming and in the mean time the village is suffering

mean time the village is suffering

mean time the village is suffering second you go there and repair the cable

second you go there and repair the cable

second you go there and repair the cable when it’s broken which is a more

when it’s broken which is a more

when it’s broken which is a more intuitive way of repair and more

intuitive way of repair and more

intuitive way of repair and more effective with the minimal loss for the

effective with the minimal loss for the

effective with the minimal loss for the village now let’s bring this analogy to

village now let’s bring this analogy to

village now let’s bring this analogy to the human body our brain is like an

the human body our brain is like an

the human body our brain is like an electric circuit where we have billions

electric circuit where we have billions

electric circuit where we have billions of neurons that communicate with

of neurons that communicate with

of neurons that communicate with electrical current to very distant

electrical current to very distant

electrical current to very distant villages which are our muscles organ and

villages which are our muscles organ and

villages which are our muscles organ and tissues and they do that through tiny

tissues and they do that through tiny

tissues and they do that through tiny cables called axons each neuron has his

cables called axons each neuron has his

cables called axons each neuron has his own axons and these are axial the

own axons and these are axial the

own axons and these are axial the desciption can be very long sometimes

desciption can be very long sometimes

desciption can be very long sometimes even one meter as in our shadek nerve

even one meter as in our shadek nerve

even one meter as in our shadek nerve this axon normally traveled together

this axon normally traveled together

this axon normally traveled together Amanda l–‘s in structure that we call

Amanda l–‘s in structure that we call

Amanda l–‘s in structure that we call nerves so each nerve will have 50 of

nerves so each nerve will have 50 of

nerves so each nerve will have 50 of hundred axons now similarly to a storm

hundred axons now similarly to a storm

hundred axons now similarly to a storm that with several ft circuit an injury

that with several ft circuit an injury

that with several ft circuit an injury that will cut one axon or a group of

that will cut one axon or a group of

that will cut one axon or a group of axon will interrupt the communication

axon will interrupt the communication

axon will interrupt the communication within the central and the village and

within the central and the village and

within the central and the village and this is probably the one of the most

this is probably the one of the most

this is probably the one of the most dramatic of this is fet is seen in

dramatic of this is fet is seen in

dramatic of this is fet is seen in during spinal cord injury where an

during spinal cord injury where an

during spinal cord injury where an injury in the axons in our spine will

injury in the axons in our spine will

injury in the axons in our spine will cause an introductory communication

cause an introductory communication

cause an introductory communication between the brain and the organ and

between the brain and the organ and

between the brain and the organ and addition downstream and the patient

addition downstream and the patient

addition downstream and the patient becomes paraplegic which means loses

becomes paraplegic which means loses

becomes paraplegic which means loses sensitivity to the lower limbs or even

sensitivity to the lower limbs or even

sensitivity to the lower limbs or even worse tetraplegic if the injury is

worse tetraplegic if the injury is

worse tetraplegic if the injury is really high in the neck which means

really high in the neck which means

really high in the neck which means losing sensitivity and movement of the

losing sensitivity and movement of the

losing sensitivity and movement of the lower limb torso and upper limbs I think

lower limb torso and upper limbs I think

lower limb torso and upper limbs I think it’s hard to overemphasize the physical

it’s hard to overemphasize the physical

it’s hard to overemphasize the physical and emotional impact on patients and

and emotional impact on patients and

and emotional impact on patients and their family where these injuries occur

now the human neurons do something

now the human neurons do something surprising when they when we cut their

surprising when they when we cut their

surprising when they when we cut their axons they do not they tend to do

axons they do not they tend to do

axons they do not they tend to do something counterintuitive they try to

something counterintuitive they try to

something counterintuitive they try to regrow the full length like if you were

regrow the full length like if you were

regrow the full length like if you were trying to rebuild the food a line from

trying to rebuild the food a line from

trying to rebuild the food a line from the circuit to the village but you might

the circuit to the village but you might

the circuit to the village but you might wonder now why a skilled neurosurgeon

wonder now why a skilled neurosurgeon

wonder now why a skilled neurosurgeon could not stitch together the individual

could not stitch together the individual

could not stitch together the individual axon and this is indeed a very promising

axon and this is indeed a very promising

axon and this is indeed a very promising Avenue in your surgery but there are

Avenue in your surgery but there are

Avenue in your surgery but there are still a lot of limitation the largest of

still a lot of limitation the largest of

still a lot of limitation the largest of one is the actual the dimension of the

one is the actual the dimension of the

one is the actual the dimension of the axon I told you that these are tiny

axon I told you that these are tiny

axon I told you that these are tiny cable the diameter of an axon is about

cable the diameter of an axon is about

cable the diameter of an axon is about 100 or 1000 times that of a millimeter

100 or 1000 times that of a millimeter

100 or 1000 times that of a millimeter and to give you a more realistic

and to give you a more realistic

and to give you a more realistic reference point in one of your air you

reference point in one of your air you

reference point in one of your air you can probably fit about 50 axons so the

can probably fit about 50 axons so the

can probably fit about 50 axons so the new the surgeon might probably stitch

new the surgeon might probably stitch

new the surgeon might probably stitch together the tissue surrounding the axon

together the tissue surrounding the axon

together the tissue surrounding the axon may be the nerve itself but not

may be the nerve itself but not

may be the nerve itself but not individual axon as he would be desirable

individual axon as he would be desirable

individual axon as he would be desirable to have a full functional recovery but

to have a full functional recovery but

to have a full functional recovery but now imagine if we had a magical glue

now imagine if we had a magical glue

now imagine if we had a magical glue that will allow us to do exactly that to

that will allow us to do exactly that to

that will allow us to do exactly that to stitch back together one broken axon

stitch back together one broken axon

stitch back together one broken axon wouldn’t that be amazing and this is

wouldn’t that be amazing and this is

wouldn’t that be amazing and this is where we can learn by looking at nature

where we can learn by looking at nature

where we can learn by looking at nature over 50 years ago scientists found that

over 50 years ago scientists found that

over 50 years ago scientists found that some animals including the crayfish the

some animals including the crayfish the

some animals including the crayfish the earthworm the leech and the sea slug

earthworm the leech and the sea slug

earthworm the leech and the sea slug they were able to spontaneously repair

they were able to spontaneously repair

they were able to spontaneously repair their injured axon by stitching them

their injured axon by stitching them

their injured axon by stitching them back together in a process that is

back together in a process that is

back together in a process that is called axonal fusion isn’t that amazing

but how do they do it how do they have

but how do they do it how do they have this superpower what molecule do they

this superpower what molecule do they

this superpower what molecule do they use this will remain a mystery for five

use this will remain a mystery for five

use this will remain a mystery for five decades

decades

decades and the reason is that we do not have

and the reason is that we do not have

and the reason is that we do not have yet tools to interrogate the genome and

yet tools to interrogate the genome and

yet tools to interrogate the genome and the DNA and find the molecules in these

the DNA and find the molecules in these

the DNA and find the molecules in these organisms however about 10 years ago a

organisms however about 10 years ago a

organisms however about 10 years ago a game-changing event happened a

game-changing event happened a

game-changing event happened a combination between engineering and

combination between engineering and

combination between engineering and microscopy allowed us to sever one

microscopy allowed us to sever one

microscopy allowed us to sever one single axon in a different species for

single axon in a different species for

single axon in a different species for which our tools in biology are nor a

which our tools in biology are nor a

which our tools in biology are nor a knowledge in the genome

knowledge in the genome

knowledge in the genome is phenomenal is limitless and this is a

is phenomenal is limitless and this is a

is phenomenal is limitless and this is a small animal is a nematode a round worm

small animal is a nematode a round worm

small animal is a nematode a round worm his scientific name is Sonora that is

his scientific name is Sonora that is

his scientific name is Sonora that is elegans we call it C elegans or simply

elegans we call it C elegans or simply

elegans we call it C elegans or simply the worm and this is like one millimetre

the worm and this is like one millimetre

the worm and this is like one millimetre long the size of a coma or one of the

long the size of a coma or one of the

long the size of a coma or one of the book you’re just reading or your

book you’re just reading or your

book you’re just reading or your abstract book today and then leave

abstract book today and then leave

abstract book today and then leave everybody in our garden what my lab and

everybody in our garden what my lab and

everybody in our garden what my lab and other lap in the words found that these

other lap in the words found that these

other lap in the words found that these animals some axons in these animals also

animals some axons in these animals also

animals some axons in these animals also have that capacity to repair themselves

have that capacity to repair themselves

have that capacity to repair themselves spontaneously now you can imagine this

spontaneously now you can imagine this

spontaneously now you can imagine this providing in an enormous experimental

providing in an enormous experimental

providing in an enormous experimental platform that will allow us to

platform that will allow us to

platform that will allow us to interrogate how they do it because now

interrogate how they do it because now

interrogate how they do it because now we have tools and in fact my laboratory

we have tools and in fact my laboratory

we have tools and in fact my laboratory together with the lab of Professor

together with the lab of Professor

together with the lab of Professor Eugene that University of California in

Eugene that University of California in

Eugene that University of California in San Diego and professor Ben bubbly which

San Diego and professor Ben bubbly which

San Diego and professor Ben bubbly which are the Technion inciden Israel have

are the Technion inciden Israel have

are the Technion inciden Israel have identified what are the molecules that

identified what are the molecules that

identified what are the molecules that mediate this process and the one of the

mediate this process and the one of the

mediate this process and the one of the the most important molecule the

the most important molecule the

the most important molecule the mediators are called few surgeons these

mediators are called few surgeons these

mediators are called few surgeons these function exactly as a biological glue

function exactly as a biological glue

function exactly as a biological glue that allowed this broken axon to get

that allowed this broken axon to get

that allowed this broken axon to get back together but al bajas do we have

back together but al bajas do we have

back together but al bajas do we have few surgeons yes we do and so do other

few surgeons yes we do and so do other

few surgeons yes we do and so do other organism the animal kingdom and viruses

organism the animal kingdom and viruses

organism the animal kingdom and viruses however in us they do not function in

however in us they do not function in

however in us they do not function in axonal repair

axonal repair

axonal repair not yet but they function in other

not yet but they function in other

not yet but they function in other essential processes such as the

essential processes such as the

essential processes such as the formation of the placenta our muscles

formation of the placenta our muscles

formation of the placenta our muscles our bones some cells in the eyes and the

our bones some cells in the eyes and the

our bones some cells in the eyes and the way they function even in that case as a

way they function even in that case as a

way they function even in that case as a glue they fuse entire cells together

glue they fuse entire cells together

glue they fuse entire cells together okay however we now know these molecules

okay however we now know these molecules

okay however we now know these molecules we know that there is a group of

we know that there is a group of

we know that there is a group of molecule they have a phenomenal property

molecule they have a phenomenal property

molecule they have a phenomenal property they can repair accents this is like

they can repair accents this is like

they can repair accents this is like having a brand new tool and we now need

having a brand new tool and we now need

having a brand new tool and we now need to learn how to use it what we can do

to learn how to use it what we can do

to learn how to use it what we can do with it where does potential of these

with it where does potential of these

with it where does potential of these molecule ends and so my lab is currently

molecule ends and so my lab is currently

molecule ends and so my lab is currently using fusion from different species and

using fusion from different species and

using fusion from different species and see if we now can repair mammalian

see if we now can repair mammalian

see if we now can repair mammalian action with the idea of providing the

action with the idea of providing the

action with the idea of providing the surgeon with that glue that is missing

surgeon with that glue that is missing

surgeon with that glue that is missing injuries are involuntary so we will

injuries are involuntary so we will

injuries are involuntary so we will never be able to fully prevent them

never be able to fully prevent them

never be able to fully prevent them being able to repair a single axon is a

being able to repair a single axon is a

being able to repair a single axon is a major goal in neurosurgery and I think

major goal in neurosurgery and I think

major goal in neurosurgery and I think it’s a rich and when we will be able to

it’s a rich and when we will be able to

it’s a rich and when we will be able to do that we’ll be one step closer to make

do that we’ll be one step closer to make

do that we’ll be one step closer to make this permanent injury into temporary

this permanent injury into temporary

this permanent injury into temporary ones that is a significant and

ones that is a significant and

ones that is a significant and unfortunate trend in the developed world

unfortunate trend in the developed world

unfortunate trend in the developed world to forget how much basic science can

to forget how much basic science can

to forget how much basic science can inform us or more develop organism like

inform us or more develop organism like

inform us or more develop organism like us so I would like to leave you with the

us so I would like to leave you with the

us so I would like to leave you with the thought that if we keep an open mind as

thought that if we keep an open mind as

thought that if we keep an open mind as a society and medical community and we

a society and medical community and we

a society and medical community and we are willing to learn from very simple

are willing to learn from very simple

are willing to learn from very simple organism such as a worm we might find

organism such as a worm we might find

organism such as a worm we might find ourselves not only in position to learn

ourselves not only in position to learn

ourselves not only in position to learn more about nature but also to find cure

more about nature but also to find cure

more about nature but also to find cure for diseases that are currently

for diseases that are currently

for diseases that are currently incurable thank you