The implanting of a 3D-printed airway splint in an infant boy born with Tracheobronchomalacia.

Presenter: Emily
Guest: Dr. Matthew Wheeler
Guest Bio: Dr. Matthew Wheeler , University of Illinois Department of Animal Sciences and member of the Regenerative Biology and Tissue Engineering Research Theme at the Institute for Genomic Biology.

Segment Overview
Dr. Wheeler discusses the collaborative effort that led to his team’s recent success – the implanting of a 3D-printed airway splint in an infant boy born with Tracheobronchomalacia. We also discuss the role of his department, and the large animal trials conducted there, in ongoing projects in regenerative biology research.



Transcription

Health Professional Radio – Infant with Tracheobronchomalacia

Emily: You’re listening to Health Professional Radio. This is Emily, and, today I’m speaking with Dr. Matthew Wheeler from the University of Illinois. Dr. Wheeler, thanks so much for speaking with me today.

Dr. Matthew Wheeler: You’re welcome.

Emily: Now, you are a member of the Regenerative Biology and Tissue Engineering Research Team at the Institute for Genomic Biology.  Can you tell me about that work?

Dr. Wheeler: Yes.  Our theme at IGB is dedicated to developing new models and new, potentially, devices and therapies for regenerative medicine, trying to harness the body’s own ability to heal itself.

Emily: Wow, and the issue that caught my attention, the reason I wanted to speak with you, was because you recently developed a 3D printed airway splint that was successfully implanted into an infant and is allowing him now to breathe on his own.  What kind of work have you done in the past that gave you the confidence to work on this project?

Dr. Wheeler: I’ve been working with Scott Hollister from the University of Michigan for seven or eight years now.  Scott’s a professor in Biomedical Engineering at Michigan, and he has been interested in using materials – biodegradable, biocompatible materials – to engineer solutions for soft and hard tissue regeneration.  My background is a developmental stem cell biologist.

Scott and I got together with several other colleagues a few years ago and basically started on a platform, I guess you could call it, ofusing 3D printed scaffolds and stem cells and grow factors to try to accelerate, and in some cases even improve on, regeneration and healing of large bone defects, initially.  But that’s spread to cartilage, both nose and ear cartilage, but in the case of the airway splint, cartilage for trachea.

Emily: Right.  I see.  I read that you’ve actually completed more than a hundred of these procedures in large animal trials.  This is a truly collaborative effort between you as a large animal scientist and then the bio-engineers and the medical doctors.

Dr. Wheeler: Correct.  Essentially, all of our projects are physician-inspired.  It’s a critical aspect of this kind of research that’s there’s a medical problem where there’s really not a therapy, that the physicians, either in discussions or in brainstorming, come up with a problem and then the engineers and the developmental biologists and the animal scientists basically try to come up with a suitable therapy that we can test in a large animal model.

Because we use the pig as our model because the pig, the physiology, is very similar to human.  It’s the best non-primate model for human bio-medical research.  Their digestive system is very similar to ours.  Their heart, lung, kidney are very similar to size to ours.  So, it’s a great model to use, and it will allow us to do some things we wouldn’t necessarily be able to do in a non-animal model or in a patient.

Emily: Wow, and for this particular project, you actually got an emergency FDA approval to implant this device into a young person.

Dr. Wheeler: Yes.  Some of the other things that we have done, looking at jaw regeneration for trauma, cancer and potentially military patients, where large pieces of bone were missing.  We have actually developed fairly large and complicated three-dimensional scaffolds for those kinds of therapies.

In this case, there was the syndrome that Dr. Glenn Green, from the University of Michigan, who’s a collaborator of Scott and myself, basically identified this problem.  A lot of the work that happens between Scott and I, well, he or I will identify a potential problem and dealing with the physicians either at Michigan or here at Carle Hospital in Urbana.

Then we’ll call each other and have one of those phone conversations like, ‘what do you think?  Do you think we could do that?  Is that possible? Is there an animal model for that?  Is that too hard to make?’  We’ll go back and forth.  Typically, essentially, 100% of the time, we say, ‘yeah, we can do that’.  We basically go back to our labs and try to engineer solutions.  Sometimes, it takes a number of iterations to come up with a correct device.

In the case of the airway splint, this was an idea that Glenn basically said, “Is there anything we can do?” Scott basically said, “I think there’s a possibility.”  He called me and we went back and forth and developed some design parameters and some study designs.  Then just serendipitously a human patient was presented, and, as you might have read in the story, this kind of condition,tracheomalacia, is a potentially fatal disease.

Emily: Right.

Dr. Wheeler: The FDA, on humanitarian grounds, basically granted Glenn Green the opportunity to implant one of these devices.  So, we’re continuing.  That was very successful and we’re all continuing to monitor and watch the patient and his success.  But now the hard work begins about, essentially, can we improve the device?  We needed to do more animal trials and those are ongoing.

As a matter of fact, Scott and his team are actually coming down tomorrow to do some … we’ve got another project.  We’re looking at a jaw scaffold, a mandible scaffold.  So, they’re actually coming down tomorrow and we’ll be here two days this week doing surgery on pigs to see if we can accelerate bone healing.

Emily: Wow.

Dr. Wheeler: It’s a very active collaboration in those 100 surgeries.  We haven’t done 100 airway splint surgeries.  We’ve done probably a dozen, or half dozen to a dozen of those.  And we’ve done a lot of other surgeries on mandible and different things over the last few years.  Yeah, it’s a very active, very fruitful collaboration that I look forward to more success in the not too distant future.

Emily: It’s incredible to hear about this, because as a non-physician and a non-scientist, 3D printing has only recently popped up on my radar.   I saw it and thought ‘holy cow, how can this possibly be?’ But then as I started reading, and I’m seeing that we’re already 3D printing so many things that are used in medicine, that are coming out of trials just like the ones that you’re doing.  How long has this been a part of your lab?

Dr. Wheeler: I think we started working with Scott in 2005, I think it was, as I recall.  Yes, so we’ve been doing it that long, and it is incredible.  I think that the public needs to know about that because certainly there’s been a lot about 3D printing, but what this gives us the opportunity to do is actually to produce a scaffold or a device that is patient-specific.

Emily: Yeah.

Dr. Wheeler: For example, if there’s a large bone defect in one side of a mandible of a human, for example, we can actually do a CT scan of that mandible, of the head, and basically take the side that’s not damaged and mathematically invert the image so that you can 3D print the damaged side so it fits perfectly, not that it’s close, but it actually fits perfectly.

So, hopefully in the future, we’ll be able to do that with long bones, certainly with the cranial facial skeleton, the mandible, the maxilla. We’re hoping that digits, fingers and toes is within reach, also nose and ear cartilage for those that have had those damaged somehow, either, again, trauma or cancer or some other injury.  It’s terribly exciting.  I think the sky is the limit with regard to patient-specific therapies.

Emily: Wow, that’s incredible.  I’m just blown away by hearing you talk about this and the excitement, I can hear it in your voice, as far as what you’re going to be able to offer.

You’re listening to Health Professional Radio.  This is Emily, and my guest today has been Dr. Matthew Wheeler, from the University of Illinois.  He is a Professor in the Animal Sciences Department, and he’s recently 3D printed an airway splint that was implanted into an infant boy who is now able to breathe on his own.  Dr. Wheeler, thank you so much for speaking with me today.

Dr. Wheeler: I’m pleased to do it.