It’s an idea straight out of science fiction, and yet it’s very real: A prosthetic hand that connects to the brain as seamlessly as a natural limb, bending and twisting and grasping in response to brain waves. An amputated limb used to mean completely relearning everyday tasks. But not anymore—just ask Keven Walgamott, the primary test subject for a revolutionary new prosthetic that could give amputees not only full control of a cutting-edge prosthetic, but also their lost sense of touch. Losing his left hand and foot after being electrocuted at his Boise home, Walgamott now participates in one of hundreds of trials led by Utah researchers who are creating innovative solutions to the most perplexing problems of the body and brain.
Utah is home to scores of groundbreaking research from the University of Utah’s Huntsman Cancer Institute to Utah’s Science Technology and Research Organization (USTAR). And, while all of the stories herein are still in development or clinical trials, early discoveries promise to make the lives of Utahns, and those anywhere who struggle with everything from addiction to amputation, better.
May Science Be With You
Amputation used to mean completely readjusting to life without limbs. The simplest tasks–opening a jar, tying a shoe–become close to impossible when you only have one hand, or one foot. Dr. Gregory Clark and his team in one of the U’s Bioengineering labs are working to develop a possible solution for amputees who have lost a hand, comically referred to as the Luke Skywalker Arm. But this isn’t science fiction. While Dr. Clark is careful to point out that the hand is made by DEKA, a company based in New Hampshire, his lab is working to make the hand more than just a remote prosthetic. “Even after amputation, the biological wires in the body, the fibers that send and receive messages from the brain, are still intact. But, with a missing hand, there is nothing to receive and enact the movement,” says Clark. “We connect the prosthetic to the existing biological wires in the muscles with the Utah Array—a wire grouping made by Utah-based Ripple that connects the fibers of the prosthesis to those in the subject’s muscles.”
Now, when a person hooked up to the prosthetic thinks about moving it, the signals will travel down the subject’s arm, into the prosthetic and move it according to the messages sent by the brain. As if this wasn’t mind boggling enough, the new Luke Skywalker hand is equipped with sensors in the fingertips connected to the subject’s neural pathways. Not only can the subject send signals to move the prosthetic like they used to move their real hand, they can once again experience touch sensations through the prosthetic. “Based on our system of signals that go up and down the biological wires of the body, the hand will feel. The information traveling up the fibers from the prosthetic are the same as those that would come from a real hand. So it’s a given that the brain will interpret them exactly the same way,” says Clark.
Though it may seem the biggest benefit of the advanced prosthetic would be gaining back the hand that was lost, Walgamott was most pleased that the prosthetic significantly mitigated his phantom pain. Amputees often experience phantom pain, a phenomenon where the person feels pain where their limb would be—a result of regrown sensory fibers with nowhere to go. “It was pretty stunning when I felt sensations for the first time. I still feel phantom pain in my hand and foot and all my fingers, but with the prosthetic, the phantom pain cancels out. It doesn’t last—an hour or so after the arm comes off, the pain comes back. But it took the phantom pain away, and it was absolutely wonderful,” says Walgamott.
Walgamott is still enjoying the small victories that come with testing the Skywalker arm. “Once the hand is attached, one of my favorite things to do was tell if something was large or small, soft or hard. My absolute favorite thing was using the hand to pull on a pillowcase. It was wonderful to be able to do that with both my hands”
Snails Save the Day?
Utah’s opioid epidemic is no secret. But it’s never been declared a “public health crisis” even though the Utah Department of Health reports prescription opioids contribute to over twice the amount of deaths caused by heroin abuse. With over 7,000 opioid prescriptions written everyday in the U.S. and the high risk of addiction, it’s no surprise that 80 percent of heroin users started out taking prescription opioid medication. Utah’s particular struggle with opioid addiction results in several alarming statistics from Intermountain Healthcare: Only 10 percent of those with a substance abuse problem will seek help; 1 out of every 20 babies are born addicted to opiates in Utah; 59 percent of opioid users in Salt Lake County alone are unemployed. The problem is so dire that Intermountain Healthcare pledged $2 million to help fight opioid abuse this year. Though it seems insurmountable, there are those working to find a way to help current substance abusers and prevent future abuse of opioids.
Enter the cone snail.
The cone snail looks like it mucus-trailed its way out of a B horror movie. These predatory marine molluscs are killers named for their cone shaped shell, tube-like appendage and venomous tooth, called a “harpoon.” Though most cone snail stings won’t hurt much more than a bee sting, certain cone snail species’ harpoons are long enough to puncture skin, penetrating gloves and wetsuits, with venom that can prove fatal. Naturally, scientists looked at this odd little marine creature and saw something else in its venom than just a creative way to die.
Dr. J. Michael McIntosh works with the cone snail team at the University of Utah led by Dr. Toto Olivera. McIntosh’s working relationship with Olivera stretches back to his days as an undergraduate researcher, but McIntosh came back to the U hoping to further Olivera’s cone snail research. “The history behind cone snail research and opioids is not new. PRIALT, a medication currently on the market as an alternative to morphine, was derived from a compound originally isolated in the cone snail,” says McIntosh.
“The cone snail venom applications are seemingly endless.”
–Dr. J. Michael McIntosh
The snail’s venom is the key. When cone snails hunt, they use their tubey appendage and harpoon to strike prey, injecting a venom that anesthetizes the prey while keeping it “fresh,” so to speak. Researchers hope to harness the venom’s anesthetic properties and develop a non-opioidal pain killer. “This compound works by acting on a nicotinic receptor, not an opioid receptor. What’s interesting is that the properties are very different from what you would see with opioids where people develop a tolerance. Opioids are less effective with repeated doses, so you need more drugs to achieve the same effect,” says McIntosh. “But [the venom alternative] works in the opposite way: you get more effect as you give it over several days and weeks. The analgesic effects last for weeks even after the medication has been stopped. Rather than just masking the pain, it’s actually helping the disease process improve and aid recovery.”
The cone snail venom applications are seemingly endless. “We’re working with one component in one cone snail’s venom,” says McIntosh. “Each cone snail has 200 different venomous components, and there are 100s of species of cone snail with their own venom cocktails.”
The cone snail team has researchers from marine biologists to chemists and psychiatrists—the last of which is one of McIntosh’s two specialties. Even with the promising results of the team’s preclinical research, McIntosh knows there is still a long way to go. “I don’t think there’s one magic bullet solution to opioid addiction, but I think it’s a piece of the puzzle. If people can manage their disease and not have the need for ongoing opioid treatment, it’s going to save lives.” Ultimately, the biggest concern is finding alternative treatments for chronic pain conditions. “As a psychiatrist, I see many who are using opiates for chronic pain, a huge psychological burden on people, leading to depression and anxiety. I see a lot of people who, but for their pain, would be in a good mood. Chronic pain is a difficult taskmaster,” McIntosh says.
The opioid crisis makes interesting bedfellows of scientists and marine life. Another group at the U is hoping to test out potential opioid dependence cures and coping strategies using zebrafish.
Zebrafish Earn their Stripes
Here’s a fun fact for your next cocktail party: According to Dr. Randall T. Peterson, Dean of the School of Pharmacy at the University of Utah, Salt Lake City is one of the world hubs for zebrafish-based research. You may not expect a small, freshwater fish native to India and other parts of Asia to be a staple in our little landlocked piece of the world, but Peterson claims that the little swimmers got started in research decades ago because zebrafish come with a number of advantages over mice and rats. For example, you don’t have to cut them open to analyze organs. Zebrafish are translucent in their young stages, so you just need a microscope.
Perhaps the most attractive feature for scientists are the uncanny similarities these tiny fish have to humans. “82 percent of all disease causing genes in humans have an analogous, or correlating, gene in zebrafish. You can find the same genetic underpinnings in these fish as in humans,” says Peterson. Not only that, but zebrafish neural networks are one of the closest natural matches to humans. At present, Peterson claims that over 20 different professors at the U use zebrafish as their primary study subjects. “We can engineer the fish so they develop some attribute of a human disease or disorder and then systematically test chemical compounds to see if any of them can make the fish better,” says Peterson.
Though Peterson began working with zebrafish and opioid dependency during his time as a faculty member at Harvard’s School of Medicine, he’s glad this particular work brought him back to Utah. “We’ve made some of the key discoveries here when [this epidemic] was really devastating the state of Utah.”
We would like to discover new or better existing drugs that can reduce drug seeking behavior in humans.
–Dr. Randall T. Peterson
“We would like to discover new or better existing drugs that can reduce drug seeking behavior in humans. If we could identify a drug already approved for human use that can reduce the urge to seek opioids, it could be a useful tool in helping people overcome their addictions,” claims Peterson. Initially, he was surprised by how many aspects of human addiction the fish seem to mimic. “It’s dangerous to subscribe human phenomena to an animal, but there are a number of things we noticed. For example, they could be conditioned to seek opioids in as few as 5 days. They would then strongly seek opioids after learning they could self-administer the drugs and would exhibit risky behaviors to get a fix,” Peterson says.
“Little tropical fish don’t like to swim in shallow water where they would be exposed to predation. But, once conditioned, they would gladly swim into shallow water to get an opioid fix, effectively going against their instincts,” says Peterson. After conditioning, Peterson hopes they can test existing drug compounds on the heavily conditioned fish to see if any reduce the fishes’ motivations and drug seeking behaviors. And early signs are encouraging.
Current therapies for addiction often use another opioid to replace or reduce dependence on the drug of choice. While Peterson says he wouldn’t discourage people from seeking these treatments, they’re not ideal. “Our hope is that we can find something that’s already safe and approved for human use, and, if it’s beneficial, could be employed in human use fairly quickly,” he says. “We hope to create a real center of excellence for this kind of research.”
Pediatric Cancer Survivors Carry Scars into Adulthood
The Huntsman Cancer Institute’s Dr. Anne Kirchhoff surveyed childhood cancer survivors and found that many report higher rates “job lock,” where they stay at a job solely to keep work-related health insurance. “Even with protections and expansions of insurance coverage in the U.S., this study proves there is still quite a bit of worry about insurance,” says Kirchhoff, “and it’s affecting how people make decisions from a job standpoint. If someone gets stuck in a certain job because they want to keep their insurance coverage, that could really affect their earning power across a lifetime. It could potentially stymie their ability to start a new company or take on a job that would allow them to have more career or income growth, all because of health insurance worries.” 23 percent of survivors reported job lock experiences compared to only 17 percent of the survivors’ siblings who never had cancer.
USTAR Picks Up Where Universities Leave Off
When you think about centers of research excellence in Utah, most would default to the University of Utah’s Huntsman Cancer Institute. Universities, especially large top-tier research universities, receive copious funding from the government and private donors to keep cutting edge research moving. But what about those developers or researchers who’ve moved on from universities? How do they bring a product or advancement to the market?
They turn to USTAR.
“We’re a state agency that’s focused on economic development through building the technology ecosystem here,” says Dr. Ivy Estabrooke, USTAR’s Executive Director. In layman’s terms, they help diversify Utah’s economy by helping technology companies get started, especially in areas that have a lot of potential growth for the state: energy and clean technology, life sciences, agriculture, automation and robotics, aerospace and big data.
Estabrooke points out that there is a definite need for transitional funding in these particular spaces. “There’s a lot of federal funding for early stage research—the kinds happening in universities—but it drops off as the technology matures. And private investment isn’t interested until you have a product and enter the manufacturing stage, which leaves you in this stage we affectionately call the Valley of Death,” she says. That’s where they find their particular funding niche. USTAR programs are designed to help early stage companies develop prototypes and continue testing and troubleshooting until they reach a stage mature enough to attract private funding.
But don’t think grant recipients are taking the money and running off to Silicon Valley. “We have our program set up so that, if they leave the state within 5 years of getting their grant, we can require them to pay it back,” says Estabrooke. “When you’re using taxpayer money, it’s important to make sure the companies stay here and grow the local economy.”
One of USTAR’s recent grant recipients is Progenitor Life Sciences who are tackling high level issues, like blood cancers, and trying to find new therapies to treat those with these devastating diseases. Dr. Barbara Araneo, USTAR’s Emerging Technology Lead, is guiding Progenitor through their grant process—which makes sense considering her extensive background in immunology.
“In an average cycle, we see over 120 applications. There’s no shortage of innovation here.”
–Dr. Ivy Estabrooke
“Progenitor is definitely in the prototype and feasibility stage,” says Araneo. Progenitor’s idea seems like something out of a medical fever dream. For those familiar with blood cancers, most are treated with bone marrow transplants: extensive and painful procedures where a patient’s bone marrow is swapped out for a matching donor’s. “Now there’s a different approach based on immune cells, so you don’t have to wipe out the patient’s bone marrow. You can take a patient’s own immune cells, put them in a petri dish, train them to identify the cancer cells and put them back in the patient to let these immune cells find the cancer and kill them using the training they got in the dish,” Araneo explains.
The only problem with this type of cell therapy is the time lapse needed to take the cells and train them—meaning the patient’s cancer is slowly killing them while the cells train. Progenitor hopes to change this. “Progenitor believes you can go to a different cell source than the patient’s immune cells, like a universal source—regular cells they’ve reverted to an almost stem cell state—and then put them through a training regimen outside of a patient,” says Araneo. And this therapy has unlimited potential for various cancers. “Now they can take these educated cells and tell them what kinds of cancer to identify—non-Hodgkin’s lymphoma, lung cancer, etc. Keep them until they’re needed, move them ‘off the shelf’ and into the patient. This alleviates a need for matching donors because there’s no risk of tissue incompatibility,” she says.
USTAR gives out millions in grant funding. Though the award amounts vary based on a proposal’s scope and projected length, grants range from $40,000 to a whopping $600,000 for projects no longer than 18 months. In the first year of their new Technology Acceleration Program (TAP) grants, USTAR awarded 30 proposals, but this year only gave out about 20. And they’re highly competitive. “We only fund about 10 percent of the proposals we get. There’s no shortage of innovation here,” says Estabrooke.
Healthy Estrangement?
Most view the idea of parent/child estrangement as a tragic thing, but that’s not necessarily the case according to USU Communications Professor and Estrangement specialist Dr. Kristina Scharp. “Most estranged adult children are reacting to some sort of significant abuse. It’s not that they got into a fight and decided not to speak to a parent anymore. There are often very serious reasons,” she says. For those new to the concept, Scharp defines estrangement as one family member who voluntarily and intentionally distances themselves from another family member because of an ongoing negative relationship. And it turns out that the rates of estrangement are much higher than most would ever suspect. “It’s pretty common. There aren’t any official statistics because it’s taboo, but rough estimates indicate anywhere between 15-25 percent of parents and children are estranged,” says Scharp.
