To Save Lives, This Scientist Is Trying to Grow Human Organs Inside of Sheep
More than 114,000 men, women, and children are awaiting organ transplants in the United States. Each day, 22 of them die waiting. To address this shortage, researchers are working hard to grow organs on-demand, using the patient's own cells, to eliminate the need to find a perfectly matched donor.
"The next step is to transplant these cells into a larger animal that will produce an organ that is the right size for a human."
But creating full-size replacement organs in a lab is still decades away. So some scientists are experimenting with the boundaries of nature and life itself: using other mammals to grow human cells. Earlier this year, this line of investigation took a big step forward when scientists announced they had grown sheep embryos that contained human cells.
Dr. Pablo Ross, an associate professor at the University of California, Davis, along with a team of colleagues, introduced human stem cells into the sheep embryos at a very early stage of their development and found that one in every 10,000 cells in the embryo were human. It was an improvement over their prior experiment, using a pig embryo, when they found that one in every 100,000 cells in the pig were human. The resulting chimera, as the embryo is called, is only allowed to develop for 28 days. Leapsmag contributor Caren Chesler recently spoke with Ross about his research. Their interview has been edited and condensed for clarity.
Your goal is to one day grow human organs in animals, for organ transplantation. What does your research entail?
We're transplanting stem cells from a person into an animal embryo, at about day three to five of embryo development.
This concept has already been shown to work between mice and rats. You can grow a mouse pancreas inside a rat, or you can grow a rat pancreas inside a mouse.
For this approach to work for humans, the next step is to transplant these cells into a larger animal that will produce an organ that is the right size for a human. That's why we chose to start some of this preliminary work using pigs and sheep. Adult pigs and adult sheep have organs that are of similar size to an adult human. Pigs and sheep also grow really fast, so they can grow from a single cell at the time of fertilization to human adult size -- about 200 pounds -- in only nine to 10 months. That's better than the average waiting time for an organ transplant.
"You don't want the cells to confer any human characteristics in the animal....Too many cells, that may be a problem, because we do not know what that threshold is."
So how do you get the animal to grow the human organ you want?
First, we need to generate the animal without its own organ. We can generate sheep or pigs that will not grow their own pancreases. Those animals can then be used as hosts for human pancreas generation.
For the approach to work, we need the human stem cells to be able to integrate into the embryo and to contribute to its tissues. What we've been doing with pigs, and more recently, in sheep, is testing different types of stem cells, and introducing them into an early embryo between three to five days of development. We then transfer that embryo to a surrogate female and then harvest the embryos back at day 28 of development, at which point most of the organs are pre-formed.
The human cells will contribute to every organ. But in trying to do that, they will compete with the host organism. Since this is happening inside a pig embryo, which is inside a pig foster mother, the pig cells will win that competition for every organ.
Because you're not putting in enough human cells?
No, because it's a pig environment. Everything is pig. The host, basically, is in control. That's what we see when we do rat mice, or mouse rat: the host always wins the battle.
But we need human cells in the early development -- a few, but not too few -- so that when an organ needs to form, like a pancreas (which develops at around day 25), the pig cells will not respond to that, but if there are human cells in that location, [those human cells] can respond to pancreas formation.
From the work in mice and rats, we know we need some kind of global contribution across multiple tissues -- even a 1% contribution will be sufficient. But if the cells are not there, then they're not going to contribute to that organ. The way we target the specific organ is by removing the competition for that organ.
So if you want it to grow a pancreas, you use an embryo that is not going to grow a pancreas of its own. But you can't control where the other cells go. For instance, you don't want them going to the animal's brain – or its gonads –right?
You don't want the cells to confer any human characteristics in the animal. But even if cells go to the brain, it's not going to confer on the animal human characteristics. A few human cells, even if they're in the brain, won't make it a human brain. Too many cells, that may be a problem, because we do not know what that threshold is.
The objective of our research right now is to look at just 28 days of embryonic development and evaluate what's going on: Are the human cells there? How many? Do they go to the brain? If so, how many? Is this a problem, or is it not a problem? If we find that too many human cells go to the brain, that will probably mean that we wouldn't continue with this approach. At this point, we're not controlling it; we're analyzing it.
"By keeping our research in a very early stage of development, we're not creating a human or a humanoid or anything in between."
What other ethical concerns have arisen?
Conferring human properties to the organism, that is a major concern. I wouldn't like to be involved in that, and so that's what we're trying to assess. By keeping our research in a very early stage of development, we're not creating a human or a humanoid or anything in between.
What specifically sets off the ethical alarms? An animal developing human traits?
Animals developing human characteristics goes beyond what would be considered acceptable. I share that concern. But so far, what we have observed, primarily in rats and mice, is that the host animal dictates development. When you put mouse cells into a rat -- and they're so closely related, sometimes the mouse cells contribute to about 30 percent of the cells in the animal -- the outcome is still a rat. It's the size of a rat. It's the shape of the rat. It has the organ sizes of a rat. Even when the pancreas is fully made out of mouse cells, the pancreas is rat-sized because it grew inside the rat.
This happens even with an organ that is not shared, like a gallbladder, which mice have but rats do not. If you put cells from a mouse into a rat, it never grows a gallbladder. And if you put rat cells into the mouse, the rat cells can end up in the gallbladder even though those rat cells would never have made a gallbladder in a rat.
That means the cell structure is following the directions of the embryo, in terms of how they're going to form and what they're going to make. Based on those observations, if you put human cells into a sheep, we are going to get a sheep with human cells. The organs, the pancreas, in our case, will be the size and shape of the sheep pancreas, but it will be loaded with human cells identical to those of the patient that provided the cells used to generate the stem cells.
But, yeah, if by doing this, the animal acquires the functional or anatomical characteristics associated with a human, it would not be acceptable for me.
So you think these concerns are justified?
Absolutely. They need to be considered. But sometimes by raising these concerns, we prevent technologies from being developed. We need to consider the concerns, but we must evaluate them fully, to determine if they are scientifically justified. Because while we must consider the ethics of doing this, we also need to consider the ethics of not doing it. Every day, 22 people in the US die because they don't receive the organ they need to survive. This shortage is not going to be solved by donations, alone. That's clear. And when people die of old age, their organs are not good anymore.
Since organ transplantation has been so successful, the number of people needing organs has just been growing. The number of organs available has also grown but at a much slower pace. We need to find an alternative, and I think growing the organs in animals is one of those alternatives.
Right now, there's a moratorium on National Institutes of Health funding?
Yes. It's only one agency, but it happens to be the largest biomedical funding source. We have public funding for this work from the California Institute for Regenerative Medicine, and one of my colleagues has funding from the Department of Defense.
"I can say, without NIH funding, it's not going to happen here. It may happen in other places, like China."
Can we put the moratorium in context? How much research in the U.S. is funded by the NIH?
Probably more than 75 percent.
So what kind of impact would lifting that ban have on speeding up possible treatments for those who need a new organ?
Oh, I think it would have a huge impact. The moratorium not only prevents people from seeking funding to advance this area of research, it influences other sources of funding, who think, well, if the NIH isn't doing it, why are we going to do it? It hinders progress.
So with the ban, how long until we can really have organs growing in animals? I've heard five or 10 years.
With or without the ban, I don't think I can give you an accurate estimate.
What we know so far is that human cells don't contribute a lot to the animal embryo. We don't know exactly why. We have a lot of good ideas about things we can test, but we can't move forward right now because we don't have funding -- or we're moving forward but very slowly. We're really just scratching the surface in terms of developing these technologies.
We still need that one major leap in our understanding of how different species interact, and how human cells participate in the development of other species. I cannot predict when we're going to reach that point. I can say, without NIH funding, it's not going to happen here. It may happen in other places, like China, but without NIH funding, it's not going to happen in the U.S.
I think it's important to mention that this is in a very early stage of development and it should not be presented to people who need an organ as something that is possible right now. It's not fair to give false hope to people who are desperate.
So the five to 10 year figure is not realistic.
I think it will take longer than that. If we had a drug right now that we knew could stop heart attacks, it could take five to 10 years just to get it to market. With this, you're talking about a much more complex system. I would say 20 to 25 years. Maybe.
Scientists aim to preserve donkeys, one frozen embryo at a time
Every day for a week in 2022, Andres Gambini, a veterinarian and senior lecturer in animal science at the University of Queensland in Australia, walked into his lab—and headed straight to the video camera. Trained on an array of about 50 donkey embryos, all created by Gambini’s manual in vitro fertilization, or IVF, the camera kept an eye on their developmental progress. To eventually create a viable embryo that could be implanted into a female donkey, the embryos’ cells had to keep dividing, first in two, then in four and so on.
But the embryos weren’t cooperating. Some would start splitting up only to stop a day or two later, and others wouldn’t start at all. Every day he came in, Gambini saw fewer and fewer dividing embryos, so he was losing faith in the effort. “You see many failed attempts and get disappointed,” he says.
Gambini and his team, a group of Argentinian and Spanish researchers, were working to create these embryos because many donkey populations around the world are declining. It may sound counterintuitive that domesticated animals may need preservation, but out of 28 European donkey breeds, 20 are endangered and seven are in critical status. It is partly because of the inbreeding that happened over the course of many years and partly because in today’s Western world donkeys aren’t really used anymore.
“That's the reason why some breeds begin to disappear because humans were not really interested in having that specific breed anymore,” Gambini says. Nonetheless, in Africa, India and Latin America millions of rural families still rely on these hardy creatures for agriculture and transportation. And the only two wild donkey species—Equus africanus in Africa and Equus hemionus in Asia—are also dwindling, due to losing their habitats to human activities, diseases and slow reproduction rates. Gambini’s team wanted to create a way to preserve the animals for the future. “Donkeys are more endangered than people realize,” he says.
There’s much more to donkeys' trouble though. For the past 20 or so years, they have been facing a huge existential threat due to their hide gelatin, a compound derived from their skins by soaking and stewing. In Chinese traditional medicine, the compound, called ejiao, is believed to have a medicinal value, so it’s used in skin creams, added to food and taken in capsules. Centuries ago, ejiao was a very expensive luxury product available only for the emperor and his household. That changed in the 1990s when the Chinese economy boomed, and many people were suddenly able to afford it. “It went from a very elite product to a very popular product,” says Janneke Merkx, a campaign manager at The Donkey Sanctuary, a United Kingdom-based nonprofit organization that keeps tabs on the animals’ welfare worldwide. “It is a status symbol for gift giving.”
Having evolved in the harsh and arid mountainous terrains where food and water were scarce, donkeys are extremely adaptable and hardy. But the Donkey Sanctuary documented cases in which an entire village had their animals disappear overnight, finding them killed and skinned outside their settlement.
The Chinese donkey population was quickly decimated. Unlike many other farm animals, donkeys are finicky breeders. When stressed and unhappy, they don’t procreate, so growing them in large industrial settings isn’t possible. “Donkeys are notoriously slow breeders and really very difficult to farm,” says Merkx. “They are not the same as other livestock like sheep and pigs and cattle.” Within years the, the donkey numbers in China dropped precipitously. “China used to have the largest donkey population in the world in the 1990s. They had 11 million donkeys, and it's now down to less than 3 million, and they just can't keep up with the demand.”
To keep the ejiao conveyor going, some producers turned to the illegal wildlife trade. Poachers began to steal and slaughter donkeys from rural villages in Africa. The Donkey Sanctuary documented cases in which an entire village had their animals disappear overnight, finding them killed and skinned outside their settlement. Exactly how many creatures were lost to the skin trade to-date isn’t possible to calculate, says Faith Burden, the Donkey Sanctuary’s director of equine operations. Traditionally a poor people’s beast of burden, donkey counts are hard to keep track of. “When an animal doesn't produce meat, milk or eggs or whatever edible product, they're often less likely to be acknowledged in a government population census,” Burden says. “So reliable statistics are hard to come by.” The nonprofit estimates that about 4.8 million are slaughtered annually.
During their six to seven thousand years of domestication, donkeys rarely got the full appreciation for their services. They are often compared to horses, which doesn’t do them justice. They’re entirely different animals, Burden says. Built for speed, horses respond to predators and other dangers by running as fast as they can. Donkeys, which originate from the rocky, mountainous regions of Africa where running is dangerous, react to threats by freezing and assessing the situation for the best response. “Those so-called stubborn donkeys that won’t move as you want, they are actually thinking ‘what’s the best approach,’” Burden says. They may even choose to fight the predators rather than flee, she adds. “In some parts of the world, people use them as guard animals against things like coyotes and wolves.”
Scientists believe that domestic donkeys take their origin from Equus africanus or African wild ass, originally roaming where Kenya, Ethiopia and Eritrea are today. Having evolved in the harsh and arid mountainous terrains where food and water were scarce, they are extremely adaptable and hardy. Research finds that they can go without water for 72 hours and then drink their fill without any negative consequences. Their big jaws let them chew tough desert shrubs, which horses can’t exist on. Their large ears help dissipate heat. Their little upright hooves are a perfect fit for the uneven rocky or other dangerous grounds. Accustomed to the mountain desert climate with hot days and cold nights, they don’t mind temperature flux.
“The donkey is the most supremely adapted animal to deal with hostile conditions,” Burden says. “They can survive on much lower nutritional quality food than a cow, sheep or horse. That’s why communities living in some of the most inhospitable places will often have donkeys with them.” And that’s why losing a donkey to an illegal skin trade can devastate a family in places like Eritrea. Suddenly everything from water to firewood to produce must be carried by family members—and often women.
Workers unloading donkeys at the Shinyanga slaughterhouse in Tanzania. Fearing a future in which donkeys go extinct, scientists have found ways to cryopreserve a donkey embryo in liquid nitrogen.
TAHUCHA
One can imagine a time when worldwide donkey populations may dwindle to the point that they would need to be restored. That includes their genetic variability too. That’s where the frozen embryos may come in handy. We may be able to use them to increase the genetic variability of donkeys, which will be especially important if they get closer to extinction, Gambini says. His team had already created frozen embryos for horses and zebras, an idea similar to a seed bank. “We call this concept the Frozen Zoo.”
Creating donkey embryos proved much harder than those of zebras and horses. To improve chances of fertilization, Gambini used the intracytoplasmic sperm injection or ICSI, in which he employed a tiny needle called a micropipette to inject a donkey sperm into an egg. That was a step above the traditional IVF method, in which the egg and a sperm are left floating in a test tube together. The injection took, but during the incubating week, one after the other, the embryos stopped dividing. Finally, on day seven, Gambini finally spotted the exact sight he was hoping to see. One of the embryos developed into a burgeoning ball of cells.
“That stage is called a blastocyst,” Gambini says. The clump of cells had a lot of fluids mixed within them, which indicated that they were finally developing into a viable embryo. “When we see a blastocyst, we know we can transfer that into a female.” He was so excited he immediately called all his collaborators to tell them the good news, which they later published in the journal of Theriogenology.
The one and only embryo to reach that stage, the blastocyst was cryopreserved in liquid nitrogen. The team is waiting for the next breeding season to see if a female donkey may carry it to term and give birth to a healthy foal. Gambini’s team is hoping to polish the process and create more embryos. “It’s our weapon in the conservation ass-enal,” he says.
Lina Zeldovich has written about science, medicine and technology for Popular Science, Smithsonian, National Geographic, Scientific American, Reader’s Digest, the New York Times and other major national and international publications. A Columbia J-School alumna, she has won several awards for her stories, including the ASJA Crisis Coverage Award for Covid reporting, and has been a contributing editor at Nautilus Magazine. In 2021, Zeldovich released her first book, The Other Dark Matter, published by the University of Chicago Press, about the science and business of turning waste into wealth and health. You can find her on http://linazeldovich.com/ and @linazeldovich.
Too much of this ingredient leads to autoimmune diseases, new research shows. Here's how to cut back.
For more than a century, doctors have warned that too much salt in your diet can lead to high blood pressure, heart disease and stroke - and many of the reasons for these effects are well known. But recently scientists have been looking deeper, into the cellular level, and they are finding additional reasons to minimize sodium intake; it is bad for immune cells, creating patterns of gene expression and activity seen in a variety of autoimmune diseases such as multiple sclerosis, lupus, rheumatoid arthritis, and type-1 diabetes.
Salt is a major part of the ocean from which life evolved on this planet. We carry that legacy in our blood, which tastes salty. It is an important element for conducting electrical signals along nerves and balancing water and metabolites transported throughout our bodies. We need to consume about 500 milligrams of salt each day to maintain these functions, more with exercise and heavy sweating as that is a major way the body loses salt. The problem is that most Americans eating a modern western diet consume about 3400 milligrams, 1.5 teaspoons per day.
Evidence has been accumulating over the last few years that elevated levels of sodium can be harmful to at least some types of immune cells. The first signal came in monocytes, which are immune cells that travel to various tissues in the body, where some of them turn into macrophages, a subset of white blood cells that can directly kill microorganisms and make chemical signals that bring other types of immune cells into play.
Two years ago, Dominik N. Müller from the Max-Delbrueck-Center in Berlin, Germany and Markus Kleinewietfeld, an immunologist at Hasselt University in Belgium, ran a study where they fed people pizza and then measured their immune cell function. “We saw that in any monocytes, metabolic function was down, even after a single salty meal,” Kleinewietfeld says. It seemed to be the cellular equivalent of the sluggish feeling we get after eating too much. The cells were able to recover but more research is needed to answer questions about what dose of sodium causes impairment, how long the damage lasts, and whether there is a cumulative effect of salt toxicity.
Kleinewietfeld and his colleagues have hypothesized that too much salt could be a significant factor in the increased number of autoimmune diseases and allergies over the last few generations.
The latest series of experiments focused on a type of T cell called T regulatory cells, or Tregs. Most T cells release inflammatory mediators to fight pathogens and, once that job is done, Tregs come along to calm down their hyperactive brethren. Failure to do so can result in continued inflammation and possibly autoimmune diseases.
In the lab, Kleinewietfeld and his large team of international collaborators saw that high levels of sodium had a huge effect on Tregs, upregulating 1250 genes and downregulating an additional 1380 genes so that they looked similar to patterns of gene expression seen in autoimmune diseases.
Digging deeper, they found that sodium affected mitochondria, the tiny organelles inside of cells that produce much of its energy. The sodium was interfering with how the mitochondria use oxygen, which resulted in increased levels of an unstable form of oxygen that can damage cell function. The researchers injected those damaged Tregs into mice and found that they impaired the animals' immune function, allowing the inflammation to continue rather than shutting it down.
That finding dovetailed nicely with a 2019 paper in Nature from Navdeep Chandel's lab at Northwestern University, which showed in mice that inhibiting the mitochondrial use of oxygen reduced the ability of Tregs to regulate other T cells. “Mitochondria were controlling directly the immunosuppressive program, they were this master regulator tuning the right amount of genes to give you proper immunosuppression,” Chandel said. “And if you lose that function, then you get autoimmunity.”
Kleinewietfeld's team studied the Treg cells of humans and found that sodium can similarly decrease mitochondrial use of oxygen and immunosuppressive activity. “I would have never predicted that myself,” Chandel says, but now researchers can look at the mitochondria of patients with autoimmune disease and see if their gene expression also changes under high salt conditions. He sees the link between the patterns of gene expression in Tregs generated by high salt exposure and those patterns seen in autoimmune diseases, but he is cautious about claiming a causal effect.
Kleinewietfeld and his colleagues have hypothesized that too much salt could be a significant factor in the increased number of autoimmune diseases and allergies over the last few generations. He says a high salt diet could also have an indirect effect on immune function through the way it affects the gut microbiome and the molecules made by microbes when they break down food. But the research results are too preliminary to say that for sure, much less parse out the role of salt compared with other possible factors. “It is still an exciting journey to try to understand this field,” he says.
Additionally, it is difficult to say precisely how this research in animals and human cell cultures will translate into a whole human body. Individual differences in genetics can affect how the body absorbs, transports, and gets rid of sodium, such that some people are more sensitive to salt than are others.
So how should people apply these research findings to daily life?
Salt is obvious when we sprinkle it on at the table or eat tasty things like potato chips, but we may be unaware of sodium hidden in packaged foods. That's because salt is an easy and cheap way to boost the flavor of foods. And if we do read the labeled salt content on a package, we focus on the number for a single serving, but then eat more than that.
Last September, the U.S. Food and Drug Administration (FDA) began a process to update labels on the content of food, including what is meant by the word “healthy” and how food manufacturers can use the term. Many in the food industry are resisting those proposed changes.
Chandel cautions against trying to counter the effects of salt by reaching for foods or supplements full of antioxidants, which, in theory, could reduce the harmful effects on mitochondria caused by a heavy hand with the salt shaker.
Until labels are updated, it would be prudent to try to reduce sodium intake by cutting down on packaged foods while making your own food at home, where you know just how much salt has been added. The Mayo Clinic offers guidance on how to become more aware of the sodium in your diet and eat less of it.
Chandel thinks many people will struggle with minimizing salt in their diets. It’s similar to the challenge of eating less sugar, in that the body craves both, and it is difficult to fight that. He cautions against trying to counter the effects of salt by reaching for foods or supplements full of antioxidants, which, in theory, could reduce the harmful effects on mitochondria caused by a heavy hand with the salt shaker. “Dietary antioxidants have failed in just about every clinical trial, yet the public continues to take them,” Chandel says. But he is optimistic that research will lead us to a better understanding of how Tregs function, and uncover new targets for treating autoimmune diseases.