R4| Thursday, March 12, 2020 THE WALL STREET JOURNAL. THE WALL STREET JOURNAL. Thursday, March 12, 2020 |R5
Researchersposition
amagneticwand
overtheheadto
transmitpulsesinto
thebrain’sfrontal
cortex.11Doctorsinject
amagnetic
micro-robotpacked
withstemcellsinto
theinjuredknee.1
Usingmagnetsonthe
skin,doctorssteerthebot
throughveinsandblood
vesselstothespecific
affectedarea.2 Onceatthesite,
thestemcellsare
heldinplacewith
amagneticband.3Scientistsusea
bioprintertomakea
nano-textured
fabricmesh,which
isthenseededwith
stemcells.1Collagenisinfusedwithstemcellsand
wrappedaroundaninjuredAchilles
tendon,helpingtostabilizethecells
andinducehealthytissuerepair.Anenzymecalled
Cas9pairedwith
aguidesegment
ofRNAslicea
DNAmolecule
likescissorsata
specificlocation.TheGeneEditingProcess
(^1) Scientistscan
thenaddor
removesegments
ofDNAbytaking
advantageofa
cell’snatural
repairmachinery.
(^2) NewDNAcouldbe
addedthat,forexample,
givesthegenome
specialinstructionsfor
morefast-fibermuscles
togivearunner’slegs
morepower.
3
2 Thepulsesexcite
neuronsthathelp
strengthensynapses
thatformneural
networks.
2 Themeshis
wrappedaround
theinjured
tendons.
3 Themeshholdsthestem
cellsinplacelongerthan
inconventionalsurgery,
fosteringmorecell
growth.
Depressed
brain
After
treatment
Effectsonadepressedbrain
Target
DNAcut
Cas9
cutter
CutDNA Modified
DNA
Stemcells
Micro-robot(0.3mm)
Micro-robot
solution
Cartilage
tear
Knee
Cartilage
Magnetic
electrical
pulse
Magneticcoil
Brain
stimulation
Stemcells
Bone
Cartilage
tear
Blood
vessel
3D-printedscaffold Ligament
Collagen
Achilles
tendon
injury
Ankle
DNAhelix
Stem
cells
Mesh
Bioprinter
DNAhelix
Injuriestotheelbow
boneusuallyrequire
graftsfromcadavers
2
3
4
5
6
7
8
1
Rotator
cuffInjury
Mesh
Quadricep
muscle
group
Gut
microbes
3D-printed
scaffoldused
toreplace
damagedbone
2
Illustrationincludesimageof
DrexelUniversityathlete
KeishanaWashington
basedonphotograph
bySteveBoyle.
BUILDING A
BETTER
ATHLETE
Here are some emerging innovations in sports medicine, based on
research at medical centers and university laboratories.
By Robert Lee Hotz and Kevin Hand
BONE
3D-Printed Implants
New treatments are on the horizon for tennis elbow. Advances
in 3D printing are allowing medical researchers for the first
time to replace ligaments and tendons with implants made
from the patient’s own cells, instead of donor cadaver tissue,
which could speed recovery. Scientists at Rice University and
the University of Maryland have created mesh-like scaffolds
that replicate the physical characteristics of the hard bone that
supports cartilage on the ends of long bones. Injuries to these
bones, from small cracks to chips, can end an athlete’s career.
The Rice team printed an experimental scaffold with a porous
ceramic material that allows the patient’s own cells and blood
vessels to grow into the implant, eventually allowing it to be-
come part of the natural bone and cartilage.
JOINTS
Better Shoulder Surgery
Injuries of the rotator cuff, a group of mus-
cles and tendons around the shoulder joint,
are common among baseball pitchers and
others. In the worst cases, the tendon tears
completely from the bone and, even after
surgery, does not readily reattach. Scientists
are developing implants made from living
tissue that can support cell growth while
the damaged tendon heals, giving the tissue
more time to grow into porous bone and
form a bond. University of Connecticut re-
searchers said they tested a polymer mesh
seeded with stem cells to restore torn rota-
tor cuffs in animals; the tendons wrapped
in fabric were stronger, with a cell structure
that looked more like undamaged tissue.
DIGESTION
Beneficial Bacteria
The microbiome—the collection of gut
microbes that help digest food to regu-
late the body’s energy—of elite cy-
clists, rugby players and marathon
runners may have characteristics
that boost metabolism, the immune
system and brain function, according
to recent research. This, in turn, im-
proves athletic performance and re-
covery. These beneficial bacteria could
enhance athletic performance among
the general population through probiotic
nutritional supplements.
TENDONS
Tissue Scaffolding
Athletes who tear or rupture their Achilles tendon risk
ending their careers. New treatments in the works in-
clude injectable gels composed of collagen and experi-
mental proteins called growth factors that stimulate
cellular growth. Researchers at Northeastern University
are working on a fabric of collagen that can be
wrapped around a damaged tendon, holding the restor-
ative gel in place. Others are experimenting with injec-
SKIN tions of donated placental tissue.
E-tattoos
Sensors printed on skin like tat-
toos may soon give athletes real-
time information about perfor-
mance. Such e-tattoos are soft,
ultra-thin, stretchable circuits that
could monitor activity during
workouts or competitions. Tattoos
may also monitor heart rate,
blood pressure, cholesterol levels
and other vitals. In February, re-
searchers unveiled a non-toxic
emulsion that can be painted onto
skin and sense strain and move-
ment. Researchers in the U.S. and
China have developed low-cost e-
tattoos that can measure the
heart’s electrical activity, skin
temperature and skin hydration.
CARTILAGE
Micro-Robot Delivery
The global sports-medicine market is dominated by damage to the knee,
the most commonly injured joint among young athletes. As an alterna-
tive to conventional surgery, orthopedics specialists are experimenting
with regular injections of stem cells cultured from a patient’s own bone
marrow, fat tissue or blood to rebuild injured cartilage. The experiments
involve multiple needle jabs, which can be damaging. Researchers in
South Korea, Switzerland and China said they demonstrated in animals
that micro-robots carrying stem cells can be safely steered through veins
and arteries to damaged knee cartilage by using non-invasive magnets,
enabling treatment with a single injection. In other experiments, re-
searchers from Duke University created a 3D-printed hydrogel that sur-
passes both the compression strength and elasticity of natural cartilage.
BRAIN
Brain Boosters
Researchers are working on dozens of
drugs that might one day help ath-
letes play smarter. Also promising
are non-invasive magnetic and
electrical fields that might tempo-
rarily affect brain activity to
boost performance, including
transcranial magnetic stimula-
tion, right. The techniques are
highly experimental, but stud-
ies of cyclists and other ath-
letes suggest that such stimu-
lation can improve strength
and motion perception and re-
duce fatigue. Researchers are
testing whether it could also
improve how well ski-jumpers
perform in competition or
speed reaction times
and reduce trem-
ors—helpful in golf.
GENES
Muscle Growth
The World Anti-Doping Agency in 2003
banned “gene-doping,” or the use of genetically
modified cells, DNA-altering drugs or gene-editing
to enhance performance. Evidence suggests that
many world-class athletes naturally possess perfor-
mance-boosting genes. Scientists have identified more
than 200 variants associated with athletic prowess. One
increases the production of red blood cells, which can
boost an athlete’s oxygen-carrying capacity. Another is
associated with greater endurance. There’s no evidence
that Olympic athletes are gene-doping. Those from the
2016 games gave tissue samples, which will be tested for
genetic enhancement as soon as a reliable test exists.
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THE FUTURE OF EVERYTHING |SPORTS