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Paper predicts bioengineering future

Over the next 25 years, the development of more sophisticated biomedical devices will revolutionize the diagnosis and treatment of conditions ranging from osteoarthritis to Alzheimer's disease, according to MIT professors in an article in the February 7 issue of the Journal of the American Medical Association (JAMA).

The MIT article was also one of three from the issue to be featured at a February 6 media briefing on "Opportunities for Medical Research in the 21st Century." It was selected from among 24 in the special theme issue.

In the article, Associate Professor Linda G. Griffith and Professor Alan J. Grodzinsky explored the recent history of biomedical engineering and made projections for the future of field. Dr. Griffith presented the article at the New York media briefing, which was a collaboration between the Albert and Mary Lasker Foundation and JAMA.

"The most visible contributions of biomedical engineering to [current] clinical practice involve instrumentation for diagnosis, therapy and rehabilitation," wrote Professors Griffith and Grodzinsky. Dr. Griffith has positions in the Department of Chemical Engineering and the Division of Bioengineering and Environmental Health (BEH). Dr. Grodzinsky is director of the Center for Biomedical Engineering and a professor in the Department of Electrical Engineering and Computer Science and the Department of Mechanical Engineering.

Biomedical engineering is broadly defined as the application of engineering principles to problems in clinical medicine and surgery. A revolution in disease diagnosis began in the 1970s with the introduction of computerized tomography, magnetic resonance imaging and ultrasonic imaging.

The field also has been responsible for the development of new therapeutic devices such as the cochlear implant, which has helped many hearing-impaired people in the United States experience dramatic improvement. Cardiovascular therapy also has been changed by the introduction of life-saving implantable defibrillators in the 1980s. In addition, vascular stent technology for the treatment of aneurysms, peripheral vascular disease and coronary artery disease has made it possible for minimally invasive procedures to replace major surgery.

"Cell and tissue engineering also has emerged as a clinical reality," the authors wrote. "Products for skin replacement are in clinical use and progress has been made in developing technologies for repair of cartilage, bone, liver, kidney, skeletal muscle, blood vessels, the nervous system and urological disorders."

At the same time, biomedical engineering is undergoing a major ideological change. "The fusion of engineering with molecular cell biology is pushing the evolution of a new engineering discipline termed 'bioengineering' to tackle the challenges of molecular and genomic medicine," the authors wrote. "In much the same way that the iron lung (an engineered device) was rendered obsolete by the polio vaccine (molecular medicine), many of the device-based and instrumentation-based therapies in clinical use today will likely be replaced by molecular- and cellular-based therapies during the next 25 years."

Professors Griffith and Grodzinsky expect to see continued growth and development in the field of biomedical engineering, resulting in new diagnostic and treatment options for patients. "In the next 25 years, advances in electronics, optics, materials and miniaturization will push development of more sophisticated devices for diagnosis and therapy, such as imaging and virtual surgery," they wrote.

They suggest that the new field of bioengineering will give rise to a new era of "lab on a chip" diagnostics, enabling routine and sensitive analysis of thousands of molecules simultaneously from a single sample.

"A potentially even greater impact of bioengineering will result from the increased ability to incorporate molecular-level information into complex models. The result will be a revolution in diagnosis and treatment of diseases ranging from osteoarthritis to Alzheimer disease," they wrote.

"Either by looking for single-signature molecules (e.g., cancer antigens) or by using appropriate algorithms to derive relationships between many interacting molecules, early prediction of onset of disease may be possible," they continued. "For example, osteoarthritis might be detected just when cartilage degradation begins and before damage is irreversible; Alzheimer's disease might be detected in early adulthood when it is believed lesions might first form and before cognitive decline."

"In each case, new drugs developed with the aid of molecular and cellular engineering will likely be available to combat disease progression," they concluded. "For osteoarthritis, these advances would obviate the need for joint replacement surgery... For Alzheimer's disease, which lacks current therapeutic options, the impact of bioengineering will be extraordinary."

A version of this article appeared in MIT Tech Talk on February 14, 2001.

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