A unit of the Department of Health and Human Services recently made grants to four academic and industry teams to do miracles, enabling the blind to see. The awardees will work on technologies to enable the transplantation of the human eye. Calvin Roberts, program manager for the Advanced Research Projects Agency for Health, joined the Federal Drive with Tom Temin for details.

Interview transcript:

Tom Temin: And this sounds like maybe the last frontier in transplantation. Tell us more about what it is you’re trying to accomplish here.

Calvin Roberts: Well, we transplant hearts. We transplant lungs. We transplant livers. We transplant kidneys. We transplant skin. We transfuse blood. Why don’t we transfuse eyes? Why don’t we transplant eyes? And the reason why we don’t transplant eyes is because eyes are nothing more than the interior extension of your brain. And so what we would need to do in order to be able to successfully transplant eyes is very similar to what we would need to do in order to transplant other parts of the central nervous system. So what we have to learn how to do is how to reconnect nerves. So how to take a nerve from one person, transplant it into another person so that the signal that’s coming through that nerve can get received by the recipient. And the brain can process that information for what we call sight.

        Get tips on how your agency should tackle the data pillar of zero trust in our latest Executive Briefing, sponsored by Varonis.

Tom Temin: Sure. And is there some characteristic of optical nerves that are different from other nerves in the body?

Calvin Roberts: So that’s the beauty that the message, as carried by my eyes, is exactly the same as would be carried by your eyes. So there’s a universal language that eyes use to speak to the brain. And so that’s why I believe that this is possible, that if we can get the nerves from the donor to send the signal to the recipient brain, then I’m very confident with the concept that the recipient is going to be able to see.

Tom Temin: And these contract awards that you recently issued, three of them are academics and one looks like a corporate recipient. What are the particular technologies or what is it you expect them to do here?

Calvin Roberts: We’ve broken down this whole program into three technical areas. And so the first technical area is harvesting the donors because that and I can only survive for minutes after the blood supply stops. And so they were going to figure out how are we going to harvest these donors. At the same time, say, as they’re taking out the hearts or the livers or the lungs for other purposes, how are we going to be able to harvest these eyes and keep them alive and viable for as long as it takes until they’re able to have the surgery, which could be as long as 24 hours. The second technical area is the one that we’ve talked about already, which is how are you going to reconnect the nerves so that the signal from the donor gets received by the recipient and therefore interpreted as such. And then the third technical error is the actual surgery. And so how are you going to connect not just the nerves, but the muscles and the blood vessels and then how are you going to keep these eyes from rejecting? Because like other organs, these eyes could reject. And how are you going to know that this is actually working? Because the restoration of sight is not going to be days or weeks is going to take months. And during that period time, how are you going to know how this is healing? So we’re going to have to develop new techniques to evaluate and watch at a cellular level how this is healing. So these first four contracts that we have already announced, two of them, the one to University of Colorado and the one to Stanford is going to look at all three of these technical areas and putting together the whole picture. But the other two, the one to the Bascom Palmer Eye Institute and the one to InGel. And what they’re going to look is just parts of it. So the Bascom Palmer team out the University of Miami, they’re going to look at the harvesting problem and keeping these eyes alive. And the InGel group, they’re going to look at how you can actually create scaffolding or other ways to promote nerve growth so that the nerves learn how to grow and grow in the right direction and grow properly.

Tom Temin: We’re speaking with Dr. Cal Roberts. He’s a program manager for Health Science Futures at the Advanced Research Projects Agency for Health. And just a detail question. If a person’s blindness is the result of the optical nerve itself and not say something in the eyeball, then a spinoff benefit could be repair of someone’s optical nerves with their eyes in their head already.

Calvin Roberts: So understanding how nerves work and how nerves repair is truly a secondary benefit because we want to learn from fear, not just the simple idea or the complicated idea of how you transplant eye, but actually understand better how it is that nerves grow, how nerves repair and consequently come up with new therapies that can have broader applications in this whole area of nerve repair and regeneration, even broader than just what we’re trying to do with transplanting eyes.

Tom Temin: Sure. Yeah, like standing up again for people that might have a spinal injury, I think isn’t that one of the holy grails of nerve research?

Calvin Roberts: Absolutely because while vision may be different than feeling or walking, the nerves are the same. And so if you can get the nerves to repair, then the applicability is so broad. And those of us who work in eyes and work in vision, what we love about our area is that we are the one part of the central nervous system that is truly at the surface. And so only in your eyes can you actually look at a part of your brain. And so you don’t need a machine or an X-ray or an MRI or something in order to see what you’re doing. You can actually look at a part of your brain. That’s why those of us who do vision research, we love working on eyes because the applicability of what we learn from the eyes is so wide and so broad, and there’s so many other ways that information can be used.

        Read more: Federal Drive

Tom Temin: And how do you or ARPA-H envision this moving from research to testing? How on earth would you possibly test a thing like this if some of the technology seemed to gel together?

Calvin Roberts: We will start out with small animals and being able to transplant eyes in small animals. When that’s successful, we’ll go to larger animals and only when we have shown that we can effectively transplant an eye in a large animal and restore sight, only then would we even consider possibly going to humans.

Tom Temin: And there have been pig hearts, I think, bovine hearts put in people and different things. We’re only talking about human to human in this case.

Calvin Roberts: In this case, we’re only talking about humans to humans, but we are talking about pigs to pigs. And so that’s how we’re going to learn how to do this.

Tom Temin: All right. And tell us more about your background. You’re an ocular type of guy to begin with. How did you come to this particular really esoteric work here?

Calvin Roberts: Yeah, so I’m an eye surgeon and I’ve spent my whole career transplanting parts of the eye. In most cases, the cornea. And a lot of people have heard of a cornea transplant. And what the cornea transplant is just taking a very small part of the eye, the front clear window that is in front of the colored part of your eye. And so just taking that cornea and transplanting corneas. I have to tell you that through my career of doing this, patients have always said to me, ‘Doc, why are you just transplanting my cornea? Why just give me a new eye?’ And then you have to explain to the person, ‘Well, the reason why I can’t give you a new eye is because you have to reconnect the nerves and things like that. No one knows how to be able to do this.’ And when the opportunity came at ARPA-H to do something that’s really hard, but something that could be really exciting with broad implication, I ran at this opportunity to be able to now take what I’ve learned through many years of doing cornea transplants and now be able to look at this much bigger issue of how you could transplant not just part of the eye, but transplant the whole eye.

Tom Temin: Question on some of the physics here, when you say correct cross-eyed in this, the doctor disconnects the muscles that control the eye movement and reconnects them. That’s mechanical, almost like reattaching an ACL or something in the knee. When you get nerves to talk to one another again, that sounds like something more molecular and less surgical. Is that makes sense?

        Sign up for our daily newsletter so you never miss a beat on all things federal

Calvin Roberts: Yeah. So both because what you do, you have to physically get the nerves to grow and to reconnect. But there’s this messaging and how this messaging occur. The messaging occurs is the use of transmitters and functional chemicals within nerves that make them work and make them function. So yes, there is the physical of getting one end of the nerve to the other end. And then it’s also the growth in the function of nurse.

Tom Temin: And while we have you, there’s another project going on at ARPA-H, the OCULAB. Tell us a little bit about that.

Calvin Roberts: So for years, doctors have wondered how can you continuously monitor someone’s blood, not just take it once, but to know what’s happening within your bloodstream all the time? And so multiple attempts have gone to continuous monitoring of blood, unsuccessfully. But I have a different way of looking at this problem because your tears are manufactured from your blood, so your tears are just part of the plasma of your blood and many of the same factors that are in your blood or in your tears. And so how about if we could monitor in your tears what’s happening in your blood? And so what I foresee are this microsensors that can sit in the tear ducts of your eye. And as your tears go by, they’re going to measure what’s happening in the tears indicative of what’s happening in your blood. The result of that is the doctors will have a much bigger idea of what’s happening in you because they’re not just getting a snapshot of one moment when they drew the blood, but actually getting a picture of what’s happening within your body 24 hours a day, seven days a week. The more information that you have, the more accurate you can be with your diagnosis and with your therapy, which makes medicine more precise and personalized.

Tom Temin: So you believe then there’s the ability to make something so small it could be in the tear duct and yet give that amount of data?

Calvin Roberts: Absolutely. This is the frontier with these microelectronics. And so we’re looking at a sensor that might be one millimeter by two millimeters smaller than a grain of rice. And it’ll sit there and it’ll measure multiple things that’s going on in your body 24 hours a day.

Tom Temin: So this would be external to the tear duct, not inside your sinus somewhere?

Calvin Roberts: No, no, no. It would just be inside your lower lid. You won’t see it. You won’t feel it. You won’t know it’s there. And it could sit there for many months at a time.

Tom Temin: And what is the status of this? Do you have wards out to develop this type of thing going on now?

Calvin Roberts: Right. So we just we just announced the program recently and so now we’re asking for proposers to send us abstracts of how they would go about building such a sensor and how you would interpret the data. And so we’re looking forward to getting their initial abstracts by the end of January.

Tom Temin: Well, it sounds like an exciting frontier. We’ll have to keep in touch with this as the research proceeds.

Copyright © 2024 Federal News Network. All rights reserved. This website is not intended for users located within the European Economic Area.