Science Friday - First Citizen Spacewalk | First Successful Whole-Eye Transplant, Over A Year Later

Episode Date: September 13, 2024

SpaceX Crew Completes First Citizen SpacewalkBig news in the world of commercial space flight: On Thursday morning, Jared Iasaacman and Sarah Gillis, members of SpaceX’s Polaris Dawn mission, became the first civilians to complete a spacewalk. The mission is a collaboration between Elon Musk’s SpaceX and Isaacman, a billionaire tech entrepreneur. While outside the spacecraft, the two crew members conducted mobility tests on their spacesuits.SciFri Producer Kathleen Davis talks with Jason Dinh, climate editor at Atmos Magazine about this and other top science news of the week including deadly cholera outbreaks, germs at 10,000 ft, and Japanese eels that can escape a fish stomach through their gills.The First Successful Whole-Eye Transplant, Over A Year LaterIn May of 2023, there was a massive advance in the world of organ transplantation: the first whole human eye and partial face transplant. The man at the center of this procedure is 46-year-old Aaron James, who sustained significant facial injuries from a high-voltage work accident.At the time, it was unclear just how successful the operation would be. Previous tests in animals had resulted in shrinkage of the transplanted eye, if not outright rejection. But now, more than a year after the transplant, a new paper in the journal JAMA outlines the success of this first-of-its-kind operation. While James cannot see out of his new eye, there is blood flow, normal pressure, and a retinal response to light.Guest host Kathleen Davis speaks with Dr. Daniel Ceradini, director of research at NYU Langone’s Department of Plastic Surgery and first author of the JAMA study. They discuss the implications this success could have for the future of eye surgery, and the dramatic improvements in James’ quality of life.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

It's been more than a year since the first whole human eye transplant. It's always been considered kind of the holy grail for vision restoration. There was an exceptional amount of doubt and no one had any precedent for it. No one knew what was going to happen. It's Friday, September 13th. Ooh, spooky. And this is Science Friday. I'm SciFri producer Charles Bergquist.

There was a lot of doubt in the scientific community around the first transplant of an entire human eye. Would it be viable? Would it shrink significant? There were lots of questions because it had never been done before. Now, a new paper in the journal JAMA outlines the successes of this transplant and what it could mean for the future of eye surgery. But first, here's guest host Kathleen Davis with some of the biggest science news of the week. Big news in the world of commercial spaceflight. Early Thursday morning, two of the four crew members of SpaceX's Polaris-Dawn mission became the first civilians to complete a spacewalk.

Joining me now to fill us in on the details and bring us up to speed on other top science news of the week is my guest. Jason D.N., climate editor at Atmos Magazine, based in Washington, D.C. Jason, welcome back to Science Friday. Thanks for having me. Okay, so to start out, can you give us a quick refresher on the basics of SpaceX's Polaris Dawn mission? Polaris is this collaboration between SpaceX and a billionaire entrepreneur named Jared Isaacman, who bankrolled the project and is actually one of the crew members on board. The others include two SpaceX engineers and a former Air Force pilot.

This particular mission is historic for a couple reasons. First, as you mentioned, this is an all-civillion crew, and it's the first time a civilian is doing a spacewalk rather than, say, a NASA pilot. The second milestone is that it actually reached a historically high altitude. They ascended to 870 miles. above Earth's surface. That's about three times higher than the International Space Station, and it's the highest orbital altitude humans have reached since the Apollo Moon mission in 1972. Now, this is just the first of three Polaris missions, and the goal of all of this

is to develop the technology that SpaceX thinks they'll need to one day send people to Mars. So who are these civilian astronauts, and what did they do on their spacewalk? The civilian astronauts are Jared Isaacman, the billionaire, two SpaceX engineers, and a former Air Force pilot. And the spacewalk itself was pretty simple. On Thursday, the crew opened up the hatch and Isaacman, the billionaire, got out of the vehicle, did some tests on his spacesuit and got back in. Then one of the SpaceX engineers did the same thing. And then they closed up the shop, finished the mission all within two hours or so. So how is this spacewalk different from the ones done by NASA or other countries government-run space agencies? There have been quite a few spacewalks in history. A lot of them have been on the International Space Station, for example. And each one really has its own objective. A lot of the stuff on the space station is to do maintenance and assembly.

And this particular one was to test out these spacesuits that SpaceX thinks one day might lead to the ones that they'll send to Mars. So the civilian astronauts are continuing with their mission doing additional experiments, and they're expected to return to Earth in the next few days. So let's wish them the best of luck. And move on to our next story, which is also going to keep us high up in the sky for a little bit longer. Scientists have recently found germs some 10,000 feet up. I have a lot of questions. But first, what motivated scientists to look towards the sky for pathogens?

This is such an interesting study. So the scientists first got this idea based on this mysterious disease called Kawasaki disease, which causes fevers and rashes and sometimes heart attacks. It's not clear what causes that disease, but these researchers noticed that cases in Japan would surge when winds blew from northeast China. And when those winds got to California, cases surged there too. So these researchers flew their airplanes up to three. 10,000 feet in the air to catch those winds and see if there were pathogens up there.

And what they found was that there are actually hundreds of species of bacteria and fungi living up there. And they think they could have flown over 1,000 miles. These germs were alive. So the team actually grew them on a petri dish back in the lab. And about a third of them can cause disease in humans. This includes E. coli, C. diff, and Staphylococcus, for example. And so just to clarify, were these germs found in planes or like just an ambient space? They were just in ambient space. Basically, they flew the planes up there, opened up a little air funnel, and then filtered out what was in the air. Wow. Okay. So could germs so high in the sky really infect us down here on Earth? The evidence isn't strong enough to say that quite yet. That might not even be likely that diseases are spreading through the air this way.

the concentrations of microbes was really low, but the fact that they're up there at all and they're traveling such long distances is enough to concern some scientists that diseases could spread around the globe as these airborne germs fall back to Earth. The researchers are actually working on follow-up experiments now, seeing what happens to human lung cells when they're exposed to this cocktail of high-altitude microbes, but as of now, it's not clear or even likely that these airborne germs are caused. causing or spreading disease. Okay.

Our next story, we're going to stay up in the clouds for just a little bit longer. Some new research shows that cities are rainier than their surrounding areas. What is going on here? You've probably talked a lot on this show about the urban heat island effect, the idea that cities are hotter than their rural neighbors. And this is a newly discovered variation of that. Scientists have now found evidence for an urban rainfall island. by analyzing two decades of satellite data from over a thousand cities, they found that

cities get significantly more rain than nearby rural areas. How much more varies between cities, but this is really a global phenomenon. Two-thirds of the cities in the study got more rain than their rural neighbors. Do scientists have any idea why this is happening? There are a couple of reasons. So first, skyscrapers can actually slow down storms that come through. Yeah, air pollution can also seed clouds, which can then, you know, pour down rain. And then there's heat from concrete and asphalt that can move air around the atmosphere in a way that promotes precipitation. Okay. Super interesting stuff. So our next story is about a disease that we don't think about that much here in the U.S., and that's cholera. A new report from the World Health Organization showed deaths from cholera soared last year.

Tell me a little bit about what they found. You're totally right that most of us haven't thought about cholera being a big problem since, say, the 1800s when modern water treatments arose. But this analysis from the World Health Organization suggests that last year we might have taken a step back. They found that in 2023, there was a 13% increase in cholera cases and a 71% increase in cholera deaths worldwide. Just to jog your memory on this, cholera is a bacterial infection that, spreads through contaminated food and water. It causes diarrhea, dehydration, and it can be fatal. And it typically affects lower income countries and places where people can't access clean drinking water. The most tragic part about this finding is that cholera is pretty straightforward and cheap to treat.

All it takes is a bag of IV oral rehydration salts, maybe some antibiotics, but a lot of people in the world today still can't even access that level of medical care. So even though it is so easy to treat, why is this still happening in this day and age? Yeah, 2023 in particular was interesting. The WHO says that the cases were actually rising because of climate change and the political conflict we saw throughout the year. So, for example, in southern Africa, we saw extreme storms and droughts that led people to use less safe water sources like boreholes or rivers. And in Sudan, there was a cholera outbreak because a civil war is driving one of the world's worst humanitarian crises. You know, 10 million people have been displaced. They're being packed into camps without proper sanitation to have food and safe drinking water. It's also worth noting that there is a cholera vaccine, but there's just not enough supply to meet the demand.

Only one company in the world manufactures them. And last year, there weren't even enough doses to get them to at-risk places like Sudan or Gaza. Okay, let's move on to our next story. I want to give a little bit of an update about something that we talked about on last week's show, Voldemir, the beluga whale that may have been a Russian intelligence agent, was found dead off the coast of Norway. We mentioned last week that two animal rights groups said that the whale was shot. Police now say that there was no evidence of gunshot wounds. What is the latest on this whale, Jason? All in all, if you are concerned, about animal cruelty, this seems like good news. Based on a forensic exam, the Norwegian police

concluded that human activity did not directly kill Waldemir. They say he died after a 14-inch stick got stuck in his mouth, and that could have prevented him from eating and could even explain why his stomach was empty when he was found. There were some superficial injuries, but they said there was no evidence that Waldemir was shot. So they're ending their investigation, and they're going to publish a full report on everything they found in about two. weeks. Well, rest in peace, Voldemir, those tricky sticks can get anybody. So our last story is a wild story about the ability of eels to escape predators. What are these eels up to, Jason? Yeah, if you can count on me for anything, Kathleen, it's bringing you a story about an animal that's just

so metal. So this study was published in the journal Current Biology, it showed that Japanese eels can escape the stomachs of their predators after they've been eaten. They swim back up the fish's digestive track into its esophagus, and then they slide themselves tail first out of the fish's gear. You might be wondering, you know, how can you tell what's happening inside of this fish? Well, they actually use these really neat X-ray videos, which you can watch online. They did 32 trials where they fed an eel to a fish. then they anesthetized the fish and put it under their x-ray video rig.

And they saw that 28 of those 32 eels tried to escape. Nine of them actually made it out. Of course, there were quite a few failed efforts. A few got stuck in the gills. A few went the wrong way and stuck their tails through the waste hole instead of the esophagus. But really the key to succeeding was speed. The eels could only survive three minutes in the fish's stomach before, you know, it got cooked by the digestive fluids and the ones that escaped got out within one minute. Jason, it's a good thing

you can't see my face right now because I am making quite a grimace. Jason, that's all the time that we have for now. Thanks so much for joining us. Thanks for having me. It's always a pleasure. Jason Din, climate editor at Atmos Magazine based in Washington, D.C. Last year, there was a massive milestone in the world of organ transplantation, the first whole human eye, along with a partial face transplant. At the time, it was unclear how this operation would go. There had never before been a successful transplant of an entire human eye. Now, more than a year later, a new paper in the journal JAMA discusses the success of this first-of-its-kind transplant and the implications this could have for the future of eye surgery. Joining me now is that study's first author. Dr. Daniel

Charadini, Director of Research at New York University Langone's Department of Plastic Surgery, Welcome to Science Friday. Thanks so much for being here. Yeah, thanks for having me. So let's start here by talking about the man who's at the center of this story. Aaron James, who received this transplant. Tell me a little bit about him. So Aaron James is a veteran, he's an Army veteran who is working at his job. He works on high voltage electrical poles.

And during one of his job assignments, he was unfortunately came in contact with a high voltage electrical wire, which caused significant injury to his face in one of his arms, and he was airlifted from the site to a specialized regional center for acute care. The high-voltage electrical injury damaged the lower half of his face, his eye, his nose was gone, and he couldn't move his jaw. So he couldn't eat properly, couldn't smell, therefore it couldn't really taste anything. And so it markedly impacted his quality of life. And so, you know, after recovering from these injuries, he presented to our multidisciplinary

clinic at NYU, where he was evaluated for a face and potentially an eye transplant. So walk me through just how extensive this transplant was that you and your team performed. So as with most face transplants, it's a pretty complicated procedure. The transplant that Aaron had basically replaced mostly the left side of his face and a little bit of his temple region, as well as parts of the right side of his face. In addition to that, because he had lost his eye, we replaced it with the eye from the donor. And so the tissues that were included, included skin,

the muscles that move or drive the face for facial expression, allow you to speak and express your motion, but also included the bones of the orbit or the eye socket, basically that support the eye and allow it to be stable enough to move and to function. We also took the nose from the donor to replace errand's damaged nose that was non-existent actually at that point and part of the chin to support the facial structures. So there was a lot of tissue involved. And then obviously also the eye and all the delicate musculature and the nerves and the blood vessels that supply the eye were also taken in the donor

algraft. And so this is my, it's my understanding that this was the first whole eye transplant on a human ever. Is that right? Yes, that's correct. It was the first successful reported whole eye transplant in humans. And so was there a lot of doubt that this would be successful? There was a ton of doubt. There was an exceptional amount of doubt and no one had any precedent for it. No one knew what was going to happen. I mean, we we have a lot of experience in facial transplantation and blood supply to the face and facial structure. So we're pretty confident in that aspect of things. But as far as the eye was concerned, it never really had been done successfully in humans. And it's always been considered kind of the holy grail for vision restoration. And so, you know, after a lengthy discussion with Aaron

and, you know, the whole informed consent process for a novel surgery is unique. And that we, we can't really offer like, we can offer reasonable expectations, but we can't offer any definitive data because it's never been done in a human before about how the outcomes would be. So we had some hope that we would get some sort of function in the eye following transplantation, but we really didn't know what was going to happen. And so why is it so hard? What are the biggest challenges with transplanting an eye? Well, the eye is, there's, the eye is obviously a very delicate organ. It's an extension of the CNS or the central nervous system. And so it contains nerves, particularly in the retina, which transdues signals from light and then converts them to an electrical

cycle and then transmits them through the optic nerve back to the brain. And so that delicate, nervous connection to the brain is really, really, really sensitive to injury and lack of blood supply. And so the process of transplantation, you're removing the entire allograph from the donor blood supply and it's outside the body for a certain length of time and that needs to be retransplanted and have circulation restored in the recipient. And so it's that window of having no blood. blood supply, it's kind of a race against time to prevent the nerves from dying. And so what is the status of Aaron's new eye now that we're more than a year after this surgery? So the status of his new eye is that's completely viable and something that, you know,

we had hoped would happen, but what did happen, is retina has complete profusion, which means the blood supply supplies all parts of the retina, as we would have hoped. In addition to that, his eye actually, when you shine, light into it, it converts it to an electrical signal, which is really huge, is a huge step for bringing eye transplantation for vision restoration to a reality. And so it generates an electrical signal. And based on preliminary data, it may communicate with the brain. It's very preliminary, though. So I can't really definitively say whether that is actually happening in Aaron or not. I can tell you that he does not have sight in his eye. But again, since this has never been done before,

there's no precedent for it in humans. It's unclear when or how or how long it will take or something to happen on the order of him or getting at least light perception. So even though Aaron can't see out of his new eye, you are still considering this a success, right? Well, it's definitely a success in the sense that it's kind of a milestone procedure in order to kind of move the whole field of site restoration through transplantation forward. It's the first time that we've successfully gotten the eye to live, so to speak. with a living retina, and not all the cells of the retina survived, but some of them did. And so that's hopeful and will be a platform to build on to incorporate other innovations in science

to maintain the optic nerves so that they survived the transplant. And so in that sense, I consider it a success for sure. Do you have hopes that this eye might actually regain some of the abilities that have been lost? Is that even a possibility as far as? we know? I think it's a very remote possibility, to be honest. And we knew that going in. I think the kind of best case scenario would be for him to regain some sort of light perception, some very, you know, gross light perception where I can just sense the lights on or lights off. But I think to envision him being able to read text on a paper or something like that, but the transplanted eye is a little bit unreasonable at this point, again, but we have no idea what's going to happen. So the study of Aaron

and his transplanted eye over time is going to be very important to figure out how to make this happen. So as we've been talking about, this is a huge milestone. What does this success tell you about the future of eye transplants? I think the future is bright, no pun intended, that this is a platform, again, to build on. And so the technical challenges of actually getting the, blood supply to the eye, which is supplied by a very small artery, which is in a completely different circulation than the face, that technical challenge and being able to procure the alrograph from the donor safely without damaging all these structures was a huge technical milestone. And so having that as a platform to build on and incorporate things that help the nerve regenerate and

preserve it during the transplantation procedure, I think all these things are going to accelerate relatively quickly. Vision loss affects millions of Americans each year. So it seems like eye transplantation, if we can get it right, could be hugely beneficial. I mean, do you eventually see that coming into reality where this could be an option for people? Yeah, I see it as a reality. I just don't know what time horizon we're looking at. I think it's going to take a little bit of time because the optic nerve regeneration is going to be a critical step,

the next critical step that we need to solve. And while there are a lot of bright people working on it and we're collaborating with a lot of them, I think that is probably the key to getting this to actually be more of a functional more of a functional eye. But I absolutely believe that it's going to be a reality at some point. It's going to move in increments. Obviously, this is going to be limited to select populations first. And then eventually, hopefully in my lifetime, this will be available to people that

suffer from blindness for non-traumatic causes. So to me, it almost seems like this is a very multidisciplinary field. Like you have people working on the optic nerve side of things. You have the surgery side of things. I mean, what other components are in this that needs support to make this a reality? Well, even in our own study, we had, you know, we have ophthalmologists. We have, you know, we're plastic and reconstructive surgeons. We have transplant surgeons.

We have neurologists. We have radiologists that help us determine how and if the optic nervous is reconnecting. You can imagine that, you know, ultimately the basic science side or the translational science side of things is going to integrate into this platform. And so you'll have all the basic scientists that are at the Neuroscience Institute at NYU, for instance, all those basic science innovations can be more rapidly translated into humans now that we've actually done in humans. not, it's no longer just an animal, an animal model that you have to look at. And again, this will happen incrementally. It's not going to happen at lightning speed quite yet. But this, again, opens the opportunity for us to incorporate these into our protocol. So circling back to Aaron and his role in all of this, have you heard from him about how his quality of life has changed

since this procedure? Yeah. I mean, you know, obviously Aaron would be the best person to speak to about that, but every time we see him, he reports having a tremendous increase in his quality of life.

And we measure it objectively, but it's hard to do that objectively. I think it's more valuable to actually speak to him. But yes, he has related to us that he has a tremendous increase in his quality of life to the point where he's kind of recognizing

his algorithm as his own now and his face looks somewhat foreign to him. The fact that he should, can eat and smell and, you know, feel his face. All these things improve quality of life for sure. And even though he doesn't have sight, I think the surgery wasn't excessive in that sense as well, and that you really changed his life for the better, obviously. And as a recipient, you know, he takes on a certain amount of risk to do that. And the fact that he was willing to do this and be the first eye transplant recipient and allow us to learn from him is really a testament to his character.

Well, that is all the time that we have for now. I'd like to thank my guest, Dr. Daniel Chiradini, Director of Research at New York University Langon's Department of Plastic Surgery. Thanks so much for talking about this with us today. Thanks. It was great talking with you. And that's all the time we have for now. Lots of folks help make the show happen, including Sandy Roberts, Robin Casmer, Jordan Smudjik, George Harper, and many more. Next time, we talk about the battle over smartphones and schools, and what the research says about smartphone bands. For now, I'm Charles Berkwist. Thanks for listening.

Have a great weekend.