By Whitney L.J. Howell

For many young people, aerospace engineering and a likely Air Force career would be an exciting, enticing option. But, Lori Setton wanted more.

Instead of using her math and science training to concentrate on military tactics and targets, Duke University Pratt School of Engineering’s William Bevan Professor of Biomedical Engineering opted for a biomedical engineering doctoral program that concentrated on the spine.

“Biomedicine is a wonderful vehicle for those interested in science and math who want to do something truly productive with their energy,” she said. “And, from an engineer’s perspective, the spine is fascinating.”

The spine, she said, is the body’s largest tissue structure that contains no blood or lymphatic structures. It can’t self-repair, but it manages to survive for an individual’s lifetime without failure. Initially, Setton wanted to reverse engineer the spine, but when the Coulter Foundation came to campus, she pivoted to applying her knowledge in a functional way. Ultimately, she focused on using stem cells to roll back the effects of degenerative disc disease and pain.

“This type of pain is an aspect of aging that we must understand,” Setton said. “It’s particularly important now that pain has become the greatest contributor to disability in the United States.”

Together, with faculty collaborators, Setton developed an innovative biomaterial designed to effectively deliver a booster shot of cells to the jelly-like cushion naturally found between spinal discs. That tissue distributes pressure and provides spine mobility. It also helps relieve pain in the neck and lower back that can lead to herniated discs, osteoarthritis, and spinal narrowing, called spinal stenosis.

The gel, that mixes together a protein and hydrogels, introduces immature, pluripotent stem cells to degenerated spinal areas. The team tested the gel in rats by tagging it with a bioluminescent biomarker and injecting it into degenerated areas of the tail. They watched where the gel collected, and results showed 30 percent of it stayed in place, relieving pain.

Although the results are early, she said, they could have a positive impact on future cell therapies. More work must be done, though, to identify and understand the characteristics of patients who might one day benefit from this type of treatment and those who are unlikely to get better even with intervention. As a result, Setton and her team plan to focus more on pain and less on anatomical reconstruction as they move forward.

And, it’s the environment at Duke that encourages faculty and researchers to take their investigations to the next level, transitioning their bench work into clinically-applicable therapies. Doing so is a priority for the University’s many funding support programs and institutes, she said.

“Through the Coulter Foundation and the infrastructure established by the Duke Translational Research Institute, Duke has created an environment on campus where it’s okay to do translational work,” Setton said. “It’s good to do it.”