By Kyrie O’Connor
The heart is a ghost.
Here it is, suspended in a glass container called a bioreactor, not just bled out but stripped of its cells so that all that remains is the fist-sized collagen hull that forms its architecture — white and nearly translucent. You can’t even tell it once beat inside a pig.
Doris Taylor, Ph.D., the director of regenerative medicine research since 2012 at the Texas Heart Institute of CHI St. Luke’s Hospital, is in charge of this heart and others.
Someday she wants to introduce human stem cells into the scaffolding and grow a human heart that will beat in a human body.
The numbers for heart failure are huge and growing, with some 5 million cases in the U.S. and a half-million more diagnosed every year.
Hearts available for transplant number in the low thousands.
Interest in this research is as high as the demand. If you use the patient’s own stem cells, Taylor says, just imagine: no transplant from a dead person, no fear of rejection, just the patient’s own heart created anew.
Taylor is at the forefront of this area of research, and everything about her life marks her as an iconoclast — from her childhood in Mississippi to her unwillingness to approach scientific questions conventionally.
Her approach could best be described by her favorite painter, the Catalan surrealist Joan Miro: “The works must be conceived with fire in the soul but executed with clinical coolness.”
The fire in the soul is evident when Taylor talks about stem cells. Get her rolling on this topic, and her liquid brown eyes shine. “It’s very cool, the stuff we’re doing,” she says.
Taylor believes in stem cells — not that they are the answer to all of medicine’s questions, but that they hold secrets humans are just beginning to untangle.
Stem cells are found both in very early-stage embryos, called blastocysts, and in adults, in the bone marrow and elsewhere. Stem cells are capable of dividing over and over and of developing into various types of cells, sometimes as agents of repair.
Taylor has found that they behave in ways that cannot yet be explained.
A group of women with heart disease, for example, was divided into thirds. One third got acupuncture. One third got sham acupuncture. One third were promised acupuncture and put on a waiting list. When tested, the third who received acupuncture produced more circulating stem cells. Exercise, too, seems to make people produce more stem cells.
And in an admittedly tiny study, the interpreter for the Dalai Lama, a Tibetan monk, was tested before and after he meditated on compassion for 15 minutes. Afterwards, he had a 40 percent increase in circulating stem cells.
“All the things people told us to do all our lives mobilize our stem cells,” says Taylor.
The mysteries of stem cells extend to gender as well. Women, Taylor says, have more robust stem cells and retain them in greater quantities for more years than men do.
The differences between men and women — always a touchy subject — come into play often in Taylor’s work. For years, and for complicated reasons, many clinical trials have included only a small number of women, or none.
“There are some data that say women do not enroll in clinical trials as often as men,” Taylor says, “and women opt out of trials more often.” They cite family more often as a reason to opt out. “Until women are included in studies we won’t really understand if they’re different and how different they are,” Taylor says.
Taylor’s work on the differences between men and women — specifically in the area of stem cells and hearts — earned her a segment of “60 Minutes” last year. (Men’s hearts, relative to women’s, are squishier.)
Taylor wasn’t always a star. In fact, she wasn’t even supposed to live.
She and her twin brother, together, weighed less than 4 pounds at birth. No one thought they would survive, but both fooled the experts. Her brother, however, was born with cerebral palsy.
After Doris’ father died when she was 6, she grew up in rural Mississippi. (Early in life, she lived in Germany. Her parents met in Japan.)
She and her two siblings grew up surrounded by books and by a sense that the world was much larger than what could be seen from the doorstep. College was a fact, not an option. “I was always told I could do or be anything I wanted to do or be,” Taylor says.
‘Made a big splash’
Nevertheless, she grew up well aware of the stereotypes of Mississippi. When she went to a science symposium in New York as a high school student, another kid asked her if she wore shoes. No, she said, but there’s a special store at the airport where Mississippians buy shoes when they go out of state. “I learned how ridiculous people are,” she says.
She is private about personal details. She describes her age as “in the fives.”
Her background helped lead Taylor to regenerative medicine. “Growing up in the South, or maybe it was me, I always wanted everyone to have an equal chance,” she says. “Regenerative medicine is the epitome of that.”
Always a voracious reader, Taylor fell into pharmacology — her doctorate is from the University of Texas Southwestern Medical School in Dallas — partly because of the polysyllabic words like “sympathomimetic,” which refers to drugs that imitate transmitters in the sympathetic nervous system.
After Dallas, she did some post-doctoral work at Albert Einstein College of Medicine in the Bronx, where she became interested in gene therapy and cardiac cells. Some 25 years ago, this was a bit out there as a research topic.
“There were a lot of strong personalities in the lab when she was there,” says her mentor, Leslie Leinwand, now a professor of biology at the University of Colorado. “We were both from the South, and there was a lot of overlap in the way we looked at the world.”
That early work, Leinwand says, planted the seeds for the scientist Taylor would become. “I’m not surprised she made a big splash in the world.”
From New York, Taylor moved to Duke University Medical Center in North Carolina, where she became an associate professor of cardiology.
In 2003, she became director of the center for cardiovascular repair and professor at the University of Minnesota. There, in 2008, she and her team used stem cells to regenerate a pinkish-red, beating rat heart.
In 2012, she was recruited to the Texas Heart Institute.
“She’s very creative and very enthusiastic, and her goal is a great one,” says James T. Willerson, president of the Heart Institute. “A lot of people are working very hard to that end,” he adds, that end being a completely regenerated human heart.
“She’s been able to deplete the cells of almost every organ of the body,” Willerson says. “An organ will be glistening, pale, listless and dead, and she will restore the function with selected stem cells.”
That perfect heart is still in the future, but Taylor’s curiosity is very much in the present. Doctors were doing regenerative medicine long before they knew they were.
Bone marrow transplants began in the ’60s. “We’re finally catching up,” she says.
Her overall goal is to “manipulate endogenous repair,” to phrase it polysyllabically, or “give nature the tools and get out of the way,” as she also puts it.
Meanwhile, she is asking the big questions: about whether aging can be treated like a chronic disease; about the relationship between stress and aging; about what makes a cell alive; about how men and women differ at the cellular level; about the role of, say, meditation in healing; about how humans can, if not live forever, at least live better.
“The future is not just treating everything ad nauseam with stem cells,” she says. “The future is understanding what the processes are and how to manipulate them.”