Biomimicry 101: Cardiovascular Medicine: Part 2: Cardiac Tissue Engineering and Other Novel Biomimetic Research

coronary-angioFigure 1: Coronary angiogram depicting adequate perfusion of the myocardium via the left coronary vasculature: the left main trunk branching out to form the left anterior descending and circumflex arteries. Among the areas of the heart that these arteries perfuse, the left-sided vasculature ultimately feeds – supplies oxygen to – the left ventricle.

Cardiovascular disease accounts for more deaths per year than all forms of cancer combined.

– American Heart Association, 2016

Given the complex yet interrelated structure and physiological design of the heart, we now center our discussion on biomimicry and bioengineering in cardiovascular medicine. First, we discuss multipotent and pluripotent stem cell therapy with respect to tissue engineering and regenerative science in cardiovascular research. Second, we expand briefly on the concept of cell plasticity related to cardiovascular medicine. Third, we point out the evolving role of protein therapy in cardiology, such as efforts to treat heart attack (i.e., myocardial infarction) by reprogramming/regenerating heart muscle cells (i.e., the cardiac myocytes). Fourth, we highlight a novel approaches to reperfusion therapy. Finally, we explore a variety of other biomimetic applications that have promising potential to impact cardiac and endovascular patient care.

When you ponder biomimicry, think design, intelligent design, and creation, but please don’t think evolution. And when considering biomimetic applications, let your imagination know no bounds.

Multipotent and pluripotent (induced pluripotency) stem cell therapy for tissue engineering and regenerative science in cardiovascular research

Cardiovascular disease (both coronary and cerebrovascular disease) accounts for more deaths per year than all forms of cancer combined (American Heart Association, 2016). Given that cardiomyocytes have a rate of turnover of 1% in youth to 0.5% in old age (Tchao et al., 2013), the heart is one of the least regenerative organs in the body. Currently, efforts remain ongoing for repopulating damaged/injured cardiac muscle tissue (the myocardium) via stem cell therapy (Naumova & Yarnykh, 2014). Moreover, it is often the case that tissue injury or damage results from ischemic events, such as heart attacks (also known as a myocardial infarctions). In fact, therapeutic goals and clinical outcomes driving much of the work behind regenerative cardiovascular research have to do with preventing the post-infarct heart from sliding into a low-functioning state of utility by regenerating the cardiomyocytes. One such approach gaining favor in recent years is the use of multipotent and pluripotent stem cells, as opposed to totipotent stem cells. Whereas totipotent stem cells are taken from embryonic tissue, multipotent and pluripotent stem cells (as well as induced pluripotency stem cells) are harvested from adult tissue and are less problematic to the recipient heart (Baldassarre, Cimetta, Bollini, Gaggi, & Ghinassi, 2018; Hirt, Hansen, & Eschenhagen, 2014; Purdom, 2007). However, because of the ability to perpetually divide, pluripotency is more advantageous with respect to the heart. Below we survey progress made in the use of pluripotent-derived cardiomyocytes. In addition, we review advances made in cardiac DTI that allow this non-invasive imaging technique to gain favor as the leading platform for the evaluation of infarct healing (via stem cell therapy) after ischemic injury in patients post-heart attack.

— Multipotent and (induced) Pluripotent Stem Cell Therapy —

With each ischemic insult that fully manifests as a heart attack, the myocardium will lose approximately one billion cardiomyocytes (i.e., the cardiac muscle cells) (Naumova & Yarnykh, 2014). What is more, such robust, immediate loss of myocardial tissue dramatically affects cardiac hemodynamics (including reduced cardiac output). Furthermore, after the initial ischemic injury, as well as the initial change in hemodynamics, a functional decline occurs over time (such as further reduced cardiac output) that can limit the physical capacity of a patient due to left ventricular remodeling. Such anatomical and physiological decline is termed heart failure. However, therapeutic strategies based on “patching” the cardiac muscle damage at or near the time of event onset (given that the patient is hemodynamically stable) by means of stem cell therapy can curb the detrimental progression of heart attack-induced heart failure, and this is especially the case with induced pluripotent-derived cardiomyocytes (Baldassarre, Cimetta, Bollini, Gaggi, & Ghinassi, 2018).

What do we mean when we say totipotent, multipotent, pluripotent, or induced pluripotent?

Totipotent – The state of a cell that is capable of giving rise to all types of differentiated cells found in an organism, as well as the supporting extra-embryonic structures of the placenta. A single totipotent cell could, by division in utero, reproduce the whole organism.

Multipotent – Having the ability to develop into more than one cell type of the body.

Pluripotent – The state of a single cell that is capable of differentiating into all tissues of an organism, but not alone capable of sustaining full organismal development. In other words, pluripotent stem cells can give rise to any type of cell in the body except those needed to support and develop a fetus in the womb.

Induced pluripotent stem cell – A type of pluripotent stem cell, similar to an embryonic stem cell, formed by the introduction of certain embryonic genes into a somatic cell, in which somatic cells are differentiated, mature cells. What is more, somatic cells are commonly referred to as “adult” cells.

Why pluripotent is important!

According to the National Institutes of Health website (n.d.):

In late 2007, scientists identified conditions that would allow some specialized adult human cells to be reprogrammed genetically to assume a stem cell-like state. These stem cells are called induced pluripotent stem cells (iPSCs). IPSCs are adult cells that have been genetically reprogrammed to an embryonic stem cell–like state by being forced to express genes and factors important for maintaining the defining properties of embryonic stem cells. Although these cells meet the defining criteria for pluripotent stem cells, it is not known if iPSCs and embryonic stem cells differ in clinically significant ways. Mouse iPSCs were first reported in 2006, and human iPSCs were first reported in late 2007. Mouse iPSCs demonstrate important characteristics of pluripotent stem cells, including expressing stem cell markers, forming tumors containing cells from all three germ layers, and being able to contribute to many different tissues when injected into mouse embryos at a very early stage in development. Human iPSCs also express stem cell markers and are capable of generating cells characteristic of all three germ layers.

Although additional research is needed, iPSCs are already useful tools for drug development and modeling of diseases, and scientists hope to use them in transplantation medicine. Viruses are currently used to introduce the reprogramming factors into adult cells, and this process must be carefully controlled and tested before the technique can lead to useful treatments for humans. In animal studies, the virus used to introduce the stem cell factors sometimes causes cancers. Researchers are currently investigating non-viral delivery strategies.

Non-embryonic (including adult and umbilical cord blood) stem cells have been identified in many organs and tissues. Typically there is a very small number of multipotent stem cells in each tissue, and these cells have a limited capacity for proliferation, thus making it difficult to generate large quantities of these cells in the laboratory. Stem cells are thought to reside in a specific area of each tissue (called a “stem cell niche”) where they may remain quiescent (non-dividing) for many years until they are activated by a normal need for more cells, or by disease or tissue injury. These cells are also called somatic stem cells.

— Bioengineering Applications of Engineered Heart Tissue —

  • Screening for drug discovery (i.e., pharmacodynamics) and cardiotoxicity testing
  • Cardiovascular disease modeling
  • Regenerative medicine: cell-based heart regeneration
    • Importance of avoiding arrhythmias
    • Immunological favorability
  • Evidence indicates that immunological tolerance to iPSC-derived tissues is favorable for utilization. Moreover, the evidence suggests that such tissues may actively participate in their own survival.

Examples of adult tissue-derived, pluripotent-derived stem cells

Cardiac progenitor cells naturally form functional, fully-fledged cardiomyocytes. However, harvesting suitable numbers of cardiac progenitor cells for the treatment of injured or failing myocardium is an insurmountable task via cardiac biopsy. For this reason, various adult stem cell sources have been identified from other human tissue, including bone marrow, adipose tissue, connective tissue, umbilical cord blood, and skeletal muscle. Notably, given these tissue types, stem cells induced from skeletal muscle present an intriguing opportunity for the treatment of debilitating myocardial ischemia that leads to myocardial infarction. In fact, stem cells associated with skeletal muscle cells are resistant to hypoxia, fibrosis, and easily achieve contractile characteristics (Tchao et al., 2013).

From myocyte to pluripotent-derived cardiomyocyte stem cell

Tchao et al. (2013) investigated the practicality of using human muscle cells (i.e., myocytes) for engineering cardiac muscle tissue by means of pluripotency induction given that cardiac and skeletal muscle share major transcription factors as well as sacromere proteins that are generally regarded as significant to either cardiac or skeletal muscle tissue but not both muscle types. In fact, skeletal muscle and cardiac muscle are known to have similar embryonic developmental pathways. What is more, according to Lewandowski et al. (2018), this similarity implies that skeletal muscle cells induced for pluripotency have what it takes to achieve greater myocardial development, compared to other tissue types, such as, for example, fibroblast cells from connective tissue.

The state of plasticity of a cell: review of Lewandowski et al.’s attempt to derive heart cells from muscle cells

In this section, we look closely at a study conducted by Lewandowski et al. (2018), who investigated the feasibility, significance, and practicality of cardiomyocytes derived from induced pluripotent stem cells of myogenic origin.

  • The work by Lewandowski et el. (2018):
  • Biochemical (regulatory) pathways and epigenetic memory
    • Importance of the Wnt signaling
    • Importance of the epigenetic memory
  • Morphological and functional properties, including electrophysiological analysis
    • Importance of mismatches between iPSC and native cardiac muscle cells
  • Paracrine effects
  • Study limitations

Cardiac muscle microarchitecture: innovative evaluation of stem cell therapy structural outcomes by cardiac DTI

Introduced in the mid-1990’s, diffusion tensor imaging (DTI) is a MRI technique capable of visualizing cardiac microstructure (Naumova & Yarnykh, 2014). One distinguishing feature of DTI is its ability to image fiber trajectories – a method known as tractography. Although tractography has been widely used in brain imaging (as well as musculoskeletal imaging), Sosnovik et al. (2014) recently published a landmark study showing the capacity of cardiac DTI tractography to characterize the integrity and spatial organization of cardiac myofibers in live mice after stem cell therapy for ischemic heart damage. According to Naumova and Yarnykh (2014):

The study [by Sosnovik et al. (2014)] establishes DTI as a new approach for assessment of the effect of stem cell therapy in a preclinical setting, in which it could prove whether cardiomyocytes derived from stem cells are actually aligned with host myofibers to regenerate heart structure and function. (p. 1720)

Furthermore, Naumova and Yarnykh (2014) stated the following:

Collectively, the present [study by Sosnovik et al. (2014)] and earlier studies have established the feasibility of DTI tractography in the human heart in vivo. However, a significant amount of work remains to translate this challenging technology to serial applications in clinical trial settings. (p.1721)

What is more, quality control protocols are a critical part of all imaging programs. With respect to protocols for cardiac DTI tractography, a dedicated phantom has only recently been developed that incorporates microtubules that allow the phantom to mimic the heart itself, specifically, the microarchitecture of the heart (Teh, Zhou, Hubbard Cristinacce, Parker, & Schneider, 2016). Testing of this phantom has been successful, and it is our conjecture that the device will help bring clinical trials utilizing serial cardiac DTI tractography a step closer to reality for assessment of the myocardium for patients with post-ischemic heart damage treated by regenerative stem cell therapy (preferably, pluripotent-derived cardiomyocytes).

Protein therapy in cardiology

Whereas protein engineering refers to various ways of modifying proteins, the benefit of protein therapy is its affinity for targeted interventions.

Protein-mediated paracrine effects identified through stem cell-derived cardiac muscle analysis, have spurred interest in protein therapy as a viable approach for cardiac muscle proliferation and myocardium repair (Jay & Lee, 2013).

Detecting artieral stenosis/occlustion: coronary angiography, coronary CT angiography, myocardial perfusion imaging, and reperfusion therapy and biomimicry

Conventional coronary angiography is the gold standard for detecting and treating coronary artery stenosis (Jiangping et al., 2013). Nevertheless, recent advances made in non-invasive, diagnostic methodologies, such as coronary CT angiography (with slice standards of 64 slices or greater) and myocardial perfusion imaging studies, are contributing to the earlier detection of the underlying pathology (i.e., earlier detection of coronary artery disease) (Gorenol, Schönermark, & Hagen, 2012; Tamarappoo et al., 2010). With respect to stress and rest myocardial perfusion imaging, according to Smith (2018):

If the coronary artery narrows less than 50% of the original vessel diameter, the effect on blood flow is clinically insignificant, but at 70% narrowing, blood flow is significantly affected during stress. During rest, the vessel must be narrowed 90% or more to reduce blood f low significantly. A cardiac event is not likely to be detected unless the coronary artery is narrowed to these degrees under stress or rest. Myocardial perfusion studies detect stress-induced myocardial schemia approximately 80% to 90% of the time, which is more sensitive than exercise electrocardiography at 60% to 70% sensitivity. This is because of the high rate of patients that undergo nondiagnostic exercise ECG tests because of baseline electrocardiographic abnormalities or inadequate stress.

What is more, a luminal stenosis at 70% to 80%, as assessed by coronary CT angiography, was correlated with electrocardiographic rhythm strips that revealed robust ST-segment depression (Lipinski, Morise, & Froelicher, 2002).

— Stents/Camouflaged Coating of Sugar —

Significant coronary artery narrowing is quantified as luminal narrowing at 70% or greater, although 50% narrowing is significant for the left main coronary artery (Bovin, Klausen, & Petersen, 2013). Given this percentage of narrowing (and the chronic nature of coronary artery disease), when cardiologists talk with patients and family members about reperfusion interventions, such as coronary artery ballooning and stenting, the discussion inevitably comes around to the likelihood of restenosis of treated vessels (including in-stent restenosis). One way to reduce the potential of in-stent restenosis, however, is a stent design that mimics the luminal lining of the tunica intima (the innermost layer of the coronary artery comprised entirely of endothelial cells) (Perez et al., 2009). In fact, such biomimetic-inspired stents have been modeled on the native coating found on endothelial cells of the tunica intima (i.e., the native glycocalyx). Production of these stents involves laser-etching technology that patterns the inside surface of the stent’s struts after these glycocalic fibers. This means that the surface area inside the stent effectually becomes camouflaged against vascular inflammatory and injury cycles that are associated with the patients’ coronary disease. The net-outcome for this design has reduced the body’s foreign body response to the stent.

monarch-caterpillar-cvcuFigure 2: The segmented structure of the monarch caterpillar has inspired a novel coronary stent concept that offers segmented movement relative to pulsatile blood flow through the coronary arteries, as well as movement related to the heart’s squeezing action.

— Stents/Dynamical, Flexible Cardionature and the Caterpillar’s Skeleton —

At rest, average heart rate is approximately 72 beats per minute, and with exercise, the typical range falls between 112 and 146 beats per minute. Therefore, we are clearly beneficiaries of the heart’s dynamical nature (including the constant movement of its surface) (Jiangping et al., 2013). What is more, the heart’s constant movement places high mechanical loads (i.e., mechanical stress and strain) on the functionality of stents, and this movement can ultimately damage the stent’s integrity. In their efforts to support the demands of this environment, Singh and Wang (2014) introduced a “flexible” stent that offers an unparalleled advantage over common, “stiff” stents. Their design mimics the flexible yet rigid skeletal structure of a monarch caterpillar. The end product is a biomimetic stent capable of flexing and bending with the movement of the heart, which, once again, is dynamical in nature as the heart adapts to the demands to supply oxygen to the body’s muscles and organs.

Endovascular angiography: reperfusion therapy and biomimicry

— Stents/High Shear Wall Flows and the Swirling Flow of Water Currents —

What about biomimicry in peripheral vascular studies? Has any attention been given to reperfusion therapy in this area of medicine? The answer to both of these questions is “yes.” For example, the superficial femoral artery (SFA) is a lower extremity artery susceptible to luminal narrowing secondary to atheromas and plaque build-up. Moreover, stents indicated for this vessel can be quite long, with lengths up to 15 cm commonly deployed. Recently, a novel stent design for the reperfusion of an occluded segment of the SFA was modeled on the flow of blood through the aorta, given that the aorta is quite resistant to atherosclerotic disease (Gaines, 2015). This intrinsic resistance identified with the aorta has been correlated with high-grade, pulsatile blood flow, which in part is also associated with the structural nature of the aortic arch. In other words, hemodynamics at the aorta not only imposes a high shear wall stress on the aorta’s inner wall (the tunica intima layer of this artery), but blood flow analysis reveals that the curvature of the aortic arch also helps give rise to a swirling, turbulent component of this high-grade, pulsatile flow.

TECHNICAL INSERT: For a conceptual image of the aforementioned dynamics in the healthy aorta, imagine that the turbulent and swirling nature of blood flow through the aortic arch repeatedly washes and rinses the luminal lining in this region of the artery. The best analogy comes from the flow of water that washes the banks along a somewhat sharp, curving bend (effectually, a U-turn) of a river as the current transits downstream.

With respect to the SFA, the stent that captures the nature of aortic blood flow has a subtle corkscrew design. Notably, such design helps impose a swirling effect on the flow of blood through the stented region of the SFA that also induces higher shear wall stress, which reduces the chances for in-stent restenosis.

— Stents/Vascular Smooth Muscle Cell Biomimetic Surface Patterns —

Because normal wound healing in the tissues surrounding a deployed stent is delayed, design schemes for stents have included antibody coatings to attract endothelial progenitor cells as a means to promote healing. However, testing of these stents has revealed that the associated lesions are often more complex than those associated with other stents, such as drug-eluting stents (whereas drug-eluting stents are known to be cytotoxic). Therefore, to address these challenges, and in a novel design twist to the aforementioned glycocalyx-mimicked stent, researchers recently introduced a stent that is designed to mimic vascular smooth muscle cells (VSMCs) at the nanometer level on the stent struts (Liang, et al., 2016). Methods similar to those used to obtain the glycocalic coating (i.e. laser-etching) were used to achieve the VSMC pattern. Testing performed on the iliac arteries of rabbits showed that a VSMC-biomimetic surface pattern was effective for rapid re-endothelialization (which translates as distinctly effective for promoting normal wound healing), as well as reducing the likelihood of in-stent restenosis.

Clearly the heart is uniquely designed! Can you imagine a career researching and developing engineered heart tissues?

The Heart is Uniquely Designed: Part of God’s Special Creation!

Quintessentially Mimicking the Structure and Function of the Human Heart:

Christian scholarship extending into professional roles is sincerely needed in education and culture, including mathematics and the sciences (including medicine). Chemical engineering and bioengineering can be a promising career for those who like to study physiology, microbiology, and biochemistry. And a well-developed understanding of anatomy and physiology plays a crucial role.

Insert: myocardial squeezing problem or atrial/ventricular filling problem

For many years echosonographers and cardiologists understood heart failure as a mechanical-type squeezing problem due to myocardial remodeling or enlargement; only recently did they learn it may also be a filling problem. The latter became known as diastolic heart failure.

As Christians, we ought to ask ourselves if we walk around with filling defects. In fact, the sermon “Why is my Heart not Filling?” given at Maranatha Baptist Church by Pastor Todd Grover (2018), gives us perspective on whether or not our own hearts might be suffering spiritually.

Consider 2 Corinthians 6:11-13 (ESV), in which the Apostle Paul expressed to the Christians living in Corinth: “We have spoken freely to you, Corinthians; our heart is wide open. You are not restricted by us, but you are restricted in your own affections. In return (I speak as to children) widen your hearts also.”

According to Pastor Grover (2018): “Here Paul revealed his heart’s condition to the Corinthians, that his heart is wide-open or enlarged, or that his heart is full and does not suffer from a filling problem.” Grover also pointed out that Paul stated he has spoken freely, and reminded listeners that Jesus said, “What comes out of the mouth proceeds from the heart.” However, Pastor Grover acknowledged that verse 11 of 2 Corinthians 6 is also clearly implying that Paul has a welcoming spirit toward the Corinthians, but not because Paul is outgoing, and has a warm and inviting personality. Rather, the reason is spiritual, since only a couple of years earlier Paul would have been killing these same Corinthians for their faith he is now trying to nurture.

So, a natural question to ask is what fills the heart. Some at Corinth were blaming Paul for their bad spiritual condition, but Paul is telling them that it is not he that should be blamed. Then, how did Paul’s heart become filled? To answer this, Pastor Grover quoted three verses from the very same epistle, and offered the applications of these verses, as follows:

  • The Spirit unveils, as we read according to 2 Corinthians 3:16 (ESV), “But when one turns to the Lord, the veil is removed.” Thus, if we don’t understand, then we can turn to the Lord, and the Lord will remove our veil of not understanding.
  • The Spirit writes, since we learn from 2 Corinthians 3:3 (ESV), “And you show that you are a letter from Christ delivered by us, written not with ink but with the Spirit of the living God, not on tablets of stone but on tablets of human hearts.” Therefore, we cannot live in the flesh and expect the Spirit to teach us.
  • Finally, the Spirit does not mix with sin, as we know according to 2 Corinthians 4:2 (ESV), “But we have renounced disgraceful, underhanded ways. We refuse to practice cunning or to tamper with God’s word, but by the open statement of the truth we would commend ourselves to everyone’s conscience in the sight of God.” And thus, we cannot allow sin to soil our hearts.

To summarize, Pastor Grover remarked: “So if our heart is not filling properly, we must develop a skill set as a Bible reader, because a heart fills as we read, learn, and know that the Spirit unveils, the Spirit writes, and the Spirit does not mix with sin.”

May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope.

– Romans 15:13 (ESV)


American Heart Association. (2016). Advanced cardiovascular life support: Provider manual. United States of America: First American Heart Association Printing.

Baldassarre, A.D., Cimetta, E., Bollini, S., Gaggi, G., & Ghinassi, B. (2018). Human-induced pluripotent stem cell technology and cardiomyocyte generation: Progress and clinical applications. Cells, 7(6), 48. [View in article] [View in PubMed]

Bovin, A., Klausen, I.C., & Petersen, L.J. (2013). Myocardial perfusion imaging in patients with a recent, normal exercise test. World Journal of Cardiology, 5(3), 54-59. [View in article] [View in PubMed]

Cremer, P., Hachamovitch, R., & Tamarappoo, B. (2014). Clinical decision making with myocardial perfusion imaging in patients with known or suspected coronary artery disease. Seminars in Nuclear Medicine, 44(4), 320-329. [View in PubMed]

Gaines, P.A., (2015). Biomimetic stents and the benefits of swirling flow. Endovascular Today, 6(3), 64-68. [View in article]

Gorenol, V, Schönermark, M.P., & Hagen, A. (2012). CT coronary angiography vs. invasive coronary angiography in CHD. GMS Health Technology Assessment, 2. [View in PubMed]

Grover, T. (Senior Pastor). [Maranatha Baptist Church Hayesville Ohio]. (2018, August 26). Why is my heart not filling? [Video file]. Retrieved from

Hirt, M.N., Hansen, A., & Eschenhagen, T. (2014). Cardiac tissue engineering: State of the art. Circulation Research, 114(2), 354-367. [View in article] [View in PubMed]

Jay, S.M., & Lee, R.T. (2013). Protein engineering for cardiovascular therapeutics: Untapped potential for cardiac repair. Circulation Research, 113(7), 933-943. [View in article] [View in PubMed]

Jiangping, S., Zhe, Z., Wei, W., Yunhu, S., Jie, H., Hongyue, W., … Shengshou, H. (2013). Assessment of coronary artery stenosis by coronary angiography: A head-to-head comparison with pathological coronary artery anatomy. Circulation: Cardiovascular Interventions, 6, 262-268. [View in article] [View in PubMed]

Lewandowski, J., Rozwadowska, N., Kolanowski, A.M., Malcher, A., Zimna, A., Rugowska, K.F., … Kurpisz, M. (2018). The impact of in vitro cell culture duration on the maturation of human induced pluripotent stem cells of myogenic origin. Cell Transplantation, 27(7), 1047-1067. [View in article] [View in PubMed]

Liang, C., Hu, Y., Wang, H., Xia, D., Li, Q., Zhang, J., …, Dong, M. (2016). Biomimetic cardiovascular stents for in vivo re-endothelialization. Biomaterials, 103, 170-182. [View in PubMed]

Liau, B., Zhang, D., & Bursac, N. (2012). Functional cardiac tissue engineering. Regenerative Medicine, 7(2), 187-206. [View in article] [View in PubMed]

Lipinski, M., Morise, A., & Froelicher V. (2002). What percent luminal stenosis should be used to define angiographic coronary artery disease for noninvasive test evaluation? Annals of Noninvasive Electrocardiology, 7(2), 98-105. [View in PubMed]

National Institute of Health website. (n.d.). Stem cell information glossary. Retrieved from

National Institute of Health website. (n.d.). Where do stem cells come from? Retrieved from

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Perez, G., Rodriguez-Granillo, A.M., Mieres, J., Llaurado, C., Rubilar, B. Risau, G., … Rodriguez, A.E. (2009). New coating stent design for patients with high-risk coronary lesions for thrombotic events: early and long-term results of the Camouflage registry. Journal of Invasive Cardiology, 21(8), 378-382. [View in PubMed]

Purdom, G. (2007, January 1). Stem cells: Does their origin matter? Answers Magazine. [View in online article]

Singh, C., & Wang, X. (2014). A biomimetic approach for designing stent-graft structures: Caterpillar cuticle as design model. Journal of the Mechanical Behavior of Biomedical Materials, 30, 16-29. [View abstract] [View in PubMed]

Sled, E. (2018). Biblical integration in anatomy and physiology: A design approach. Answers Research Journal, 11, 141-148. [View in article]

Smith, R. (2018). Myocardial perfusion study to detect coronary artery disease. Radiologic Technology, 90(2), 131-144. [View in PubMed]

Sosnovik, D.E., Mekkaoui, C., Huang, S., Chen, H.H., Dai, G., Stoeck, C.T., … Liao, R. (2014). Microstructure impact of ischemia and bone marrow-derived cell therapy revealed with diffusion tensor magnetic resonance imaging tractography of the heart in vivo. Circulation, 129(17), 1731-1741. [View in article] [View in PubMed]

Tamarappoo, B.K., Gutstein, A., Cheng, V.Y., Nakazato, R., Gransar, H., Dey, D., … Berman, D.S. (2010). Assessment of the relationship between stenosis severity and distribution of coronary artery stenosis on multislice computed tomographic angiography and myocardial ischemia detected by single photon emission computed tomography. Journal of Nuclear Cardiology, 17(5), 791-802. [View in PubMed]

Tchao, J., Jin Kim, J., Lin, B., Salama, G., Lo, C.W., Yang, L., & Tobita, K. (2013). Engineered human muscle tissue from skeletal muscle derived stem cells and induced pluripotent stem cell derived cardiac cells. International Journal of Tissue Engineering, 198762. [View in PubMed]

Teh, I., Feng-Lei, Z., Hubbard Cristinacce, P.L., Parker, G.J.M., & Schneider, J.E. (2016). Biomimetic phantom for cardiac diffusion MRI. Journal of Magnetic Resonance Imaging, 43(3), 594-600. [View in article] [View in PubMed]

Wininger, K.L. (2018, September 14). Biomimicry 101: Biomaterials and tissue engineering. [blog post]. Retrieved from

Previous articles in this series:

Other medical applications are featured in the next installment in our biomimicry series!

In our next installment on biomimicry, we will touch finally on cardiac function and fractal behavior via the area of concentration we have coined mathematical cardiology. We then move forward from our focus on the heart, as we turn our attention to two unrelated fields in medicine where biomimetic solutions have garnered exciting outcomes: diabetic solutions and work towards spinal cord regeneration.

Diamond Caverns – the true gem among the Mammoth Cave caving system


A trip to Diamond Caverns in Park City, Kentucky, off of Exit 48 on I-65, just on the outskirts of Mammoth Cave National Park, is quite an adventure. The cave has a particularly abundant source of large flowstone formations, as well as beautiful “bacon” formations. Undoubtedly, though, visitors get to enjoy their caving while exploring one of the most beautifully laid-out cave tails in Kentucky’s caving system. Oh, and be on the lookout for cave crickets!

Fun Fact: As a product of the Flood’s aftermath, some of Diamond Caverns’ flowstones are thought to be the byproducts of underground waterfalls. (Flowstones are estimated to deposit at rates of 1-cubic centimeter every 150 years.)

Creation Science High School and Undergraduate Essay Contests

The third question in our series of writing prompts for our creation science writing contest asks students to consider the growth and formation of stalactites and stalagmites, including consideration of factors influential on their rates of growth. For instance, the 1932 article “An Unusual Occurrence of Stalactites and Stalagmites” by Karl Ver Steeg serves as a credible reference offering such valued information. In fact, for students choosing this question, a summary that highlights any differences between stalactites exposed to the elements (like the kind mentioned in Ver Steeg’s 1932 article) and stalactites formed underground (like those formed within Diamond Caverns, see the picture above) is encouraged. Such contrasted settings may show intriguing results with respect to stalactite growth rates. (Hint: Ver Steeg’s article will help with such a comparison.)

diamond-caverns-2Diamond Caverns – discovered in 1859, and rediscovered daily.

Just maybe the writing prompt that deals with geology (as well as the fossil record) was developed specifically for you!

We invite you to browse the aforementioned question here, as follows: “essay contests.”

Could you consider yourself in a role that helps improve our understanding of the geology of the planet?

Starting out now on your very own discovery of the intricacies of God’s creation today through scientific study might very well help in discerning what path you should take in the future. For example, for a possible career path, such study could help you better understand the activities of geologists. And one of your first activities ought to be growing your very own stalactites. In fact, in the book 77 Fairly Safe Science Activities for Illustrating Bible Lessons by Professor Donald B. DeYoung (2013), lesson #74 called “Cave Icicles” allows readers to do this very thing.

This blog is the third blog entry related to this year’s caving expeditions. Please click below to see the other two sites we explored.


DeYoung, D.B. (2013). 77 fairly safe science activities for illustrating Bible lessons. Grand Rapids, MI: Baker Books.

Ver Steeg, K. (1932). An unusual occurrence of stalactites and stalagmites. The Ohio Journal of Science, 32(2), 69-84. Retrieved from

Christmas Greetings – iterations of the Koch snowflake

koch-snowflake-2-uChristmas greetings – the 0th through 5th iterations of the Koch snowflake (2018).

For unto you is born this day in the City of David a Saviour, which is Christ the Lord. And this shall be a sign unto you; Ye shall find the babe wrapped in swaddling clothes, lying in a manger. And suddenly there was with the angel a multitude of the heavenly host praising God, and saying, Glory to God in the highest, and on earth peace, good will toward men.

– Luke 2:11-14 (KJV)

We at Ashland Creation Colloquium want to wish everyone Merry Christmas and Happy Holidays!

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The Koch snowflake is a recursive, self-similar mathematical pattern, with the zeroth through fifth iterations shown above. In other words, the Koch snowflake is a fractal.

According to Weisstein (n.d.):

The Koch snowflake is a fractal curve, also known as the Koch island, which was first described by Helge von Koch in 1904. It is built by starting with an equilateral triangle, removing the inner third of each side, building another equilateral triangle at the location where the side was removed, and then repeating the process indefinitely.

The 2018–2019 Creation Science Essay Contests

Challenge yourself this Christmas break by exploring our 2018-2019 creation science essay contests for high school students and college undergraduates. Select from informative writing prompts with diverse subject matter. For more information, please see our contest flyer (or download our printer friendly version of the writing prompts and contest submission guidelines).

The truth Ashland Creation Colloquium adheres to is that the Bible is the inerrant Word of God, and although it is not a book of science, everything the Bible says about science is true.


Weisstein, E.W. (n.d.). Koch snowflake. WolframMathWorld. [View in online article]

Dent in the armor of the Big Bang theory


So we don’t miss the mark, the fact that…

Annihilation of matter (such as electrons) and anti-matter (such as positrons) occurs with such a high degree of reliability, the consistency invokes a sense of precision inherent with the most accurate time piece. Moreover, such consistency ratchets up the applicability factor associated with PET scans. However, this same reliability as well as applicability (and the very same exacting precision) serves as the Achilles’ heel of the Big Bang theory because matter/anti-matter annihilation interactions raise questions concerning the origin of matter in the universe.

Where does ordinary matter come from?

According to the Big Bang theory, matter and anti-matter arose at the same time. Nevertheless, neither a surplus in matter nor a deficit of it are detected from anti-matter and matter collisions performed experimentally (that is, from experiments thought to mimic conditions associated with the Big Bang). And this fact leaves us with an important question: where did all of our plain, ordinary matter existing abundantly around us come from? You can help answer this question by taking part in our creation science writing contest, by choosing the question that deals with PET scans in medicine.

pet-schemaThe technique of PET imaging

And who knows, maybe a career path too

Nuclear Medicine Technologists are the professionals responsible for implementing PET scans for the physicians who order these tests. So, who knows, from the knowledge gained through contest participation, you could be taking the first steps toward an exciting, patient-focused career. We look forward to reading your entry!

An extraordinary imbalance between ordinary matter and anti-matter

annihilation-interactionSchematic of pair production and annihilation interaction

We are recommending the short online article, “Baryon Conservation and the Antimatter Mystery,” by physicist Vernon R. Cupps. This article appears in the November 2018 issue of the science- and creation- magazine Acts & Facts, and, in our opinion, proves extremely insightful for students interested in our creation science writing contest, specifically those students who pick positron emission tomography for their essay topic. Here Dr. Cupps not only discusses the extraordinary science and deeper theological issues surrounding the disparity between ordinary matter and anti-matter, but he also approaches the topic in a way that translates exceptionally well for students concerned with the issue-at-hand for their essay option (that is, explaining pair production and annihilation in PET scanning in medicine for their entries).

pet-schemaThe technique of PET imaging

Biomimicry 101: Cardiovascular Medicine: Part 1: Thinking Outside the – Stem Cell – Box

anat-stent-ekg-monarch-caterpillarFigure 1: Anatomy of the heart, with blood flow schematic (top left panel); profile of a coronary artery stent application (top right panel); the electrocardiogram – abbreviated ECG or EKG – representing the heart’s conduction system (center panel); and the monarch caterpillar (bottom panel).

When you ponder biomimicry, think design, intelligent design, and creation, but please don’t think evolution. And when considering biomimetic applications, let your imagination know no bounds.

The previous article in our biomimicry series introduced several key issues describing the feasibility and use of engineered tissue in different health and medical fields. Presently, this article (in two installments) will focus on various examples concerning bioengineering and biomimicry in the field of cardiovascular medicine. For example, we address the ethics and challenges concerning the regeneration of cardiac tissue via stem cell therapy. At the same time, however, we draw the spotlight away from a stem cell model to survey other novel clinical cardiology and endovascular biomimetic research. What is more, a first principle that continues to serve as motivation for exploring biomimetic applications that deal with cardiac tissue is our viewpoint that the heart is uniquely and deliberately designed, as emphasized with respect to tissue scaffolds in our prior article, as follows:

Because of the unique makeup of cardiac tissue, the work surrounding cardiac tissue scaffolds has focused on mimicking the physiological properties of the heart itself. This fact is true whether we are talking about designing artificial heart valves that mimic the mechanical properties of native heart valve tissue (Capulli et al., 2017), or boldly seeking to engineer myocardial tissues that elicit the unique mechanical, biological, and electrical properties existing at cell-tissue interfaces throughout the heart (Kaiser & Coulombe, 2015). (“Three examples of biomimicry applied to tissue engineering,” para. 3)

Once again, the aim of this series, and in particular this subject matter, is to bring glory to God and His creation, which includes human beings as a special creation. We begin our discussion with an overview on heart anatomy and physiology.

Anatomy and physiology of the heart

Tissues that make up the heart integrate a distinct blend of mechanical, biological, and electrical properties. To best examine these properties, we first review this unique organ.

— Location, Location, Location —

The heart is centered within the chest cavity, just left of midline between our two lungs. In fact, our bodies accommodate its exact location because our left lung is comprised of only two lobes, whereas our right lung has three. This means our hearts are nuzzled into the space made available by the “missing” part of our left lung. What is more, an intimate vascular network exists between our heart and lungs, and when taken together these organs and their connections comprise our cardiopulmonary system (i.e., the heart-lung system).

— Circulation —

Our circulatory system, which includes the associated vasculature of the heart, is a closed-loop system that is responsible for moving blood through our bodies. With the heart serving as the system’s pump, there are three types of blood vessels: the arteries, the capillaries, and the veins.

  • Arteries are specialized blood vessels composed of three individualized layers: the innermost layer, the tunica intima; the middle layer, the tunica media; and the outermost layer, the tunica adventitia. Within the tunica media are smooth muscles that control the diameters of arteries via influence of the autonomic nervous system. Arteries function as conduits that, in all but one circumstance, carry oxygenated blood away from the heart. In addition, healthy arteries are well-known for their resilient, elastic nature. A very large artery known as the aorta is the first artery in the circulatory system.
  • Capillaries facilitate the exchange of oxygen, nutrients, and waste by-products resulting from cellular respiration and metabolism.
  • Veins are characterized by their one-way valves that help direct blood flow toward the heart (and thus prevent the back-flow of blood).

— The Big Squeeze —

The heart’s squeezing action is what circulates blood throughout our vasculature. What is more, a heart cycle is easily detected via the heart’s squeezing sounds, the so-called lub-dub sound of the heart. The lub sound represents simultaneous contraction of the two top chambers (i.e., the atria), and the dub sound represents simultaneous contraction of the two bottom chambers (i.e., the ventricles). Blood has four main components: oxygen-carrying cells called red blood cells; functional immunity cells called white blood cells; cell fragments that are important for clotting called platelets; and a liquid constituent called plasma. What follows is the path our blood takes within the cardiopulmonary system:

  • After a red blood cell releases its oxygen content to our muscles and organs, it is called deoxygenated. Deoxygenated red blood cells, together with the aforementioned constituents, make their way back to the heart through our systemic venous system (i.e., our veins). As this pathway draws closer to the heart, it converges to form two large venous trunks known as vena cava. The superior vena cava brings back blood from the upper part of the body, and the inferior vena cava brings back blood from the lower part of the body. This returning systemic flow of blood then enters the first of our heart’s four chambers – the right atrium.
  • Once inside the right atrium, blood passes through the tricuspid valve into the second chamber of the heart – the right ventricle. This occurs in synchrony with the first of the two squeezing sounds, the so-called lub sound associated with atrial contraction.
  • As a result of ventricular contraction (i.e., the dub sound), the blood then passes from the right ventricle through the pulmonary semi-lunar valve and flows toward our lungs via both pulmonary arterial trunks, the right and the left pulmonary arteries. The pulmonary arteries carry the blood to the lungs where red blood cells are oxygenated within the lung’s capillary beds. The oxygenated blood will now flow back towards the heart by way of the pulmonary veins, a process returning this pulmonary flow of blood to the heart’s third chamber – the left atrium.
  • Once in the left atrium, the blood passes through the mitral valve into the fourth and final chamber of the heart – the left ventricle. Again, this occurs in synchrony with atrial contraction.
  • Finally, with contraction of the left ventricle, the oxygenated blood enters systemic circulation as it passes through the aortic semi-lunar valve (i.e., flowing out of the left ventricle and into the aorta).

TECHNICAL INSERT: Arteries and veins are recognized by the directional flow of blood that they facilitate away from – or toward – the heart, respectively, and not by whether or not the blood within the artery or vein is oxygenated or deoxygenated.

What is more, each squeezing action initiating a new cardiac cycle will simultaneously generate a pressure spike within our vessels, causing the blood to effectually pulsate through the circulatory system. Notably, this spike or wave of pressure is called systole, whereas the underlying pressure is referred to as diastole. Both systole and diastole make up our body’s systemic blood pressure. Normal systemic systolic pressure is 120 mmHg, and normal systemic diastolic pressure is 80 mmHg.

The term that describes the volume of blood pumped through the body is cardiac output, and this volume is seen as a marker of efficiency of cardiac mechanics and hemodynamics. To adequately deliver oxygen to our body’s tissues (called perfusion), cardiac output is approximately five liters per minute. In fact, investigations looking into cardiac output during cardiopulmonary resuscitation (CPR) led to guidelines from the American Heart Association to favor compression-only CPR to better achieve adequate blood flow and perfusion (Wininger, 2007). Investigators discovered that two different theories describing CPR-related chest compression – the cardiac pump theory and the thoracic pump theory – actually work together and in tandem depending on the physiological situation. One study helping investigators reach this level of insight was a review of the use of CPR for emergent care during coronary angiography. Today, there are even mechanical chest compression devices that heart catheterization labs can use, if necessary, during interventional care (Wagner et al, 2010).

Perspectives such as this illuminate how far we have come. Currently, a prototype of a ventricular assist device that mimics the natural squeezing/compression action of the heart has proven feasible. The device is a soft robotic sleeve that wraps around the heart, and it is being devised for those patients with severe heart failure (Roche et al, 2017). A major benefit of this particular device is that it never contacts blood, unlike traditional assistive devices, and thus eliminates the need for patients to be on blood thinners for prolonged periods of time.

— The Conduction of Electricity: The Conduction Pathway —

Cardiac squeezing action is controlled by the heart’s electrical activity. In fact, the conduction pathway that exists for this electrical activity is what we observe when looking at electrocardiogram tracings (abbreviated ECG, or colloquially known as EKG rhythm strips). ECG tracings show three main waves: the P-wave, the QRS-complex, and the T-wave. Crucially, analysis of these waves provides cardiologists with critical diagnostic information. The conduction pathway begins in the right atrium with a group of “like-minded” heart cells known as the sinoatrial node (abbreviated SA node and also called the heart’s “pacemaker cells”). Once the SA node fires, electrical charge disperses across the atrium and arrives at the aterioventricular (AV) node. At the AV node, the electrical charge then travels down through the intraventricular septum (a tissue that separates the chambers associated with the left and right ventricles), traveling down and along the bundle of His.

Continuing on – the charge follows the pathway that is made available by the bundle of His, a fibrous tissue pathway that splits within the septum and forms a right bundle branch and a left bundle branch. Here the electrical charge flows through the right and left bundle branches within the septum. Finally, both the right and left bundle branches divide and carry the electrical charge into terminal filaments of delicate, feathery-like fibers called Purkinje fibers.

The conduction pathway within the heart, not to mention the heart itself, is an electrochemical process. In fact, a physiological redundancy has been designed into the cardiac electrical system. By this I mean that the heart’s muscle cells, the cardiac myocytes, have the capacity to fire at sustained rates, and thus each contract individually on their own accord. However, specified regions exist throughout the myocardium, as well as along the conduction pathway, that are designed to fire in a hierarchal fashion, with each region firing at determined rates and led by the SA node, or in other words, the so-called pacemaker cells.

— The Arteries That Crown the Heart —

Coronary arteries are special arteries that crown the heart. These arteries are important because they provide the heart with oxygen so that it pumps effortlessly. Notably, all coronary arteries stem from two main divisions, aptly named the right coronary artery and the left main coronary artery. Of these two divisions, the left main coronary artery further divides into the left anterior descending artery and the left circumflex artery (with the latter known simply as the circumflex artery). However, the coronary arteries are important not only because they supply the heart with oxygen, but because they are also susceptible to inflammation and injury that may lead to an occlusive artery disease known as coronary artery disease, a condition that restricts oxygen delivery.

Coronary artery disease is a silent, chronic process that has two phases. The first phase begins when white blood cells respond to inflammation between the innermost and middle layers (the tunica intima and tunica media layers, respectively) of one or more of the coronary arteries. As more and more white blood cells arrive, over time they form a viable bump called an atheroma within the inner wall (i.e., the luminal lining) of the affected artery. If the surface of the lumen over the bump bursts, then the second phase of coronary artery disease is initiated. In the second phase, the rupture or burst triggers platelets to aggregate around the injured tissue in an attempt to clot off the injury. In fact, this clot formation is called a thrombus. If the clot (or thrombus) significantly occludes the vessel, or if the clot formation occludes the vessels at just the right place within the coronary artery vasculature, a person may suffer from a heart attack. Heart attacks are a life threatening situation because the surrounding heart tissue, or the so-called mycocardium, that is normally supplied with oxygen by the flow of blood from the effected artery, will no longer receive its supply.

TECHNICAL INSERT: The lumen of the artery (i.e., the inner passageway of the artery) is characterized by a clean, smooth lining. This luminal lining is made up of endothelial cells, and it is these cells themselves that compose the innermost arterial layer (i.e., the tunica intima). This layer is much more delicate compared to the middle and outermost layers, the tunica media and the tunica adventia, respectively. Notably, the tunica media contains bands of smooth muscle, whereas the tunica adventia contains connective tissue. However, all three layers play an important role in the elastic nature of all arteries, but in the coronary arteries particularly.

One of the best ways to guard against coronary artery disease is to observe Virchow’s triad. Although a comprehensive exam of the three aspects of Virchow’s triad is beyond the scope of this article, it is interesting to note that the prevention of endothelial injury, or the reduction of endothelial dysfunction, is plausible through proper diet and exercise. When taken together, proper diet and adequate exercise can reduce or even counteract the inflammatory process that endothelial cells endure. And again, endothelial cells are those cell types that make up the tunica intima layer of arteries, and thus, it is these cells that are responsible for the smooth luminal lining of coronary arteries (i.e., the smooth inner-wall of the passageway of an artery).

virchow's-triadFigure 2: The three sides of Virchow’s triad.

And, indeed, diet and exercise are important since a luminal narrowing of 20%, as evidenced by coronary catheterization studies, is considered normal (Bovin, Klausen, & Petersen, 2013). What is more, studies show that between 30% – 50% of patients undergoing coronary CT angiography can have a stenosis (or a luminal narrowing) of up to 50% and not indicate signs of ischemic disease detectable by myocardial perfusion imaging, such as SPECT imaging (Cremer, Hachamovitch, & Tamarappoo, 2014).

— The Husk of Life: Glycocalyx —

The word glycocalyx is shaped from the prefix glyco or “sweet” and the suffix kalyx or “husk.” Because the glycocalyx forms a sugary, slimy coating of certain cell types in various animals, as well as several different cell types of the human body, we may think of it as the sweet husk (i.e., coating) of life. What is more, the prefix refers to the coating’s composition, which is carbohydrate-based. Microscopically, gylcocalyx looks like feathery fibers. First-year anatomy and physiology students would recognize the coating as the feathery elements of the microvilli of our intestinal tracts (recalling that the microvilli are actually the lining of the villi). However, important for our purposes, a glycocalyx coating is present on the innermost layer of our vasculature (i.e., on the luminal surface of the endothelial cells that comprise the tunica intima). In fact, a protective barrier made up of glycocalic fibers functions as a vital component to our cardiovascular health (Sieve, Munster-Kuhnel, & Hilfiker-Kleiner, 2018). Moreover, researchers investigating the embryonic stages of certain bird species have shown that a glycocalyx layer is present and viable as soon as blood flow starts (Henderson-Toth, Jahnsen, Jamarani, Al-Roubaie, & Jones, 2012).

For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well.

– Psalm 139:13,14 (ESV)

— A Unique Thing About Cardiac Myocytes: The Heart’s Muscle Cells —

From organ to tissue to the cellular level, the cardiac myocytes are rather specialized muscle cells. According to Ferrari’s comprehensive review (2002) of these cells:

The myocytes are extraordinary cells. They are immortal and contract for a lifetime, supporting the peripheral circulation. In order to do so, they have a unique ultrastructure and unique biochemical machinery that allows them to produce enough adenosine triphosphate to support the contraction. This article deals with the ultrastructure of cardiac muscle and myocytes, and with our current understanding of cardiac metabolism. In addition, the process of contraction is taken into consideration, as well as the mechanisms that allow the adult myocyte to be a terminal cell. However, even the myocytes can die; this can happen by necrosis as a result of an external insult (e.g. a lack of oxygen due to an abrupt occlusion of a coronary artery) or by apoptosis – a genetically programmed type of death that is operative in foetal life. Interestingly, and quite amazingly, under pathological conditions such as acute myocardial infarction or congestive heart failure, this genetic programme is reinstated and apoptosis can then occur, thus resembling features that occur in the embryonic phenotype. The metabolic alterations that occur under pathological conditions such as myocardial ischaemia are also addressed in depth, with several references to the so-called ‘new ischaemic syndromes’, such as stunning, hibernation and reperfusion paradox. The review is presented in light of an understanding of the biochemical and biomolecular changes that occur in pathological conditions, with the hope that this will provide room for innovative therapeutic intervention.

Thinking outside the embryonic stem cell box

In her 2007 article “Stem Cells: Does Their Origin Matter?” published in Answers Magazine, Dr. Georgia Purdom, a molecular geneticist with Answers in Genesis, presented several key points:

  • Stem cells are classified as either totipotent or pluripotent/multipotent.
  • Totipotent stem cells are taken from embryonic tissue, an action that kills the embryo in the process. These cells are capable of forming any cell type in the body, but carry certain risks for the recipient.
  • Pluripotent and multipotent stem cells are harvested from adult tissue, and notably, the process does no harm to the adult. These stem cell types are capable of forming almost every cell type in the body.
  • Ethical issues concerning life and its preservation can be easily reconciled through a biblical worldview.
  • Interestingly, an alternate approach to using embryonic stem cells taps the potential to reprogram adult cells to become more like embryonic stem cells. Here Dr. Purdom cited the work by Silva, Chambers, Pollard, and Smith (2006) with the protein Nanog on nervous system cells, published in the journal Nature.

Optimistic remarks concerning the reprogramming of adult cells surfaced ten years later in an interview with acclaimed materials scientist Buddy Ratner, PhD of the University of Washington. The interview appeared in a 2017 issue of the biotechnology journal Future Science, and celebrated Dr. Ratner’s forty-nine years of work in biomaterials science. When asked about exciting advances we should look for in the next five years within the biomaterials arena, Dr. Ratner’s response touched on the plasticity of adult cells. What follows is the relevant excerpt of that interview:

Another interesting area is a new concept I call ‘cell plasticity’. Through most of Modern Biology we have used the term ‘terminally differentiate’ – a mature cell cannot go any place. Now people are getting the idea that cells are actually very plastic, they change from one cell type to another, and the ability to control these transformations means almost any cell has a stem cell-like ability. We do have defined stem cells but I think the ability to take an adult cell and to crank it back to a more plastic, stem-like state, then direct it, gives us tremendous options in the area we call regenerative medicine. Within the initial biomaterials ideas we said ‘well if a part fails we’ll replace it with plastic and metal’ – the regenerative medicine field says ‘if a part fails we’ll just regrow it’. Regenerative medicine interest is increasing and efforts in that area are rightly accelerating. The interesting thing is, this still requires an extensive use of biomaterials in many different forms such as scaffolds and drug delivery platforms, so biomaterials are an important foundation technology to make regenerative medicine a reality. (“Question #5,” para. 2)

Part 2 will focus on biomimetic applications in cardiovascular medicine!

Keeping the preceding paragraphs in mind, we now outline the second installment of our focus on cardiovascular medicine (part two of our article) in this biomimicry series. First, discussion related to tissue engineering and regenerative science in cardiovascular research will center specifically on multipotent and pluripotent stem cell therapy. Second, we will briefly expand on cell plasticity related to cardiovascular medicine. Third, we will draw attention to the interesting, evolving role of protein therapy in cardiology, such as efforts to treat heart attack (i.e., myocardial infarction) by reprogramming/regenerating heart muscle cells (i.e., the cardiac myocytes). Fourth, we will highlight a novel approach to reperfusion therapy by Singh and Wang (2014), who introduced the concept of using coronary artery stents mimicked after the skeletal structure of the monarch caterpillar. Finally, we will explore a variety of other biomimetic applications that have promising potential to impact cardiac and endovascular patient care.

monarch-caterpillar-cvcuFigure 3: The segmented structure of the monarch caterpillar has inspired a novel coronary stent concept that offers segmented movement relative to pulsatile blood flow through the coronary arteries, as well as movement related to the heart’s squeezing action.


Bovin, A., Klausen, I.C., & Petersen, L.J. (2013). Myocardial perfusion imaging in patients with a recent, normal exercise test. World Journal of Cardiology, 5(3), 54-59. [View in article] [View in PubMed]

Cremer, P., Hachamovitch, R., & Tamarappoo, B. (2014). Clinical decision making with myocardial perfusion imaging in patients with known or suspected coronary artery disease. Seminars in Nuclear Medicine, 44(4), 320-329. [View in PubMed]

Ferrari, R. (2002). Healthy versus sick myocytes: Metabolism, structure and function. European Heart Journal Supplements, 4 (supplement G), G1-G12. [View in article]

Henderson-Toth, C.E., Jahnsen, E.D., Jamarani, R., Al-Roubaie, S., & Jones, E.A. (2012). The glycocalyx is present as soon as blood flow is initiated and is required for normal vascular development. Developmental Biology, 369(2), 330-339. [View in article] [View in PubMed]

Purdom, G. (2007, January 1). Stem cells: Does their origin matter? Answers Magazine. [View in online article]

Ratner, B. (2017). Forty-nine years in Biomaterials Science: An interview with Buddy Ratner. Future Science OA, 3(1), FSO158. [View in article] [View in PubMed]

Roche, E.T., Horvath, M.A., Wamala, I., Alazmani, A., Song, S.E., Whyte, W., … Walsh, C.J. (2017). Soft robotic sleeve supports heart function. Science Translational Medicine, 9(373), eaaf3925. [View abstract] [View in PubMed]

Sieve, I., Munster-Kuhnel, A.K., & Hilfiker-Kleiner, D. (2018). Regulation and function of endothelial glycocalyx layer in vascular diseases. Vascular Pharmacology, 100, 26-33. [View in article] [View in PubMed]

Silva, J., Chambers, I., Pollard, S., & Smith, A. (2006). Nanog promotes transfer of pluripotency after cell fusion. Nature, 441, 997-1001. [View abstract] [View in PubMed]

Singh, C., & Wang, X. (2014). A biomimetic approach for designing stent-graft structures: Caterpillar cuticle as design model. Journal of the Mechanical Behavior of Biomedical Materials, 30, 16-29. [View abstract] [View in PubMed]

Wagner, H., Terkelsen, C.J., Friberg, H., Harnek, J., Kern, K., Lassen, J.F., & Olivecrona, G.K. (2010). Clinical arrest in the catheterization laboratory: A 5-year experience of using mechanical chest compressions to facilitate PCI during prolonged resuscitation efforts. Resuscitation, 81(4), 383-387. [View abstract] [View in PubMed] [View in article]

Wininger, K.L. (2007). Chest compressions: biomechanics and injury. Radiologic Technology, 78(4), 269-274. [View abstract] [View in PubMed]

Wininger, K.L. (2018, September 14). Biomimicry 101: Biomaterials and tissue engineering. [blog post]. Retrieved from

Previous articles in this series:

Stay tuned as we continue our focus on cardiovascular medicine!

In our next installment, we not only continue our discussion on cardiac tissue engineering, but we will also highlight novel biomimetic applications across various areas of clinical cardiology and endovascular research.

Help us celebrate NASA’s 60th anniversary

apollo-11-bootprintApollo 11 bootprint (Courtesy of Buzz Aldrin and NASA)

Today marks NASA’s 60th anniversary!

Please help celebrate our unique place in the universe by liking (and sharing) some of our recent blogs related to all things cosmological and meteorological.

The blogs:

  1. Interviewing Steven Gollmer, PhD

  2. About the Moon – Armstrong Air and Space Museum

Selected excerpt:

Armstrong’s Famous Walk
History indeed offers much perspective on Armstrong’s famous first steps on the lunar surface. What follows is an excerpt from the book From Beirut to Jerusalem by author and columnist Thomas L. Friedman (1991):
When American astronaut Neil Armstrong, a devout Christian, visited Israel after his trip to the moon, he was taken on a tour of the Old City of Jerusalem by Israeli archaeologist Meir Ben-Dov. When they got to the Hulda Gate, which is at the top of the stairs leading to the Temple Mount, Armstrong asked Ben-Dov whether Jesus had stepped anywhere around there.
“I told him, ‘Look, Jesus was a Jew,’” recalled Ben-Dov. “These are the steps that lead to the Temple, so he must have walked here many times.”
Armstrong then asked if these were the original steps, and Ben-Dov confirmed they were.
“So Jesus stepped right here?” asked Armstrong again.
“That’s right,” answered Ben-Dov.
“I have to tell you,” Armstrong said to the Israeli archeologist, “I am more excited stepping on these stones than I was stepping on the moon.”
The Exchange between the Astronaut and the Archeologist
Considering Armstrong’s reclusive nature, it is quite amazing that the exchange between Armstrong and Ben-Dov was ever captured in the annals of history. Even more remarkable is how we came to know of it, as if we were there alongside Armstrong in Jerusalem touring the Temple Mount and listening in on him questioning Ben-Dov. But, most importantly, rather than getting a potentially biased opinion about the first moon walk appearing in an op-ed piece somewhere from some pundit, we can directly credit Armstrong himself as the one offering such a candid viewpoint on his own first steps.
  1. A Trek of Galactic Proportions

  2. The Expanding Universe: The Redshifts of Galaxies and Quasars Indicate Distance

  3. Pi Day Celebrates 3.14159…

orion-and-the-pleiadesAll of creation points to a Creator

Can you bind the chains of the Pleiades or loose the chords of Orion?

– Job 38:31 (ESV)

All of Creation Points to a Creator

The truth Ashland Creation Colloquium adheres to is that the Bible is the inerrant Word of God, and although it is not a book of science, everything the Bible says about science is true.

As an example, consider Orion and the Pleiades. The Book of Job says that the Pleiades is confined, whereas the three stars making up Orion’s belt are not. In recent decades, observations from modern physics and astronomy have shown that the constellation Pleiades, appearing to the right of Orion as a faint ball of light, is in reality a globular star cluster containing hundreds of stars. By imposing a gravitational pull, each star in the Pleiades constellation constrains its neighbor within the cluster. Conversely, similar observations of the most identifiable and perfectly aligned three stars in the night sky, those comprising the belt of Orion – that is, the stars Alnitak, Alnilam, and Mintaka – reveal no such gravitational attraction on each other. In other words, despite their linear appearance, distances among these three stars go well beyond the constraining gravitational effects of any one star on either of the other two. Therefore, the alignment of Orion’s belt is much more than just an illusion of accidental geometry and optics.

Let’s consider a puzzle. Despite the limitations of our human condition, why are we able to understand the universe? Why can we study it – from far-reaching macroscopic vistas, as seen in Orion and the Pleiades, to the delicate microscopic level of subatomic particles, such as protons, neutrons, and electrons? Answering these types of questions is what Ashland Creation Colloquium is all about.

The 2018–2019 Creation Science Essay Contests

Celebrate further and challenge yourself by entering our 2018-2019 creation science essay contests for high school students and college undergraduates. When choosing from selected writing prompts that include diverse subject matter related to cosmology and meteorology, you can investigate the expanding, observable universe by describing the duality of light, or research and report on the heating and cooling of the planet, or even explore the interactions of particle physics by detailing concepts related to PET scans in medicine. Please click here for more information.