World’s Most Wired
Dr. Joachim Kohn has never seen combat. He has never retaliated enemy fire, deployed with a platoon to some foreign, war-ravaged nation, or ridden shotgun in a tank. But from his first years of childhood to his military-funded, revolutionary scientific innovations, Kohn’s life has been indelibly marked by armed conflict.
“One of my earliest memories is at three years of age, making a playground out of bombed-out buildings,” Kohn, now a spry 60 years old, recalls. “Houses, offices, these shells of buildings that were simply everywhere.”
In fact, Kohn’s playground was the urban carcass of Munich, Germany, where he was born to Jewish parents shortly after the end of World War II. Having lost much of his extended family, including grandparents and seven aunts and uncles, during the Holocaust, Kohn grew up with an intimate understanding of war’s human toll.
And the understanding seems to have stuck: More than five decades later, Kohn, a chemist, is at the helm of a $250 million, Pentagon-funded exploit into regenerative medicine called AFIRM. His goal: to take those people ravaged by war, and help put them — quite literally — back together.
Kohn himself pioneered a new class of degradable compounds that are now used inside the body to provide controlled drug delivery, as well as for tissue engineering and regenerative processes like bone and nerve repair. And during his leadership of the AFIRM program, scientists under Kohn’s guidance have already completed an array of futuristic therapies to heal wounded soldiers: Among them are the country’s first-ever face transplant; lab-grown ears nearly ready for human transplantation; and an engineered skin substitute that will soon be tested on soldiers with extensive burns.
When he emerges from his office, tucked into a wing on the first floor of Rutgers University’s sprawling Life Sciences building, Kohn looks more like a lawyer or an accountant than he does a chemist. Clad in a gray suit and tie, his cellphone — which vibrates incessantly — clipped to his belt, Kohn is trying to rub the glare of a computer screen from his eyes.
Before the launch of AFIRM in 2008, Kohn spent most of his career in the lab. But in his role as an AFIRM director, he now spends “99.9 percent” of his time managing the monumental undertaking from the confines of his campus office.
AFIRM, short for the Armed Forces Institute of Regenerative Medicine, was established by Pentagon brass to do what, just four short years ago, seemed nearly impossible: target the most common, debilitating injuries from this generation’s wars, including burns, lost limbs and invasive wounds, and use cutting-edge medical technology to heal them utterly and completely. Instead of prosthetic arms, create flesh-and-blood replacements. Rather than burned skin partially repaired with a messy patchwork of grafts, replace that skin using sheets of lab-grown epidermis. And in lieu of acquiescing to bones, muscles and nerves that will be permanently missing, spur the soldier’s body to regrow what they’d lost.
Not only that, but do it quickly: The Pentagon intended for AFIRM to accelerate the rate of regenerative medicine progress by decades, and later infused a handful of promising projects with extra money to garner even speedier results. “Ten years doesn’t satisfy any of us,” former Joint Chiefs of Staff Admiral Mike Mullen told AFIRM researchers in 2010 of the impetus to fast-track regenerative medicine from the lab into the human body.
To do it, the Pentagon assembled two consortia of scientists. One of them, the Rutgers-Cleveland Consortium, is directed by Kohn. He oversees dozens of research projects, performed by nearly 150 scientists at 21 different institutions, including Harvard, the Mayo Clinic and the Massachusetts General Hospital.
“I didn’t endanger my life in any way, and I didn’t put myself on the line to save anyone,” he says. “I was just sitting in my laboratory, waving my hands around, sometimes having good ideas.”
Plenty of the consortium’s projects remain firmly in the lab, but a handful are either already treating wounded soldiers, or are expected to enter clinical trials within the next few years. “Our field of regenerative medicine is today wildly overhyped,” Kohn says. “We have done very impressive things, but I don’t want to make promises about therapies that maybe work in a lab, but [end up] not working in a person.”
But with six clinical trials already under way or slated to start soon, the team is already treating some injured servicemembers. At the University of Virginia, surgeons are using transplants of a patient’s own fat to accelerate the healing of burn wounds — which account for 12 percent of injuries among today’s soldiers — and prevent rampant scarring that was once inevitable. At the Cleveland Clinic, doctors continue to hone extensive facial transplants, and are actively enrolling and operating on soldiers and civilians who qualify for the extreme procedure.
Other therapies will soon be tested on patients. Among them is a procedure developed at the University of Cincinnati, which will grow fresh reams of skin within the lab — a process that takes merely three weeks — and use the skin to replace a patient’s burned flesh. Yet another, nearly underway at the Mayo Clinic, will one day restore sensation lost to devastating injuries by using an implanted scaffold to spur nerve regeneration across large gaps.
Kohn is responsible for keeping those projects on-track. “The man is the single best research manager I have ever met,” says Col. (Dr.) Bob Vandre, who spearheaded and later directed the AFIRM program. “Under him, [this research] is already looking to make a huge difference for patients.”
Kohn’s role in AFIRM successes actually started decades ago: That was when, thanks to a lab experiment gone serendipitously wrong, Kohn invented an entirely new class of polymers that are ideal for use in the human body.
In 1972, Kohn left Germany for what he intended to be a one-year exchange program at Israel’s Hebrew University. “Of course,” he smiles, “Then I met a girl.”
One year in Israel turned into 11, that girl became his wife, and Kohn completed his undergraduate degree and Ph.D. in the country.
Midway through his studies, Kohn was conscripted into two years of mandatory military service, though he never endured combat. Instead, a 25-year-old Kohn found himself working in the Army Surgeon General’s office during the aftermath of the 1973 Yom Kippur War.
He remembers seeing soldiers suffering from often-deadly burn wounds — the signature injury of that conflict. Shortly thereafter, Kohn started the scientific investigations that would one day, albeit unintentionally, catalyze regenerative treatments for the very same affliction.
“I never set out thinking, ‘Oh, in my career I want to treat these war injuries,’” he says. “Somehow, though, that’s the path I found myself taking.”
- The goal behind much of Kohn’s work is to use degradable polymers and tissue scaffolds to regenerate human body parts, replacing a wide array of existing prostheses and artificial implants, which are shown in this image.
ohn’s investigations started during his PhD, under the leadership of Dr. Meir Wilchek, a renowned biochemist. Wilchek, now 78, remembers Kohn — known affectionately as “Micha” after the Hebrew-speaking registrar’s office translated his first name from right-to-left, spelling it backwards — as his best-ever student, and one who would often join him “to drink beer and talk chemistry,” on the rooftop of Wilchek’s apartment building.
Those chats sometimes revolved around the art of enzyme immobilization, which was the focus in Wilchek’s lab and of Kohn’s Ph.D. studies. Scientists at Israel’s Weizmann Institute of Science were trying to figure out how an enzyme could be permanently bound to polymers, large molecular structures comprised of repeating sub-units. But in his efforts to keep those enzymes attached, Kohn discovered a reaction that yielded the opposite effect.
7 Favorite Breakthroughs
The first kidney transplant Pioneered by Army doctor Joseph Murray, who performed the first transplant with a surviving patient.
“Golden hour” trauma care Today, the chances of surviving a serious injury in remote Afghanistan are better than surviving the same one in Times Square.
The mystery of yellow fever Solved by Army Surgeon Walter Reed in 1900, when he discovered that mosquitos were responsible for transmitting the disease.
Cadaveric face transplantation With the exception of the first transplant, every American face transplant operation has been DoD-funded.
Replacement skin Work funded through AFIRM and Rutgers will revolutionize severe burn treatment, and clinical trials are starting in 2013.
Quikclot A new type of bandage that helps stop the flow of blood from gushing wounds, this DoD innovation will control massive bleeding by clotting blood.
Blood supply strategies The DoD has led the development of blood supply strategies. In the event of a major civilian crisis, these are instrumental in securing adequate supply under adverse conditions.
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