The work of a local scientist borders on science fiction. THEO PANAYIDES meets a man trying to understand the bigger picture
Take a “pig container”, for instance. The idea – if you’re a researcher in stem-cell regenerative medicine specialising in the kidney, like Christodoulos Xinaris – is to create a genetically modified pig that’s unable to develop kidneys (this is apparently do-able, albeit expensive). Then, while the pig is still an embryo, you introduce stem cells taken from humans – which would mean creating human embryos though it’s now become possible to use “induced pluripotent cells”, i.e. ordinary skin cells that have been “induced” to behave like embryo cells (this is also do-able, and the first man who did it won a Nobel Prize). The hope is that the cells will develop into kidneys “in vivo”, someday doing likewise in human patients as well as GM pigs – but of course you need to be careful. If, for instance, some of the human cells accidentally went to the neurons of the pig’s brain (maybe because you’ve modified a gene that affects the brain as well as the kidneys), you’d have … what? A pig with a part-human brain? A pig that thinks like a person?
That’s the kind of science-fiction scenario that constantly lurks on the fringes in Christodoulos’ line of work (he’s a senior researcher at the Mario Negri Institute, a non-profit research centre in Bergamo, near Milan) – though admittedly the “pig container” is still a work in progress: “That’s the final destination of the project,” as he puts it. On the other hand, it’s not exactly science fiction. Christodoulos and his team have been able to construct “organoids” using stem cells since 2012 – a discovery for which he won ‘Scientist of the Year’ at the local ‘Man of the Year’ awards – and are now trying to make that kidney tissue transplantable. “In the beginning we found out how to fly, let’s say,” he explains in fluent but non-native English. “Now we have to reach a destination.”
Scientists love to talk about this stuff, of course. Talk of a brave new world – he quotes a TIME magazine article claiming that children born today will live to be 150 years old – highlights their own role as gatekeepers, which translates into more funding and money in their purse. Yet Christodoulos is different. For one thing, he seems to have little interest in the lucrative side of science. None of his discoveries are patented (the Institute, as already mentioned, is non-profit) and he’s something of a medical missionary, in a small way. He travelled to Mexico some years ago, taking medicines to the Zapatista rebels in Chiapas, and now plans to go to Malawi for a couple of months with a “laboratory in a suitcase”, a portable kit that’ll allow him to perform blood tests and so on. Last year he taught in an Italian orphanage, introducing biology to 17-year-olds “who had never heard of ‘cell’, they didn’t even know they were made of cells” (most were migrants, including a couple of kids who’d been rescued at sea after trying to cross from Africa). His lectures included practical lessons, getting the kids to point microscopes at themselves; “You should’ve seen the light in their eyes when they saw their cells!”.
There’s another sense in which he’s not your typical scientist – because scientists tend to be monomaniacs, wholly invested in science, whereas Christodoulos is something of a free spirit. He’s 38, but could pass for younger; his laugh is startlingly open, an unrestrained adolescent’s laugh that accelerates into mini-hysteria. He reads widely (not just medical textbooks), currently revisiting Camus and the ancient Greeks; he’s a big theatre buff, though literally has no time for television – last year he marked two decades without TV, not having turned on the idiot box since 1994. What got him interested in regenerative medicine? “I always had existential questions, like why we live, why we die. Why should something die, and not regenerate itself? Science was a natural development of my life. I had these questions from the beginning of my life, and I studied also other disciplines – philosophy, religion – and science was the most honest with me”. If science doesn’t know something, it simply says so. That’s where research comes in.
He’s in Cyprus for a few days, giving a lecture organised by the Rotary Club of Nicosia-Aspelia; we actually meet in his sister’s house, out in the leafy suburbs. His sister Maria is in banking, but both she and her husband also paint (I didn’t get the husband’s job, but he’s at work on a Saturday morning so it must be important) and the walls are dotted with their vivid, abstract paintings. “Research is actually on the edge of science and art,” Christodoulos tells me, as if inspired by the artworks around him. “Because sometimes you’re doing things that nobody saw before – like in art. And you have to find the language in order to communicate these things – like in art”. His own language is personal, with an impish sense of humour; he chuckles as he tells how Giuseppe Remuzzi, his mentor at the Institute, hopes to launch the ‘pig container’ project (“Pigs for Human Organs”) with funding from Portugal, Italy, Greece and Spain – the crisis-ridden ‘PIGS’ countries! In science, “you have to do innovative things. And sometimes you are doing useless things – like in art. And you need imagination, a lot of imagination.”
It takes vision, a childlike faith in the impossible. Christodoulos has no children, but his two nephews – nine-year-old Ektoras and seven-year-old Polis – seem to be on to him, recognising one of their own kind. “Polis! Get out!” yells his uncle mock-fiercely when the younger boy strays into the room; “You get out!” replies Polis in the same tone of voice, and giggles. Christodoulos is clearly the fun uncle, obviously an adult but not boring and pedestrian like the other adults. What was he like as a child? “I was hyperactive, always. I couldn’t relax,” he sighs. Even now, “when you talk about relaxation, I cannot imagine what you are talking about”. He’s restless, and easily bored. He keeps fit with martial arts – an hour or so after work – but “every five years I change discipline”, just to keep things fresh (he’s tried kung fu, tai chi, krav maga, wing chun and now kickboxing). When he comes to Cyprus, his friends post Facebook messages like “Xinaris is here, prepare yourselves!” he says, and laughs his manic laugh again.
Maybe that’s why he’s able – indeed, happy – to look at the bigger picture. Scientists often clam up when asked about bioethics, for obvious reasons – but Christodoulos candidly admits that yes, there’s a problem. Today he’s putting “reprogrammed” stem cells in GM pigs, tomorrow someone might be putting them in humans – and of course the elite will be able to afford such treatment, the plebs will not. “So the differences between classes are not just social, but they’re becoming biological – like in [Aldous] Huxley’s Brave New World”.
Our current path is increasingly unsustainable. It’s all very well for TIME magazine to rave that today’s kids will live to be 150 – but at what cost? How to pay for all the drugs they’ll need? “Because we are not programmed to live 150 years, we need pharmacological support. And at the same time, in Africa, every minute a child dies because of famine, different diseases, etc”. In Nigeria, he tells me, the average life of a patient with chronic kidney disease is one month from the time they start dialysis – “because they usually have money to pay only the first round of dialysis”. Meanwhile, “in Europe there are people living in dialysis for 30 years,” costing the state some €80,000 annually. This kind of largesse can’t last forever, indeed it’s estimated that Western health systems will start to buckle in the next decade, as the population ages. That’s why there’s growing interest in stem-cell kidneys – but then what? Do we end up with a two-tier world, one half able to regenerate itself while the other lives in misery?
“There are great ethical issues in these things,” he says, nodding vigorously. “I think it will be one of the major problems of Western civilisation”. Medicine, it seems, can do anything now. Just last month, he tells me, doctors took the vaginas from two girls in Mexico, “decellularised the vaginas in order to keep the scaffold” then introduced stem cells, essentially rebuilding the vagina. What should a scientist do, caught up in this golden age of science? “You have to ask, as a scientist, and respond to this question for yourself.”
Who should have access to these wonders? Everyone, if possible. He doesn’t patent, Christodoulos reminds me. “If I find the solution and make a new kidney, it can be transplantable to the whole world,” whether in New York or Nigeria – but of course that’s a bit utopian, and he also admits that you can’t do much as a scientist without the support of a pharmaceutical company looking to maximise its profits. What about the larger question, though? Should we even be doing these things – modified pigs, man-made vaginas? Isn’t it somehow against Nature?
A long pause. “OK,” he begins, “what is Nature? We are Nature”. Life began, oxygen appeared and “the universe took a form in which it can self-observe” – our own form, the human form. “OK? We are universe. We are pieces of the first oxygen, nitrogen. We are the same things that stars are composed of. We are the same material. And we called ourselves ‘humans’ – OK, who cares”. It’s all Nature, he explains. If people create a Nietzschean superman, that too will be Nature.
“I don’t believe there are rules,” he affirms, nor does he believe in religious dogma. “I believe in people. I like to watch and give and receive from around [myself], not from the skies. Because sometimes, when you are looking at the skies, you forget your environment”. Astromeritis was one such environment, the village where he grew up (his grandpa was a shepherd, his parents refugees from nearby Zodia) and spent “some of the most beautiful years of my life”. Bergamo is another environment, creating in the lab, sometimes riding horses (one of his passions) across the Alpine foothills in the summer. Mexico was another, seeking Zapatistas in Chiapas, fleeing a bar in Mexico City – one of the world’s most dangerous cities – after five sinister men started asking questions. The Atlas Mountains in Morocco were another (he’d gone there to study the mountain macaques), rescued by Berbers after his car broke down, dealing with a local mechanic who repaired his car in between smoking the world’s biggest joint and looked at him quizzically when Christodoulos offered money.
“I’ve had many adventures,” he admits. “It’s not that I like taking risks – [but] I want to do some things, and when I find obstacles, I go on”. It’s the scientist’s way, the researcher’s guiding maxim. Be fearless. If things get weird, just keep going. Christodoulos Xinaris is no fool; a million years from now, he muses, Earth might be run by rats who’ll look back wryly on that strange species called humans, who destroyed themselves with a surfeit of consciousness. Consciousness is still very new – the dinosaurs didn’t have consciousness – and we don’t know for sure that it’s a good thing. It may be our fatal flaw, as a species.
Yet we have to keep going, in this brave new world of science fiction – guided by fairness and humanity, not unhelpful notions of Good and Evil. Look at ancient Greece, he tells me: “There is no sin, no bad and good. There are no such stupid things – that is Christianity! There is only ‘metron’ [i.e. limits, moderation]. Not to overcome the limits. If you pass the limits, you cannot come back. All of them paid because they didn’t respect the metron. Oedipus, everybody. So, in science, it’s the same thing.”
A few months ago he received an email from a man in Greece, says Christodoulos. Both he and his wife had been unemployed for many years, wrote the man, but they had a four-year-old child in dialysis; “Could I send you €20 every month, to help with your science?”. This is the point, he tells me; this is the reason why he does what he does – to help, to cure disease, to make a better world. “About the future and the applications [of the work], it’s the same as Daedalus and Icarus. The principle was right: you can fly! But try not to go too close to the sun, because it’s dangerous”. We can fly. Now let’s choose a destination.