Table of contents
Introduction
Our Living Scaffolds project is particularly close to our hearts, as it aims to help people who live with the pain and silent consequences of osteoporosis on a daily basis. This disease affects more than 200 million people worldwide, the majority of whom are women, and causes bone fragility that can profoundly affect quality of life.
We built our approach around one central question: how can we be sure that our work is responsible and truly beneficial to society?
How Society Influences Our Project
From the outset, we identified the various stakeholders involved:
- Researchers and clinicians (rheumatologists, medical biologists)
- Patient associations and healthcare organizations
- Teachers and students
- Non-specialist citizens
- People with osteoporosis
These discussions enabled us to better identify real needs.
For example, Dr. Sophie Trijou, a rheumatologist in Marseille, explained to us that current osteoporosis treatments are not always sufficient to effectively stimulate bone regeneration and can sometimes have limitations in terms of tolerance. This testimony reinforced our idea of developing a complementary, more targeted, and innovative solution.
How Our Project Affects Society
Ultimately, our project could contribute to:
- Improving patients' quality of life by reducing pain and the risk of fractures.
- Reducing medical care costs (hospitalizations, major operations).
- Stimulating biomedical innovation by paving the way for new approaches in regenerative medicine.
However, we have also identified limitations and risks:
- Ethical: ensuring that our technology is not misused or used irresponsibly.
- Technical: verifying the safety of the scaffold and preventing any uncontrolled dissemination.
- Societal: ensuring public acceptance of the use of synthetic biology solutions.
We have chosen to bring our project to life not only in the laboratory, but also by reaching out to society.
On the one hand, we have carried out interventions in schools, from middle school to high school, in order to:
- Awaken students' scientific curiosity and introduce them to fields such as synthetic biology, biochemistry, and engineering.
- Raise awareness among young people about major health issues, particularly osteoporosis, a disease that is still too little known despite its significant impact.
With students: we organized presentations in middle and high schools to spark young people's scientific curiosity and raise their awareness of major health issues. Using osteoporosis as an example, we showed that biology and biotechnology can offer concrete solutions to real problems.
With the general public: finally, we distributed a questionnaire to better understand the perceptions and fears of the population regarding the use of genetically modified bacteria in a medical context. This feedback enabled us to adapt our communication and anchor our project in a transparent approach. The results were very revealing:
- 64.8% of respondents fear unknown side effects.
- 31% express concern about biosafety.
- 50% believe that there is still a lack of scientific perspective.
Finally, we also developed a survey to gauge public opinion and better understand their fears about the use of genetically modified bacteria to treat osteoporosis, as well as a questionnaire for people with osteoporosis, which we gave to rheumatologists.
By combining public awareness and exchanges with the medical profession, our project therefore seeks to have a dual impact: to inform, educate, and prepare future generations while addressing the real needs of patients.
Public response on osteoporosis :
Question: Have you ever heard of osteoporosis? (yes = blue, no = red) :
Question: What do you think of the idea of an injection of hydrogel that helps your bones regenerate? (it's a very good idea = blue, it's interesting but I need more explanation = red, I'm not reassured by the bacteria = orange) :
Question: If you had a loved one with osteoporosis, would you like them to benefit from this type of innovative solution? (Yes = blue, No = red, I don't know = orange) :
Question: In your opinion, what aspect of this disease makes daily life particularly difficult for sufferers? (Risk of fracture = blue, pain and fragility = red, loss of independence = orange, all three at the same time = green, all of the above) :
Question: The hydrogel contains harmless bacteria that are enclosed to avoid any risk. Do you think this safety measure is sufficient? (Yes, it reassures me = blue, Not entirely, I still have doubts = red, No, I would prefer a different approach = orange) :
Question: What do you fear most about this treatment that uses modified bacteria? Unknown side effects, poor safety, lack of scientific perspective, nothing :
Question: Do you think such a treatment would be useful for elderly or frail people? (Yes, definitely = blue, Maybe = red, No, not really = orange) :
Patients response on osteoporosis :
Question: For you, what is the most important aspect in a future osteoporosis treatment? (That it is effective [Blue], That it doesn't require many procedures or medical visits [Red], That it quickly improves quality of life [Orange]) :
Question: What is the biggest difficulty you face because of osteoporosis? (Pain [Blue], Fear of falling or breaking a bone [Red], Loss of independence [Orange]) :
Question: Did you know that osteoporosis affects about 40% of women after menopause? (Yes [Blue], No [Red]) :
Question: The hydrogel contains non-pathogenic (harmless) bacteria, and for added safety, they are enclosed in the gel and cannot escape. Does this biosafety reassure you? (Yes [Blue], Somewhat [Red], No [Orange]) :
Question: Among the properties of méJanine (antioxidant, protective, aids regeneration), which seems most useful to you for osteoporosis? (Bone regeneration [Blue], Both [Red]) :
Question: For you, what matters most in a future osteoporosis treatment? (That it prevents fractures [Blue], That it restores bone strength [Red], That it reduces pain [Orange], That it has few side effects [Green], That it quickly improves daily life [Purple]) :
Question: How long have you been living with osteoporosis? (Less than 1 year [Blue], 1–5 years [Red], More than 5 years [Orange]) :
Question: Have you ever had a fracture related to osteoporosis? (Yes, several times [Blue], Yes, once [Red], No [Orange]) :
Question: What is the biggest consequence of osteoporosis for you? (Daily pain [Blue], Difficulties walking or moving [Red], Fear of falling [Orange], Loss of independence [Green]) :
Question: What do you think of the idea of a hydrogel that helps bones repair themselves better? (Very interesting [Blue], Why not, but I have concerns [Red], Not reassuring at all [Orange]) :
Question: What do you think of the idea of an injection of a bioresorbable hydrogel that helps your bones regenerate? (I find it very interesting [Blue], I am interested but a bit worried [Red], I am against it [Orange]) :
Question: What are your main concerns? (Safety (fear of infection, rejection...) [Blue], Effectiveness (will it really work?) [Red], Cost [Orange]) :
Question: If this gel became available, would you be ready to try it? (Maybe (I would like more information) [Blue], Yes [Red], No [Orange]) :
Integration of Ethical Considerations and Feedback
Discussions with our partners have prompted us to:
- Consider the sustainability and future cost of our solution, so that it is accessible to as many people as possible.
- Develop clear educational materials to explain what synthetic biology is, in order to combat misconceptions and promote social acceptance.
Ethical Challenges Encountered
We faced several dilemmas:
- How can we balance scientific innovation with respect for public sensitivity to GMOs and life sciences technologies?
- How can we ensure that our project does not only serve a limited audience but truly benefits society as a whole?
- How can we anticipate the risks of misuse while encouraging open and collaborative research?
These considerations have fueled our commitment to working in a transparent, secure, and responsible manner.
Prospects for the Future Thanks to Human Practices
Our Human Practices activities have above all enabled us to lay the foundations for long-term thinking. Although our project is still at the academic stage, the discussions we have had with doctors, students, and the general public are already opening up several avenues for the future:
- Gather more in-depth medical feedback by consulting more osteoporosis specialists in order to tailor our project to real clinical needs.
- Continue to raise awareness among younger generations by expanding our activities to other schools and developing interactive educational materials that are accessible online.
- Expand the dialogue with the general public through new questionnaires and discussion workshops in order to anticipate issues of ethics, safety, and social acceptability.
- Consider the sustainability of the solution, particularly its affordability and integration into various healthcare systems.
In short, even if our Human Practices approach has not yet radically transformed our experimental design, it has enabled us to identify clear areas for the development of our project in the next stages. It has also enabled us to identify a need to strengthen our safety tests and add another safety mechanism. The addition of a bacterial self-destruction system could be implemented to reassure patients about our therapy. These discussions enable us to prioritize the next phases of the project.
Conclusion
Our Living Scaffolds project is not limited to scientific innovation. It is part of a broader reflection in which science, society, and ethics advance together.
By incorporating feedback from stakeholders and considering the social, safety, and environmental implications, we want this project to be not only a scientific success, but also a responsible, sustainable project that is aligned with society's expectations.