On entering the research building in the Wedding district of Berlin, one of the first things that catches the visitor’s eye is the German translation of a famous aphorism reputedly coined by Thomas Alva Edison, inventor of the lightbulb: “Invention is one percent inspiration and ninety-nine percent perspiration.”

For Georg Duda, the quotation also fits well with his work and scientific inquiry in general. “We want to make big strides and improve patient health care. The only way to make those strides is to work hard and to understand and bring together clinical medicine and basic research. Waiting for inspiration is not enough.”

“I never planned to be a professor of medicine.”

Georg Duda conducts research into the interplay of bone and muscle and how the two types of tissue influence each other during regeneration following injury. Duda is actually an engineer by training, having studied precision mechanics and biomedical engineering at Technische Universität Berlin in the 1980s. He came to medicine by chance: “I never planned to be a professor of medicine.”

After completing his studies in Berlin, Duda first went to the U.S. for a position in the biomechanics lab at the renowned Mayo Clinic in Minnesota. He subsequently took his doctorate in biomechanics at Hamburg University of Technology (TUHH) and then worked as a postdoc in accident surgery research and biomechanics at Ulm University. The Berlin-born researcher moved to Charité in 1997. As director of the research laboratory at the Centrum for Muskuloskeletal Surgery, Duda and his team applied to the German Research Foundation (DFG) to establish a clinical research group, and Duda was appointed Professor of Biomechanics and Biology of Bone Regeneration. Together with his partner, Professor Georg Bergmann, he founded the Julius Wolff Institute in 2008.

Biomechanical research at the Julius Wolff Institute benefits greatly from close ties with the interdisciplinary Berlin-Brandenburg Center for Regenerative Therapies (BCRT), which was established in 2006 as an alliance between Charité and the Helmholtz Association. At BCRT, clinicians, scientists, and engineers work together to improve our understanding of regenerative processes and to develop therapies based on the outcomes. The close collaboration between immunologists, bone and muscle researchers, cardiologists, and cardiac surgeons researching together under a single roof provides ideal conditions for this work, Duda explains.

“What drives me to this day is the interplay between biology and mechanics. These two worlds mostly have nothing to do with each other at school, but in nature – including in the human organism – they are extremely closely interlinked.” Medicine has been very strongly focused on molecular research in recent decades, he says, largely to the exclusion of the essential interplay between the molecular and the cellular level, let alone organs. “It has only become clear in the last few years that mechano-biology – a young research area that addresses the interactions between biology and mechanics – is at play at many levels within the human body,” says Duda. Tissue elasticity, for example, influences stem cell differentiation, and surface geometry affects cell movement and the function of the cell nucleus. “Cells organize and orchestrate themselves by mutual attraction and also by coordination via physical signals. Mechano-biology thus opens up undreamed-of possibilities in medicine that we have largely neglected by taking an exclusively molecular approach. That is what fascinates me,” says Duda.

From Basic Research to Therapeutic Application

It is often forgotten, Duda explains, that living tissue is constantly under mechanical strain, which is ultimately essential for organs to function and maintain their structure. “When a patient goes to the doctor and says they have pain somewhere, then we are looking at an organic malfunction and thus something to do with tissue. Everything in the body is about tissue formation and degradation and hence constant regeneration. Our aim at our research center is therefore to make possible a form of medicine that investigates the interplay between different types of tissues and the principles of tissue regeneration inherent to the human body and to make use of that in treatment.”

By way of example, Duda cites the fact that we do not yet know quite what role the immune system plays in influencing or perhaps even orchestrating regeneration. Working together with immunologist colleagues, he is conducting research among other things into which immune cells promote and which ones tend to inhibit bone regeneration. “All questions we address have their origin in the clinical setting, notably in orthopedics and accident surgery. And that is where we want our research findings to go back to.” The inestimable advantage of university medicine in Germany, says Duda, is that due to close ties between research and clinical medicine, findings can be gained directly on the patient, enabling clinical therapy to be enhanced by basic research. “That is often beyond the means of many pharmaceutical and medical engineering companies today. At BCRT, we have built up the infrastructure for clinicians and researchers to make use of this reversed internal translation at an early stage.”

Georg Duda has perfected bone regeneration implants that are now in use the world over. With basic research on stress and strain in the human body, his team laid the groundwork for all current type approval standards in international orthopedics. He is currently part of a working group investigating ways to assist faster, scar-free muscle regeneration. An example is musculature damage in an operation – and such damage occurs in every operation – where the muscles concerned are not only important to the functioning of the musculoskeletal system, but also for rapid and complication-free regeneration. “To this day, we don’t really have any satisfactory therapeutic approach for damaged muscle,” says Duda. Together with surgeons, biomaterial experts, stem cell researchers, and a company, Duda’s team has therefore developed a cell therapy that significantly reduces scar formation in regenerating muscle and restores muscular function more rapidly after surgery. “It is the first cell therapy for muscle regeneration worldwide, and it is now in phase III clinical trials for approval,” Duda says.

Researchers at Interdisciplinary Boundaries

Duda, who is one of the three founding directors of the Berlin-Brandenburg Center for Regenerative Therapies and spokesperson of the associated graduate school, BSRT, also works closely with sports scientists at Berlin’s Humboldt-Universität. It is his firm belief that research today can only work on a collaborative basis and, in his specific area, regeneration must go hand in hand with prevention: “I find it extremely exciting when researchers work together at interdisciplinary boundaries to create something truly new. Collaboration enables scientists to improve their techniques and take their research to a deeper level of understanding.”

As Duda confirms, Berlin offers special opportunities in this regard: “The city has an inestimable wealth of expertise with its many highly regarded scientists and the associated intellectual potential. The only downside to such a wealth of expertise is that you always have to make sure someone hasn’t already had a better idea,” says Duda, laughing. But that extra effort presumably comes under the ninety-nine percent perspiration without which there would be no new ideas or inventions.