We highlight recent developments pushing medical markets toward the future.
Type 1 Diabetes Mellitus and Artificial Pancreas Development
This month, the NIH announced that it is funding four projects to test fully automated artificial pancreas devices in Type 1 diabetics.
This important because, aside from Medtronic’s MiniMed 670G device (FDA approved in 2016), there are no other artificial pancreases on the market, and patients are begging for these to test successfully and be made available. I have a family member with Type 1 and can confirm that a “closed system” — one that tests glucose and adjusts insulin (and/or glucagon) in response — would dramatically ease the burden of managing this disease. No endless finger pricks, bouts of hypoglycemia or hyperglycemia, no elevated HbA1C — no bad sequellae from poorly managed diabetes, like peripheral neuropathy, retinopathy, vascular disease.
Three of the four trials, slated to begin in 2017 and 2018, are focused on testing devices in predominantly under 18 patients, while one trial will be for those 18 and over. These studies will refine the algorithms so that they more closely approximate normal glucoregulation.
The real future for diabetes management is likely to be determined by a biotech development — stem cells that regenerate pancreatic cells combined with mechanism to prevent the autoimmune response of type 1 that destroys functional insulin-producing pancreatic cells. The perfect solution to this disease is a cure, and maybe a form of cell therapy will ultimately be developed to provide that. Advances in cell biology and immunology suggest this may still be 5-10 years away.
In the interim, the liberation provided by safe, effective glucose control in an “artificial pancreas” (pump/glucometer) is likely to be dramatic for those type 1 patients fortunate enough to get one.
This month, a number of developments occurred in the area of body-machine interface, the connection of implants or other devices/systems to the body tissues:
- Prosthetic arm to detect nerve signals
- Stentrode electrode implanted minimally invasively in brain to record signals from the motor cortex and transmit them wirelessly through the skin to a device outside the body.
- Harvard study to place implant on visual cortex in brain to reverse blindness, potentially paralysis as well.
- Living diode: Using cardiac muscle cells and cardiac fibroblasts — cells found in connective heart tissue — researchers at the University of Notre Dame have created a “living diode,” which can be used for cell-based information processing, according to a recent study in Advanced Biosystems. Bioengineers created the muscle-based circuitry through a novel, self-forming, micro patterning approach.
- Knitted muscles with electroactive material
Neuroscience is perhaps one of the biggest sources of new innovation for treatment, spinning off many new technologies for monitoring and treatment.
Artificial Intelligence, Machine-Learning, Computational Modeling
Advanced information systems are creating new possibilities in the development and application of therapeutics. Computer modeling of prospective drugs is accelerating the process toward manufacture of new safe and effective drugs, predicting complications based on better data integration of chemistry, biology, genetics, and other factors impacting drug efficacy.
- Toxic liver effects of drugs predicted through computational modeling.
- Computational modeling in stent design
- Drug evaluation
- Voice analysis for diagnosis
As evidence of the force for innovation coming in these areas, the number of AI-related companies is surging. CB Insights reported that, in Q1-2011, there were 10 deals in artificial intelligence, but by Q2-2016, that number had hit 120 deals.
ALSO: CRISPR gene-editing patent dispute between MIT Broad Institute and University of California, Berkeley, resulted in a win for MIT Broad Institute, which will garner multitudes of money from licensing in “eukaryotes”(cells with nucleii) while UC Berkeley is left with open loopholes for patenting prokaryotic cells — Or, as Berkeley’s Jennifer Doudna (patent applied for) described it, “They have a patent on green tennis balls. We [likely] will have a patent on all tennis balls,” says Doudna. Meanwhile, CRISPR developments continue to emerge (e.g., gene-edited virus resistant pigs).