Light introduced through an optical fiber can
determine whether a patient's blood is coagulating
by measuring the vibration of red blood cells.
(Credit: Andrii Pshenychnyi)
A University of Central Florida professor has invented a way to use light to continuously monitor a surgical patient's blood, for the first time providing a real-time status during life-and-death operations.
The technology developed by UCF scientist Aristide Dogariu uses an optical fiber to beam light through a patient's blood and interpret the signals that bounce back. Researchers believe that in some situations it could replace the need for doctors to wait while blood is drawn from a patient and tested.
"I absolutely see the technique having potential in the intensive care setting, where it can be part of saving the lives of critically ill patients with all kinds of other disorders," said Dr. William DeCampli, who is chief of pediatric cardiac surgery at Arnold Palmer Hospital for Children a professor at the UCF College of Medicine. DeCampli helped develop the technology and test it during surgery on infants.
During surgery, physicians are wary of the patient's blood coagulating, or clotting, too quickly. A clot can lead to life-threatening conditions such as stroke or pulmonary embolism. Coagulation is of particular concern during cardiovascular surgery, when a clot can shut down the heart-lung machine used to circulate the patient's blood.
Doctors administer blood-thinning medication to prevent coagulation. But every 20-30 minutes, blood must be withdrawn and taken to a lab for a test that can take up to 10 minutes. That's a slow process with gaps of time without up-to-date information, especially in operations that can last four hours or more.
Dogariu, a Pegasus Professor in UCF's College of Optics & Photonics, developed a machine with an optical fiber that can tap directly into the tubes of the heart-lung machine. The optical fiber beams light at the blood passing through the tube and detects the light as it bounces back.
The blood-monitoring device taps directly
into the heart-lung machine used to circulate
blood during a patient's surgery.
(Credit: University of Central Florida)
As reported in a paper published recently in the journal
Nature Biomedical Engineering
, the machine constantly interprets the light's back-scatter to determine how rapidly red blood cells are vibrating. Slow vibration is a sign blood is coagulating and a blood-thinner may be needed.
The technology can alert doctors at the first sign of clotting, and provide nonstop information throughout a long procedure. "It provides continuous feedback for the surgeon to make a decision on medication," Dogariu said. "That is what's new. Continuous, real-time monitoring is not available today. That is what our machine does, and in surgeries that can last for hours, this information can be critical."
Over the past year, DeCampli tested the technology during cardiac surgeries on 10 infants at Arnold Palmer Hospital for Children. The recently published paper is based on a small, proof-of-concept study, and a larger study is in the works.
Successful results of a University of Liverpool-led trial that utilised nanotechnology to improve drug therapies for HIV patients has been presented at the
Conference on Retroviruses and Opportunistic Infections
(CROI) in Seattle, a leading annual conference of HIV research, clinical practice and progress.
The healthy volunteer trial examined the use of nanotechnology to improve the delivery of drugs to HIV patients. The results were from two trials which are the first to use orally dosed nanomedicine to enable HIV therapy optimisation.
Currently, the treatment of HIV requires daily oral dosing of HIV drugs, and chronic oral dosing has significant complications that arise from the high pill burden experienced by many patients across populations with varying conditions leading to non-adherence to therapies.
Developing new therapies
Recent evaluation of HIV patient groups have shown a willingness to switch to nanomedicine alternatives if benefits can be shown. Research efforts by the Liverpool team have focused on the development of new oral therapies, using Solid Drug Nanoparticle (SDN) technology which can improve drug absorption into the body, reducing both the dose and the cost per dose and enabling existing healthcare budgets to treat more patients.
The trial results confirmed the potential for a 50 percent dose reduction while maintaining therapeutic exposure, using a novel approach to formulation of two drugs: efavirenz (EFV) and, lopinavir (LPV). EFV is the current WHO-recommended preferred regimen, with 70% of adult patients on first-line taking an EFV-based HIV treatment regimen in low- and middle-income countries.
The trial is connected to the University's ongoing work as part of the multinational consortium OPTIMIZE, a global partnership working to accelerate access to simpler, safer and more affordable HIV treatment. Funded by the U.S. Agency for International Development, OPTIMIZE is led by the Wits Reproductive Health & HIV Institute in Johannesburg, South Africa, and includes the interdisciplinary Liverpool team, Columbia University, Mylan Laboratories and the Medicines Patent Pool (MPP). OPTIMIZE is supported by key partners including UNITAID and the South African Medical Research Council (SAMRC).
Benny Kottiri, USAID's Office of HIV/AIDS Research Division Chief, said: "The potential applications for HIV treatment are incredibly promising. By aligning efforts, these integrated investments offer the potential to reduce the doses required to control the HIV virus even further, resulting in real benefits globally. This would enable the costs of therapy to be reduced which is particularly beneficial for resource-limited countries where the burden of disease is highest."
Screenshot from the English version of the VR application
used to screen for Mild Cognitive Impairment.
(Credit: Aristotle University of Thessaloniki)
Mild cognitive impairment (MCI), a condition that often predates Alzheimer's disease (AD), can be remotely detected through a self-administered virtual reality brain training game.
MCI patients suffer from cognitive problems and often encounter difficulties in performing complex activities such as financial planning. They are at a high risk for progressing to dementia, however early detection of MCI and suitable interventions can stabilize the patients' condition and prevent further decline. Greek researchers have now demonstrated the potential of a self-administered virtual supermarket cognitive training game for remotely detecting MCI, without the need for an examiner, among a sample of older adults.
It has been shown that virtual reality game-based applications and especially virtual supermarkets can detect MCI. Past studies have utilized user performance in such applications along with data from standardized neuropsychological tests in order to detect MCI. The team that conducted this study was the first scientific team to achieve reliable MCI detection using a virtual reality game-based application on its own. In that previous study , administration of the virtual super market (VSM) exercise was conducted by an examiner. The present study eliminated the need for an examiner by calculating the average performance of older adults using a special version of the VSM application, the VSM Remote Assessment Routine (VSM-RAR), at home on their own, for a period of one month. It is the first instance where a self-administered virtual reality application was used to detect MCI with a high degree of reliability.
In an article published in the
Journal of Alzheimer's Disease
, the researchers have indicated that the virtual supermarket remote assessment routine (VSM-RAR) application displayed a correct classification rate (CCR) of 91.8% improving VSM's CCR as assessed in the previous VSM study while achieving a level of diagnostic accuracy similar to the most accurate standardized neuropsychological tests, which are considered the gold standard for MCI detection.
Self-administered computerized cognitive training exercises/games are gaining popularity among older adults as an easy and enjoyable means of maintaining cognitive health. Such applications are especially popular among older adults who consider themselves healthy and are not inclined to visit specialized memory clinics for cognitive assessment. If self-administered games and exercises could also detect cognitive disorders, initial cognitive screening could be conducted remotely. The wide implementation of this method of remote screening would facilitate the detection of cognitive impairment at the MCI stage thus allowing for more efficient therapeutic interventions.
This preliminary study indicates that automated, remote MCI screening is feasible. This method could be utilized to screen the majority of the older adult population, as it dramatically lowers examination-related costs. The social and economic benefits, especially caregiver and healthcare service burden, of the early detection of cognitive disorders could be enormous. At the same time, as older adults are becoming increasingly computer savvy, it is important to create software that meets their needs and allows them to remain healthy and active. The research team continue their research on the VSM with the aim of improving usability, shortening administration time and supplementing the science behind VSM with additional data.
Globally, an estimated 350 million people of all ages suffer from depression, and unfortunately, 1 in 3 does not recover from medications or therapy. Electroconvulsive therapy (ECT), a form of brain stimulation technique, can be effective against treatment-resistant depression, but require anesthesia, have significant cognitive side effects, and high stigma. Another brain stimulation technique that is emerging is repetitive transcranial magnetic stimulation (rTMS), which does not require anesthesia and has no cognitive side effects, offering a higher tolerability. However, it has a much lower potency and efficacy than medications and ECT.
The Ottawa-based startup
specializes in magnetic brain stimulation technology, and is determined to get more people with depression into remission faster. Their technology is based on rTMS and uses magnetic pulses to send tones directly into the brain of patients to create positive feedback. By doing so, the brain is trained to prolong a healthy brainwave pattern permanently. While traditional rTMS system involves manually placing a coil on the patient’s scalp, through which small electromagnetic currents stimulate the brain, the startup’s technology is guided by brain images and coils precisely positioned using robotics. This provide far more precision and accuracy, and the magnetic field that is generated penetrates deeper into the brain for increased stimulation. In addition, NeuroQore measure its results with biomarkers as physical evidence, taking out some of the guesswork of current treatment options, and help guide both treatment and progression.
NeuroQore is already approved in Canada and is working on getting FDA approval. Their new rTMS system was installed at the Royal Ottawa Mental Health Centre in 2015 and successfully passed tolerability testing in a pilot study, and is now recruiting patients for the next round of testing. Preliminary clinical data is promising, with the startup claiming an 87.5% remission success rate over drug-resistant depression.
Every year, more than 16 million people are diagnosed with major depressive disorder in the US alone, and more than 4 million remain drug-resistant. Currently, there is a large unmet need, with current options having major side effects or low remission rates. NeuroQore has developed an innovative technology that make the treatment of drug-resistant depression more accessible and effective. The startup could change mental health care and psychiatry as we know it, allowing patients to come to centers to monitor their depression and get effective outpatient treatment in 10 to 15 minutes. In addition, the technology has the potential to be used for a range of cognitive and psychiatric disorders, including Parkinson’s, Alzheimer’s and post-traumatic stress disorder.
The startup has the potential to be a disruptive innovation that results in improved health care for patients with treatment-resistant depression. And it could even be a good alternative for elderly and youth, who often are unable to take antidepressants. The technology could increase access to care, improve outcomes and quality of life of millions around the world, potentially reducing the burden of depression that is on a dramatic rise globally.
NeuroQore has been part of the
incubator, and previous financing sources include the
National Research Council
The Natural Sciences and Engineering Research Council
Ontario Centres of Excellence
. The startup has also been part of the winter 2016 program of
, the world’s largest seed biotech accelerator, run by
Researchers at FAU have developed a portable device that
can be used in airports or a remote location in South
America to detect Zika. (Credit: Florida Atlantic University)
About the size of a tablet, a portable device that could be used in a host of environments like a busy airport or even a remote location in South America, may hold the key to detecting the dreaded Zika virus accurately, rapidly and inexpensively using just a saliva sample. While scientists across the world are scrambling to find some sort of immunization, researchers from Florida Atlantic University are working to develop a diagnostic tool to reduce the impact of the outbreak until a vaccine is identified.
“Most of the Zika cases in the United States and especially in Florida are travel related,” said Waseem Asghar, lead investigator. “We are working to develop a tool that can be used without expensive laboratory equipment and skilled technicians in various settings like an airport or a community health center to provide reassurance to expectant families and those concerned because of recent travel. For about $2 and within 15 minutes, we hope to accurately determine whether or not an individual has an active infection.”
Currently, patients are diagnosed by testing whether they have antibodies against the Zika virus in their bloodstream, however, the antibody test cannot discriminate accurately between the Zika virus and other flaviviruses such as Dengue, West Nile virus and Chikungunya. The more accurate method for detecting the virus is by looking for pieces of the viral genome in a patient’s blood sample using a test known as polymerase chain reaction (PCR). PCR is costly ($20,000+), bulky and requires highly skilled laboratory personnel to operate. Furthermore, results for PCR testing can take hours to yield results.
“Flaviviruses are found in mosquitoes and ticks that may infect people and cause a range of mild-to-fatal diseases,” said Asghar. “Because flavivirus antibodies cross-react with one another current tests cannot distinguish between them.”
This new device is based on technology that Asghar and colleagues developed to
. It uses inexpensive paper- or plastic-based materials, a cassette-sized container holding up to 12 samples at a time and a receptacle about the size of a tablet. These materials are easy to make, easy to use, and can easily and safely be disposed of by burning, providing an appealing strategy for developing an affordable tool for diagnosing the Zika virus in developing countries as well as low- and middle-income countries where there is limited laboratory infrastructure.
They are working to adapt their device to diagnose the Zika virus, and recently received a $199,280 one-year grant from the Florida Department of Health to establish proof-of-principle and then further test and commercialize this device.
“We would also like to thank FAU’s Institute for Sensing and Embedded Network Systems Engineering (I-SENSE) for providing seed grant support to develop a Zika test, which significantly contributed to the development of our current device prototype,” said Asghar.
This image shows large clonal colonies of cochlear
progenitor cells formed from single cells and converted
into high-purity colonies of hair cells (cyan) with intricate
hair bundles (red). (Credit: Will McLean)
Within the inner ear, thousands of hair cells detect sound waves and translate them into nerve signals that allow us to hear speech, music, and other everyday sounds. Damage to these cells is one of the leading causes of hearing loss, which affects 48 million Americans.
Each of us is born with about 15,000 hair cells per ear, and once damaged, these cells cannot regrow. However, researchers at MIT, Brigham and Women's Hospital, and Massachusetts Eye and Ear have now discovered a combination of drugs that expands the population of progenitor cells (also called supporting cells) in the ear and induces them to become hair cells, offering a potential new way to treat hearing loss.
"Hearing loss is a real problem as people get older. It's very much of an unmet need, and this is an entirely new approach," says Robert Langer, the David H. Koch Institute Professor at MIT, a member of the Koch Institute for Integrative Cancer Research, and one of the senior authors of the study published
in the Feb. 21 issue of
Noise exposure, aging, and some antibiotics and chemotherapy drugs can lead to hair cell death. In some animals, those cells naturally regenerate, but not in humans.
The research team began investigating the possibility of regenerating hair cells during an earlier study on cells of the intestinal lining. In that study, published in 2013, the researchers reported that they could generate large quantities of immature intestinal cells and then stimulate them to differentiate, by exposing them to certain molecules.
During that study, the team became aware that cells that provide structural support in the cochlea express some of the same surface proteins as intestinal stem cells. The researchers decided to explore whether the same approach would work in those supporting cells.
They exposed cells from a mouse cochlea, grown in a lab dish, to molecules that stimulate the Wnt pathway, which makes the cells multiply rapidly.
At the same time, to prevent the cells from differentiating too soon, the researchers also exposed the cells to molecules that activate another signaling pathway known as Notch.
Once they had a large pool of immature progenitor cells (about 2,000-fold greater than any previously reported), the researchers added another set of molecules that provoked the cells to differentiate into mature hair cells. This procedure generates about 60 times more mature hair cells than the technique that had previously worked the best, which uses growth factors to induce the supporting cochlea cells to become hair cells without first expanding the population.
The researchers found that their new approach also worked in an intact mouse cochlea removed from the body. In that experiment, the researchers did not need to add the second set of drugs because once the progenitor cells were formed, they were naturally exposed to signals that stimulated them to become mature hair cells.
Because this treatment involves a simple drug exposure, the researchers believe it could be easy to administer it to human patients. They envision that the drugs could be injected into the middle ear, from which they would diffuse across a membrane into the inner ear. This type of injection is commonly performed to treat ear infections.
Some of the researchers have started a company called
, which has licensed the MIT/BWH technology and plans to begin testing it in human patients within 18 months. "We hope that our work will allow other scientists to pursue studies of supporting cells and hair cells that have not been possible because such limited quantities of hair cells were available," leader author, and a recent PhD recipient at the Harvard-MIT Division of Health Sciences and Technology, Will McLean says.
The researchers are also working on applying this approach to other types of cells, including types of intestinal cells involved in insulin regulation and control of the gut microbiota.
According to the WHO, 1 in 160 children has an autism spectrum disorder. While some with the disorder are able to live independent and productive lives, others have severe disabilities and require life-long care and support. As a consequence, people with autism are often subject to stigma, discrimination and human rights violations. Early diagnosis and targeted therapy are associated with dramatically improved quality of life, however, only one in four children gets timely care. On average, it takes over 2.5 years for patients to receive a diagnosis from the time they first contact their physician.
The Polish startup
is determined to help people live better lives through early diagnosis and targeted therapy of mental disorders. They have developed an innovative technology to support early assessment of autism spectrum disorder. The technology, called Play.Care, is the first tablet-based technology that detects early signs of developmental delay in children through games. The technology is based on research that suggests that children with autism behave differently while using a tablet-based application than their typically developing peers, which can be used to identify the potential risk of autism through movement pattern analysis.
The assessment starts with the child playing two educational games specifically designed to encourage motor, social and cognitive behaviors. While playing, algorithms measure the child’s behavior through over 340 parameters per second, comparing movement patterns to those observed in typically developing children. Within 15 minutes, a personalized, easy-to-understand report is generated, which provide a skill profile that with a 90% accuracy estimate the risk of autism. In addition, the report can be used to track skills over time to help parents, doctors and therapists make more informed decisions.
Early intervention is important to promote the optimal development and well-being of people with autism spectrum disorder. Harimata has developed an innovative technology that support the early assessment of the disorder, thereby increasing the number of children who get timely care. Globally, access to services and support for people with autism is inadequate, and Play.Care can help increase access to a reliable assessment tool for children and their families who are affected all over the world. In only 15 minutes, the test identify behavioral patterns related to autism, providing support for both parents and health care providers through a period which today is far too time-consuming. In addition, the quantitative nature of the technology enable the tracking over time, supporting more targeted therapy and evaluation of its efficiency. Most importantly, Harimata has developed a technology that can change the lives of children around the world. Early assessment and intervention promote the optimal development and well-being, increasing outcomes and quality of life. It could be the difference between an independent, productive life, or requiring life-long care and support.
The technology has been validated in three scientific studies, with research partners including
University of Strathclyde
Jagiellonian University in Krakow
Gdansk University of Technology
. The startup has previously been part of
, a Warsaw-based accelerator funded by EU, and has received funding from
, a German-based investor focusing on digital health startups. In 2016, Harimata was selected among 100 global social tech projects in
the Nominet 100
, celebrating people and organizations who use digital technology to tackle a significant social challenge.
It is crucial that children with speech and language impairments receive ongoing speech therapy. Speech plays an important part in communicating basic needs and wants to others in their environment, and interacting with others in their community and life. Speech therapy can make an enormous difference in someone’s life and help build confidence. However, as the demand keeps growing, there are fewer speech therapists available. As a result, the price for therapy is increasing, and developing technology that can make the process more efficient while delivering quality care is of high importance.
The Latvian startup
is developing interactive games designed as early intervention for speech improvement and emotion expression stimulation. The interactive computer-guided system enable children with speech and language impairments to receive speech therapy from the comfort of their home. The platform is specially designed to engage and motivate children through its gamification approach, and use 3-D webcams to monitor facial muscles and tongue position and movement in real-time for immediate feedback. To complement the system, the startup has also developed a web platform that allow families to manage profiles and plans from any smart device, and help speech therapists track all their patients, their performance and visualize results.
The therapy process is a long-term commitment for everybody involved. Research shows that 30% of work done by speech therapists are oral motor speech exercises, which are repetitive, tedious and can be automated. CheeksUp has developed an innovative solution that allow therapists to remotely and quantitatively track the progress of patients, making the therapy process more efficient and reduce the cost by up to 30%.
Most importantly, the platform help accelerate therapy progress. Regularity of sessions is proven to be the most important factor in achieving results. CheeksUp ensure that children can perform therapy exercises at the therapist's office, as well as home,
and keeps users engaged and motivated with gamification elements and incentives for an exciting user experience. Intensive and boring therapy routines are made relevant and effective, making treatment fun. It can increase access to treatment, help children communicate, build confidence and improve quality of life for both children and their families. In addition, the system can be used in myotherapy and physiotherapy, highlight the huge potential of the startup and how their technology can help people around the world.
CheeksUp was founded in 2015 and has previously been part of
, a Rockville-based startup incubator focused on health technology, and won
Start Tel Aviv 2016
, a global competition that brings together startups from 31 different countries. In 2017, the startup has been selected as a finalist of
, a Finnish health accelerator with a hand-picked international team of over 200 mentors.
An analysis of a patient’s deadly brain tumor helped doctors at Smilow Cancer Hospital identify new emerging mutations and keep a 55-year old woman alive for more than five years, researchers report in the journal
The median survival rate for patients with glioblastoma multiform (GBM) is only 15 months, but three separate genomic analyses of the tumor identified new mutations that allowed doctors to adjust treatment and keep the patient alive for over five years, through two recurrences of the cancer.
“We were able to identify the molecular profile at each recurrence,” said Dr. Murat Günel, chair and the Nixdorff-German Professor in the Department of Neurosurgery, researcher with Yale Cancer Center, and senior author of the paper. “The molecular make-up of the cancer changed after each treatment and with time, but we were able to adjust treatments based on those profiles.”
For instance, the last genomic analysis revealed mutations of the cancer — under selective pressure from targeted therapies — had increased 30-fold, making the patient a good candidate for immunotherapy. Although there was an initial response, the cancer ultimately progressed.
The researchers were able to extend the findings on this case to more than 100 other GBM cases, leading to the observation that most GBMs change their genomic profile during therapy. “These findings have significant implications for precision treatment of these tumors” said Dr. Zeynep Erson Omay, the first author of the study and a research scientist in neurosurgery. “We now do a genetic analysis on every glioma surgically removed at Smilow Cancer Hospital during each recurrence or progression, comparing the molecular genomic profile to the original cancer to make treatment decisions.”
With new drugs available, there is hope that “we will soon start to see real changes in patient outcomes,” Gunel said.
Other Yale authors included Dr. Octavian Henegariu, Dr. S. Bülent Omay,
Dr. Akdes Serin Harmancı, Mark W. Youngblood, Dr. Ketu Mishra-Gorur,Dr. Jie Li, Dr. Victoria E. Clark, , Dr. Alexander O. Vortmeyer, Dr. Kaya Bilguvar, Dr. Katsuhito Yasuno, Dr. Joachim Baehring, and Dr. Jennifer Moliterno. The study was performed in collaboration with clinicians at the Memorial Sloan Kettering Cancer Center in NY.
The study was funded by the Gregory Kiez and Mehmet Kutman Foundation.
Credit: Joan Costa / CSIC Communication
Researchers from the Spanish National Research Council (CSIC) have developed a biosensor that can detect type 1 HIV during the first week after infection. The experiments, performed on human serum, detect the p24 antigen, a protein present in the HIV-1 virus. This new technology detects the protein at concentrations 100,000 times lower than current techniques, and the total test time is 4 hours, 45 minutes, meaning clinical results could be obtained on the same day. The research is published in the journal
The biosensor combines micromechanical silicon structures with gold nanoparticles, both functionalised with p24-specific antibodies. At the end of the immunoassay procedure, p24 is sandwiched between the gold nanoparticles and the micromechanical silicon structures. The gold nanoparticles have optical resonances known as plasmons. These are capable of scattering light very efficiently and have become one of the structures to attract most interest in the field of optics over the last decade. Micromechanical structures are excellent mechanical sensors capable of detecting interactions as small as intermolecular forces. The combination of these two structures produces both mechanical and optical signals which amplify one another, producing remarkable sensitivity, to detect the p24.
The technology, which has been patented by CSIC, is also being applied in the early detection of certain types of cancer.
"The chip itself, the physical part, is identical for HIV tests and for cancer biomarker tests. What changes is the chemical part - the solution we apply - so that it reacts accordingly to what we are looking for. That's why our fundamental work is focused on developing applications for this new technology", CSIC researcher Javier Tamayo, who works at the Institute of Microelectronics in Madrid, points out.
"The biosensor uses structures which are manufactured using well-established microelectronics technology, thus making large scale, low cost production possible. This, combined with its simplicity, could make it a great choice for use in developing countries", notes Tamayo.
How the biosensor works
Picture showing the biosensor, which is able to detect
type 1 HIV during the first week after infection.
Credit: Joan Costa / CSIC Communication
The experiment begins by incubating one millilitre of human serum on the sensor for one hour at 37 °C to allow binding of any existing HIV-1 p24 antigens to the capture antibodies located on the sensor's surface. Next, it is re-incubated at 37 °C, though in this case with gold nanoparticles, for 15 minutes so the captured p24 proteins can be marked.
Finally, the resulting material is rinsed to remove any unbound particles. "The test takes a total of 4 hours 45 minutes, which is really rapid. In fact, to confirm the diagnosis you could even repeat the test and the clinical results could be back on the same day as the medical examination. The results are statistically significant and could be adapted to medical requirements", explains the CSIC researcher.
HIV detection systems
Acute human immunodeficiency virus infection is defined as the time from virus acquisition to seroconversion, i.e. the onset of detectable antibodies to HIV in the blood. Today there are two ways to detect HIV in the blood. Firstly, infection can be diagnosed by detecting viral RNA in the blood using nucleic acid amplification tests (NAAT), and secondly by detecting p24 protein with fourth generation immunoassays.
The first method, based on detecting viral RNA in the blood, has a detection limit of 20 to 35 copies of RNA per millilitre, i.e. a concentration typically occurring two weeks after HIV acquisition. In the second method, during the fourth generation immunoassays, a detection threshold of p24 in 10 picograms per millilitre is reached. This occurs approximately three to four weeks after infection.
"This new technology is capable of detecting p24 at concentrations up to 100,000 times lower than the previous generation of approved immunoassays methods and 100 times lower than methods for detecting viral RNA in blood. This reduces the undetectable phase after infection to just one week", says CSIC researcher Priscila Kosaka from Madrid's Institute of Microelectronics.
Detecting HIV in blood
The period between infection and seroconversion is approximately four weeks. The early detection of HIV is crucial to improving a person's health. Progressive changes occur after HIV acquisition, such as irreversible depletion of gut CD4 lymphocytes, replication in the central nervous system, and the establishment of latent HIV reservoirs.
"The potential for HIV infectivity in the first stage of infection is much higher than in the later stages. Therefore, initiating antiretroviral therapy prior to seroconversion improves immune control and has been associated with benefits in CD4 cell count, a reduction in systemic inflammation, the preservation of cognitive function, and a reduction of the latent reservoir. Logically, its detection is critical to the prevention of HIV transmission", explains Kosaka.
Patented by CSIC, this technology has been licensed to the Mecwins company (a CSIC spin-off) created in 2008 by Javier Tamayo and Montserrat Calleja, and current owner of three patents which represent the fruit of the CSIC researchers' labour. This recent research has received funding from the Spanish Cancer Association.
Non-invasive delivery of biological drugs and vaccines remains a major challenge in healthcare, especially in developing countries where the often warm conditions can degrade the pharmaceuticals. Patients with chronic conditions are particularly vulnerable, and would greatly benefit from administration via alternative routes than currently possible. Non-invasive delivery could increase compliance rates and convenience to patients, while assuring dosing accuracy, a concern with subcutaneous administration.
Multiple companies are trying to find a solution to non-invasive delivery, particularly in diabetes management. They all have different solutions, ranging from dermal patches with microneedles, intra-nasal delivery systems to oral drugs using different kinds of formulation technologies. The Swiss startup
is trying a different approach. While most companies rely on advanced chemical excipients, BioLingus has been inspired by the nature. Seeds of plants contain high concentrations of proteins, and have to survive and remain intact for years, often in extreme conditions of temperature, moisture and drought. Using advanced bio-engineering, the startup is mimicking these mechanisms seen in plants to stabilize biological molecules at room temperature.
Using their cutting-edge technology, BioLingus is developing oral and mucosal delivery of peptides and proteins for chronic diseases, such as diabetes and inflammatory diseases, and immune-therapies, for instance in cancer, auto-immune diseases and development of oral vaccines. Their pipeline include a wide range of products, including an oral version of the diabetes drug Exenatide, and oral vaccines for influenza and for the treatment of leishmaniasis, a much-neglected tropical disease. They are also exploring the use of IL-2 for early onset juvenile type 1 diabetes, as well as multiple allergies and rheumatoid arthritis, which has shown promising results in animal models.
Their technology creates the potential to change the way we deliver biological molecules in pharmaceuticals, and have multiple benefits over current more invasive methods. Its ease of administration could radically improve quality of life for patients who are dependent on daily self-injections, reducing the risk of infections due to needle handling. It offer a safer and more stable delivery of vaccines, particularly in developing countries without a stable infrastructure. In fact, BioLingus aim to broaden access to medicine to the developing world. Their technology enable storage of medications in room temperature, unlike injection solutions that must be refrigerated, reducing the need for a cold chain. And although hi-tech, the technology is relatively low-cost, making it more cost-effective.
The startup has developed a unique, proprietary technology, allowing for different types of innovations to happen in parallel, whether it is incremental, social or disruptive innovation. The technology is applicable to the treatment of a wide variety of diseases, from chronic to neglected tropical diseases, and can greatly improve health outcomes and quality of life for millions around the world.
BioLingus has been widely praised by the WHO, and the startup announced in September, 2016 that they had entered a co-marketing agreement with
. The startup has won multiple awards, including the ‘Most Innovative Biotech Company’ in 2016 from the
European CEO Magazine
, as well as the 2016 ‘Best Delivery System Award’ from the
Global Health & Packaging magazine
. They have also won the ‘Gamechanger Award’ and ‘European Biotech Award’ 2016 from the
annual award programs, recognizing organizations and individuals that have achieved outstanding commercial success.
The first 30 days following a procedure has been identified as a major focus area in health care. A majority of complications develop during this time period, resulting in many unexpected visits to the emergency department and re-admission to the hospital, costing billions of dollars annually. As hospitals face increased financial pressure, initiatives such as expedited discharge and fast-tracking programs require new solutions that help monitor and maintain quality of care while patients recover at home.
The London-based startup
is building a communications bridge between doctors and patients with the aim to make the post-procedure process more efficient. They have developed a messaging platform that proactively communicates with patients, enabling doctors to receive patient responses to treatment and easily track the recovery progress. The solutions starts with the practice entering patients details into the web application, selecting the relevant procedure to be performed. On the day of the procedure and for the duration of their recovery, the patient receives check-in text messages or emails with instructions and questions regarding their recovery. FollowApp.Care monitors the patient’s recovery and notifies the clinic and doctor of potential complications before they occur, allowing doctors to take action and reduce unnecessary visits and readmissions.
The innovative technology enable patients to respond to questions specifically tailored to their procedures, and is available on whatever device they feel most comfortable communicating in. This drive positive customer experience, and can have tremendous effect on patient engagement. In addition, patient responses can be seen anytime from anywhere, allowing doctors to intervene and take action if necessary.
This enable doctors and clinics to save time and money by responding to complications more efficiently, and allow reallocation of resources to patients who require immediate care. It could even help reduce readmissions, which currently cost the healthcare system billions of dollars every year.
Most important is its focus on the patient. The technology increase quality of care and reduce adverse outcomes, ultimately improving health outcomes and give peace of mind. Patients know they have access to their doctor with the push of a button if there are questions about their recovery process, potentially reducing the uncertainties and anxiety that many feel after being discharged.
FollowApp.Care was founded in December 2014, and was awarded a place at the
program in 2015, a workshop developed and run by the
at Saïd Business School, Oxford to help accelerate the startup process.
Already in September, 2015 the startup got their first paying customers, and are today used across the US, UK and Australia.
Diagram showing differences that can be observed in cell
morphology in normal skin cells versus melanomas. Pink
images show differences following biopsy and staining by
a pathologist. Green slices show differences in fluorescence
pattern of mitochondria using multiphoton microscopy.
Credit: Irene Georgakoudi, Tufts University.
Researchers funded by the National Institute of Biomedical Imaging and Bioengineering have developed a non-invasive imaging technique that accurately detects skin cancer without surgical biopsy. Multiphoton microscopy of mitochondria—small organelles that produce energy in cells—accurately identified melanomas and basal cell carcinomas by detecting abnormal clusters of mitochondria in both types of skin cancer.
Skin cancer is the most common type of cancer in the U.S. and most types of skin cancer are highly treatable, especially if detected early. “The technology developed here has the potential to make the detection of skin cancers extremely rapid and feasible at very early stages,” says Behrouz Shabestari, Ph.D., director of the NIBIB Program in Optical Imaging and Spectroscopy. “Rather than taking a biopsy sample that must be processed and then examined under a microscope by a pathologist, this system involves simply looking through the microscope at the patient’s skin and determining whether it is cancerous or not, within minutes.”
A group of international collaborators led by co-senior author Irene Georgakoudi, Ph.D., in the Department of Biomedical Engineering at Tufts, found that mitochondria behave very differently in healthy versus cancerous tissue. They used a laser microscopy technique that takes advantage of the characteristics of a key molecule in mitochondria, nicotinamide adenine dinucleotide (NADH), that is central to energy production. They found that NADH, which naturally fluoresces without injecting any dye or contrast agent into the individuals being screened, can be detected using multiphoton microscopy to provide diagnostically useful information about the organization of the mitochondria in skin cells.
“The system allows us to obtain very high-resolution images of individual cells without having to slice the tissue physically,” explained Georgakoudi. “With this technique, we found that in normal cells the mitochondria are spread throughout the cell in a web-like pattern. Conversely, cancerous skin cells show a very different pattern with the mitochondria found in clumps or clusters typically at the center of the cell along the border of the nucleus.”
Web-like arrangement of mitochondria in normal cells on
the left contrasts sharply with the clustered mitochondria
surrounding the cell nucleus in cancer cells on the right.
Credit: Irene Georgakoudi, Tufts, University
In this study the technique was tested in 10 patients with skin cancer (melanoma or basal carcinoma) and four who did not have skin cancer. The imaging technique results were compared to the traditional biopsy results obtained from each patient. The results demonstrated that the imaging technique correctly identified skin cancer in all 10 cancer patients, and made no false diagnoses in the four individuals without skin cancer.
Georgakoudi estimates that this test could be routinely used in doctor’s offices within five years, although the $100,000 price tag for the laser used in this microscope could limit the medical facilities that would be able to make such an investment. “Less-expensive lasers are on the horizon,” concludes Georgakoudi. “However, this approach would enable a doctor to make a quick diagnosis and begin treatment immediately, which could ultimately lower health care costs associated with these very common cancers.”
The research was published in the November 2016 issue of
Science Translational Medicine
This reusable, multi-layered and microfluidic device
incorporates a porous growth substrate, with a physiological
fluid flow, and the passive filtration of the capillaries
around the end of a kidney, called the glomerulus, where
waste is filtered from blood. (Credit: Gretchen Mahler)
Instead of running tests on live kidneys, researchers at Binghamton, University State University of New York have developed a model kidney for working out the kinks in medicines and treatments. Their research has been published by
Developed by Assistant Professor Gretchen Mahler and Binghamton biomedical engineering alumna Courtney Sakolish PhD '16, the reusable, multi-layered and microfluidic device incorporates a porous growth substrate, with a physiological fluid flow, and the passive filtration of the capillaries around the end of a kidney, called the glomerulus, where waste is filtered from blood.
"This is a unique platform to study interactions between drugs and cells or tissues, specifically in the kidney, where current models were lacking," said Sakolish. "These platforms will, hopefully, in the future, be used as an animal alternative during pre-clinical testing to more accurately direct these studies toward successful results in humans."'
"This is tissue engineering, but not for the purpose or replacing an organ or tissue in a person," said Mahler. "The idea is that we can recreate the major organ functions in a simplified way for use as a drug screening tool. Finding new drugs is very hard, expensive and inefficient. We hope that by using human cells in a physiological environment we can help to direct resources toward the most promising new drug candidates and determine that other new drug candidates will fail, faster."
Results suggest that cells grown in the device exhibit more natural behaviors than when grown in traditional culturing methods, and the filtration by the glomerulus is necessary for healthy cell function.
"We found that the more complex, dynamic culturing conditions (like those used in this project) are necessary to accurately predict renal drug toxicity in human systems," said Sakolish. "When we compared physiological renal function and drug toxicity in traditional static culturing against our new model, we found significant differences in the ways that cells behaved. In our platform, cells looked and acted like those that you would find in the body, showing more sensitive responses to drugs than traditional static culturing."
Mahler said that while others have developed microfluidic models of the proximal tubule before, this is the first to offer glomerular filtration.
"This type of device uses human cells in a dynamic, more physiologic environment, potentially making it better at predicting the body's response to drugs than animals (animal effectiveness studies often don't translate to humans) or static cell cultures, which are the most commonly used preclinical screening tools," said Mahler.
Preeclampsia is a serious pregnancy condition marked by high blood pressure and elevated protein in the urine, leading to restricted blood supply to the fetus. Every year, between 70,000 and 80,000 women and in excess of half a million newborns die as a direct result of preeclampsia. While the only treatment, once diagnosed, is the delivery of the baby prematurely, identifying mothers at risk is the first step to effective intervention and prevention. Although there is no cost effective or reliable screening test for preeclampsia, prenatal consultations check for early signs of hypertension and proteinuria. However, the standard intervals between prenatal visits may delay diagnosis, increasing the chance of severe complications.
The Cork, Ireland-based startup
is determined to deliver a breakthrough technology to provide predictive diagnosis of preeclampsia in early pregnancy. They develop a blood test, called PrePsia, to be administered 15 weeks into a pregnancy, which can accurately predict the risk the woman have of developing preeclampsia later in their pregnancy. The test measure a combination of metabolites, which along with certain clinical data are fed into a classification algorithm. The algorithm extrapolates the results, allowing clinicians to offer targeted surveillance and medical care to patients who are at higher risk of developing the condition.
The technology is of enormous global significance with an estimated 10 million women develop preeclampsia each year around the world. The majority of deaths are avoidable through timely and effective care, and Metabolomic Diagnostics has developed a revolutionary test that help identify women at risk early in the pregnancy. This could transform the lives of millions around the world, and help save thousands of women and children who every year die of the condition. PrePsia could dramatically improve patient outcomes, and reduce the lifelong health complications that survivors live with. In addition, the cost of prenatal care associated with preeclampsia is over $7 billion in the US alone. Identifying women at risk could significantly lower these costs, while help offer targeted preventative care.
In contrast to other technologies, such as the detection of angiogenic factors, PrePsia works in early pregnancy at a time point when risk stratification would be most beneficial for ongoing management and intervention. In addition, their technology has high sensitivity and specificity for distinguishing between preeclampsia and other maternal disorders. While initial work has focused on preeclampsia, it could also be used to screen for a range of complications of pregnancy, highlighting its wide applicability and huge potential.
Metabolomic Diagnostics has previously won the Enterprise Ireland Life Sciences & Food Commercialisation Award for their development and commercialization of PrePsia, and has been awarded research funding from the European Union. The startup has also secured over $4 million in multiple funding rounds, with investors including
AIB Seed Capital Fund
, as well as a number of private investors.
Medulloblastoma is the most common pediatric malignant brain tumor. Current treatments consists of surgically removing as much of the tumor as possible, followed by craniospinal radiation and chemotherapy in children older than 3 years. Although treatment improves survival, the regimens are highly toxic to the developing brain and associated with significant morbidity. While up to 90% survive after 5 years if the disease has not spread, treatment often results in significant neurocognitive impairment in children younger than 8 years old.
The Belgium-based startup
is focused on developing innovative medicines for the treatment of pediatric brain tumors. Their first project, TB-403, is a therapeutic antibody being studied for the treatment of medulloblastoma. The drug candidate is based on research published in the
, highlighting for the first time that PIGF plays a vital role in the brain, and that its expression is required for the growth and spread of medulloblastoma. This relies on the binding of PIGF with the Neuropilin receptor on the tumor cell. Medulloblastoma cells induce the production of stromal PIGF and becomes a self-enforcing cycle. The research, conducted by Prof. Rakesh Jain from the Massachusetts General Hospital at Harvard and the team of Prof. Peter Carmeliet from VIB/KU Leuven, also illustrated that blocking PIGF signaling resulted in tumor regression and improved survival. TB-403 binds to PIGF, blocking its binding with Neuropilin, subsequently suppressing the tumor growth.
TB-403 has been granted orphan drug designation by the Eurpean Commission, and the drug candidate is currently in a Phase I/IIa clinical trial. Although still early, it has the opportunity to be the first targeted therapy for pediatric patients with medulloblastoma. It has the potential to improve outcomes and survival as a first-line treatment, as well as relapsed patients. While the current regimens often results in significant neurocognitive impairment, TB-403 could help avoid some of these detrimental effects and lead to better outcomes. This could translate into a long-lasting impact on these children’s lives, significantly improving their quality of lives and helping multiple families around the world. With PIGF and Neuropilin being overexpressed in other pediatric tumors, TB-403 may have additional applications, and the startup is looking at other scientifically novel therapeutics to extend their impact in pediatric oncology.
Oncurious NV was founded in 2015, with main shareholder being
, a biopharmaceutical company focused on developing and commercializing ophthalmic medicines, and
, a leading life sciences institute in Belgium. The startup has partnered with
, a pharmaceutical company focused on discovery and development of antibody-based drugs against cancer, to co-develop TB-403.