WHY THIS MATTERS IN BRIEF
- Hundreds of millions of people suffer every day from chronic disease, pain and illness but now a new class of medicine is on the horizon
Imagine a world where we can treat diabetes, chronic pain and autoimmune disorders with a small zap of electricity delivered by a device no larger than a speck of dust. The devices, which would be implanted into a patient using microsurgery, would sit silently on a single nerve bundle monitoring the electrical signals sent out by the brain. When it detects a problem — a rogue misfire, or a change in electrical activity patterns — the device powers up and sends out counter-pulses to correct the signal keeping your body running smoothly and keeping disease at bay. No pills. No injections and perhaps most importantly no more pain or disease.
This is the future that, according to Google’s parent, Alphabet, and pharmaceutical giant GlaxoSmithKline (GSK) is now just seven years away and it represents a new era for healthcare called “Bioelectronic Medicine”.
This week, Verily, Alphabet’s life science unit, formerly Google Life Sciences, teamed up with Britain’s biggest drug maker GSK to announce their new $715 million venture “Galvani Bioelectronics”. With research centers based in GSK’s biotech hub in the UK and around the Bay Area, the company hopes to develop miniaturized, implantable electronic systems — dubbed “Electroceuticals” — to correct irregular nerve pulses that are known to contribute to a multitude of chronic diseases and their hopes are high. Kristoffer Famm, head of bioelectronics research at GSK and president of Galvani, says that their first products might be submitted for marketing approval as early as 2023.
Electricity as medicine
Eletroceuticals may sound futuristic but using electricity to treat disease is nothing new. Our whole body essentially runs, manages and organises itself using electricity – from our Automnic Nervous System to the minute electrical impulses that control Mitosis and cell division. And we already use electricity in pacemakers to control patients heartbeats and for stimulating and rewiring broken neural pathways in Parkinsons patients.
It’s easy to see why electroceuticals are sparking interest. Unlike run of the mill chemical drugs that act on specific proteins or other molecules, and which often have complicated side effects, electrical pulses directly hack into the main language of our nervous system to change its operating instructions.
“The nervous system is crisscrossing our viscera to control many aspects of our organ function,” explains Famm, “rather than using drugs, which are rarely specific for a single biological process, we could zap a major nerve and, with surgical precision, change the instructions that an organ receives and thereby alter its function.”
Electricity can not only jump start a heart or jolt a brain into health but it can also coax resistant pancreatic cells to release insulin, persuade clenched arteries to relax, or berate hyperactive immune cells to stop attacking your own tissue.
Rather than developing a library of chemical drugs that targets individual diseases, a single electroceutical prototype could be programmed to treat multiple diseases and Galvani plans to use the technology to target a wide range of chronic diseases that are inflammatory, metabolic and endocrine disorders – from Asthma to infertility, from Type 2 diabetes to Cancer.
Last year already saw big wins for electroceuticals. In May the US Food and Drug Administration (FDA) approved a device that contracts airway muscles to help people with severe sleep apnea breathe properly without using an oxygen mask. A month later, they also gave the nod to an implantable weight-loss device that stimulates a nerve near the stomach to make a person feel full.
To really tap into the potential of electroceuticals though the devices will have to get much, much smaller. Nerves are incredibly compact, and unrelated circuits often run in close proximity. Because of this, electrical devices that zap a whole chunk of tissue run the risk of significant side effects — it’s like jump starting your car, but also blowing out the fuses in your entire house and that’s not a good thing especially when we’re dealing with your health!
This is where Galvani comes in. By combining engineering, bioinformatics and neuroscience, the company hopes to shrink the implanted devices down to the size of a grain of rice and although specific plans are still under wraps, back in 2013 GSK published a roadmap that will likely guide the fledgling company.
“Many of the stepping stones are already in place,” says Famm.
First, the scientists will need to trace neural circuits that control disease to identify easy access points for intervention. They’ll also need to understand the signals running through those circuits in order to build a ‘dictionary’ of patterns that represent healthy and diseased states. By decoding the neural language, researchers can then program future electroceuticals to understand nerve impulses and, in turn, generate corrective pulses of their own.
Then there’s the engineering side of things. Bioengineers will need to design wireless, biocompatible microchips that can reliably perform real time computation with low power. When implanted through keyhole surgeries, the hope is that these electroceuticals will last at least decades. According to Famm, the first generation of marketable implants will be roughly the size of an average pill. However, eventually they’ll be smaller than a grain of rice and then eventually they’ll be the size of dust particles and that goal may not be far off. that said though Galvani’s got serious competition.
A team at the University of California, Berkeley published a new wireless, implantable sensor that’s only three millimeters in length. Aptly named “neural dust,” the device contains a piezoelectric crystal that converts ultrasonic vibrations from outside the body into electricity. This energy is then used to power a tiny transistor that contacts both the crystal and a nerve fiber. When an impulse jolts through the nerve, it tweaks the circuits in the transistor, which in turn change the vibration of the crystal. These tiny flutters are then picked up by an ultrasound receiver and subsequently decoded. In this way, the device lets researchers closely monitor each spike of activity in a nerve.
Although the device is currently “read-only,” the team, who aren’t associated with Galvani say that they are developing neural dust that can also stimulate nerves in a self sustaining, closed loop system.
Famm seems to welcome a healthy dose of competition in the nascent but burgeoning field.
“Clearly, open innovation will be important,” he said, then he went on to quote the poet Cesare Pavese, “If you wish to travel far and fast, travel light. Take off all your envies, jealousies, unforgiveness, selfishness and fears. Together we can bring about the era of electroceuticals.”
Admittedly while that might be a strange way to use prose from a Twentieth century poet if Famm and his teams pull it off then they will have done nothing less than helped to change medicine as we know it forever.