We sifted through hundreds of innovations that grabbed attention last year.
In this series of nine posts, we share the most interesting and impactful ideas.
How to fight cardiovascular diseases?
Cardiovascular diseases (CVD) kill more people than any other disease worldwide. In 2019 alone, they claim about 18 million lives. High blood cholesterol, particularly low-density lipoprotein (LDL), is one of the major risk factors for CVD. High level of LDL makes arteries harden and clog. Statins are a common treatment for high cholesterol. However, it needs to be taken every day and might have side effects. An American biotechnology company, Verve Therapeutics, is conducting a clinical trial in New Zealand to use gene editing to solve the problem. The 40 participants have familial hypercholesterolemia, a condition where high cholesterol is due to genetics. A gene-editing tool called CRISPR is used. While this method has been around for a decade, editing human genes to treat a disease has never been used on many people. In the clinical trial, nanoparticles are injected into human body to deliver some RNA. The RNA will direct human cells to make a base-editing protein, which modifies one base in the PCSK9 gene in liver cell DNA. The gene will be turned off, which leads to lower LDL, potentially permanently. At least, experiments in monkeys show 60% reduction in LDL for more than a year. However, editing human genes could be very risky. For example, it is less clear how to undo gene editing if it turns out undesirable. Nevertheless, the possibility of eliminating the LDL problem once and for all, saving millions of lives, is tantalizing.
The purpose
To permanently lower cholesterol (LDL)
The idea
Use gene editing to turn off a related gene
Another medical breakthrough comes from the field of organ transplantation. For the first time ever, a genetically engineered pig heart was transplanted in a living human. The 57-year old otherwise-dying patient had high blood pressure and other conditions that disqualified him for a human heart transplant. Physicians at University of Maryland School of Medicine, led by Muhammad Mohiuddin, conducted the transplant after patient consent. One of the major risks of putting a pig heart in a human is the immune system response because the system recognizes the alien organ because of the sugar molecules on pig cell surface. The researchers, however, had devised methods to address the issue and shown success in putting pig organs into baboons. The pig heart used in this transplant was from a biotech company called Revivicor. There were ten gene editing changes, some removing certain sugar molecules from pig cell surface, some adding human genes, and one gene change that prevents the heart from growing too big. In addition, a new immunosuppressant drug was used to further reduce immune responses. The patient body showed no typical signs of rejection. The patient lived another 2 months with the pig heart. This is much longer than many would expect. In the future, if organs can be developed from pigs, it would save a lot of people who otherwise cannot find a suitable human organ for transplant. Some scientists are developing alternative methods, such as 3D-printing tissues and making organoids from stem cells. Yet those developments are at early stages.
The purpose
To allow more people who need heart transplant to get one
The idea
Make pig hearts more human-like through gene editing
Medical imaging is often a key step in making diagnosis. However, such imaging tends to be a snapshot and typically does not allow continuous monitoring of medical situations. For example, medical ultrasound needs specialized equipment and trained technician, making it unsuitable for continuous monitoring. The research team led by Xuanhe Zhao from MIT designed a stamp-sized flat chip that can stick to skin as ultrasound probe. Traditional ultrasound needs a technician to spread conductive goop on skin. The newly invented sticker instead uses a layer of novel adhesive, a hybrid of hydrogel (a polymer) and elastomer (a rubberlike material). The adhesive allows the sticker to stay for up to 48 hours, allowing the attached probe to monitor internal organs continuously. Other ultrasound wearables are often stretchy to accommodate stretchy skin, but sometimes end up with inaccurate images. In contrast, the sticker has a firm probe array, combined with flexible layer of adhesive. The new sticker can generate high quality videos of internal organs for two days. With this capability, the device might be used in early diagnosis of heart attack, tumor monitoring, lung monitoring in COVID patients, and the general evaluation of heart and muscle. One major limitation for now is that the sticker must be connected to a computer. The team aims to develop small power source for the device, as well as wireless data transmission capability. When these challenges are tackled, heart imaging while playing sports, an impossible task for traditional ultrasound, will become feasible. A new paradigm of continuous medical imaging through wearable is unfolding.
The purpose
To enable continuous ultrasound monitoring
The idea
Put a sticker with ultrasound probe on skin
Further Possibilities
1. Use wearables to monitor transplanted organs
By integrating ultrasound probes into wearable devices, medical professionals can monitor transplanted organs in a non-invasive and continuous manner.
2. Wearable emotion assistant
By leveraging wearable devices to monitor and assist with emotions, individuals can gain insights into their emotional well-being, receive real-time support, and develop strategies for managing their emotions effectively.
3. Use gene editing to slow aging
Age-related accumulation of DNA damage contributes to cellular dysfunction and aging. Gene editing can be employed to enhance DNA repair mechanisms by targeting specific genes involved in DNA damage response and repair pathways.
4. 3D print gene-edited tissues
Gene-edited tissues created through 3D printing have the potential for patient-specific applications. By using a patient's own cells, gene editing can be performed to correct genetic defects or introduce therapeutic genes before 3D printing the personalized tissue. This personalized approach reduces the risk of immune rejection and improves the compatibility and effectiveness of the engineered tissues.
5. Use the novel adhesive for making artificial organs
The use of the new adhesive, combining hydrogel and elastomer properties, might have the potential to enhance bonding, flexibility, biocompatibility, and sealing capabilities, thereby contributing to the creation of functional and long-lasting artificial organs.
Questions
1. How might we undo gene editing in humans when it turns out undesirable?
2. How else might we make organs on demand?
3. What might be all the medical data that we can collect from wearables?
