Discover How Electricity Could
By Jana Soeldner Danger
Imagine a world where tiny devices implanted in the body replace the need for injections and pills to treat diseases. And imagine a world without the often annoying, and even debilitating and life-threatening, side effects of medications.
It’s a world that may become reality through bioelectronicmedicine, a relatively new science that brings together molecular medicine, bioengineering and neuroscience. Researchers are hard at work trying to uncover new technologies that can treat conditions like rheumatoid arthritis, inflammatory bowel disease, hypertension, kidney disease, diabetes, and even cancer by controlling biological processes through nerve regulation instead of with drugs. “It’s a new approach to treating disease,” said Dr. Christopher Czura, PhD, vice president
of scientific affairs at the Feinstein Institute for Medical Research in Manhasset, NY.
A Communication Conduit
Here’s how it works: Nerves deliver electrical signals about what’s going on in body organs to the brain, which can both monitor and regulate organ functions. “The brain receives the information and then sends signals back,” said Dr. Czura.
Most diseases begin when something goes wrong in one of the body’s organs and the electrical signals become distorted. The goal of bioelectronic medicine is to restore their normal transmission and stimulate the body’s immune system. “By tapping into those back-and-forth signals, we’ll be able to treat disease by listening in on the conversation,” said
Tiny electronic devices approximately the size and shape of a Tic-Tac are implanted into the body or placed against the skin where they analyze, record, stimulate and block nerve signals. “A doctor working remotely will be able to hear the signals and change their activity,” Dr. Czura said.
In the future, once a device is implanted, a patient may be monitored and treated at home, eliminating costly and inconvenient trips to the clinic or hospital. That’s not yet a reality, however. “First we need to be able to interpret the language of the nervous system,” Czura said.
Bioelectronic research at the Feinstein Institute began in the 1990s when doctors discovered that the vagus nerve, which extends all the way from the brain stem to the abdomen, could directly control the immune system. While many nerves in the body deliver electrical signals to and from the brain, the vagus is the primary conduit.
“We were studying inflammation,” said Dr. Czura. “Inflammation in itself can be a good thing, but many diseases are caused by inflammation gone wrong. We thought if we could understand the normal brakes, maybe we could make them work better. And at first, we were thinking about drugs.”
But then to their surprise, researchers realized that electrically stimulating the vagus nerve could turn off immune system pathways associated with some inflammatory diseases. It was an amazing revelation. “Many things in science are discovered by accident,” Czura said.
Because all organs in the body are stimulated by nerves, investigators began to wonder if the technology that modulated neural signals might also provide effective treatment for other diseases. Happily, further research indicated that it could.
“This is a real breakthrough in our ability to help people suffering from inflammatory diseases,” said Kevin J. Tracey, MD, president and CEO of the Feinstein Institute for Medical Research, discoverer of the inflammatory reflex and co-founder of SetPoint Medical. “…until now we had no proof that electrical stimulation of the vagus nerve can indeed inhibit cytokine production and reduce disease severity in humans. I believe this study will change the way we see modern medicine, helping us understand that our nerves can, with a little help, make the drugs that we need to help our body heal itself.”
The process is a complex one that involves cutting-edge teams of experts. First, molecular and cellular biologists must identify the targets to be treated. Neurophysiologists then map neural pathways and work to understand how nerve fibers propagate signals. Finally, neurotechnologists must figure out how to stimulate, block, record and analyze respective nerve signals.
Research in bioelectronic medicine is burgeoning around the world and is still in its infancy. Some of the therapies , however, are already available. Two devices currently have FDA approval. One treats sleep apnea by regulating movement of the tongue. The other targets obesity by controlling signals, which otherwise might be delayed, that tell the brain the body has had all the food it requires and it’s time to stop eating.
Meanwhile, a California company is conducting clinical trials for bioelectronic treatment of rheumatoid arthritis and inflammatory bowel disease. While focused on rheumatoid arthritis, the trial’s results may have implications for patients suffering from other inflammatory diseases, including Crohn’s, Parkinson’s, Alzheimer’s and others. The tiny electronic device wraps around the vagus nerve in the neck to provide needed control of electrical impulses. Maintenance is simple. “Once a month, the patient wears a collar to charge the battery,” Dr. Czura said.
Dr. Czura himself is co-inventor of a bioelectronic device that controls bleeding. It is an external device that works through the skin, making it practical for the quick treatment required in cases like accidents and gunshot wounds. “The first trial will be for postpartum hemorrhage,” said Dr. Czura.
Bioelectronics Versus Pharmaceuticals
The devices have advantages over some drug therapies, particularly those which have harmful and even potentially lethal side effects. While pharmaceuticals that target specific disease processes do exist, once the drugs circulate through the body, they may affect other, non-targeted processes. Bioelectronic devices, on the other hand, are stationary. “Because these devices are specifically targeted, they avoid side effects,” Dr. Czura said.
The science is still very young — stay tuned!