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Anthony Arnold offers an overview and update of bioelectronic medicine.
Electrical Pulses Spark New Ways to Treat Diseases: Bioelectronic Medicine Overview and Update
By Anthony Arnold, CEO of SetPoint Medical
1. What is bioelectronic medicine?
Bioelectronic medicine is a new scientific approach to treat diseases using electrical pulses instead of drugs to trigger the body’s biological responses, combining bioengineering, immunology, and neuroscience to reach molecular targets and create a systemic disease-fighting effect. Though the concept of using electrical pulses to treat patients has been around for decades, recent advances have propelled the new field of bioelectronic medicine. Technological progress, along with greater understanding of disease causes and mechanisms, are enabling us to research new targets while at the same time dramatically shrinking the size of implantable devices and discovering new ways to deliver therapies.
2. How are bioelectronic therapies similar to and different from drug-based therapies?
Similar to large and small molecule drugs, bioelectronic medicine therapies act through targeted mechanisms of action to treat diseases. Specifically, certain bioelectronic devices can trigger the release of endogenous neurotransmitters to affect immune-mediated and receptor-mediated pathways. However, the method of triggering the signal release is different, using the delivery of targeted electrical impulses. These impulses stimulate, block or regulate the electrical signals used by the nervous system to communicate information. Virtually every cell in the body is directly or indirectly controlled by these neural signals.
3. How does bioelectronic medicine work?
Bioelectronic medicine uses short-duration bursts of energy designed to elicit a cellular response that produces both local and coordinated systemic effects with therapeutic durations of hours or even days. For example, at SetPoint, we apply vagus nerve stimulation to activate a known fiber type within the vagus nerve to activate the body’s natural Inflammatory Reflex. Neurons within the reflex pathways then interact with immune cells through known receptors in specific anatomic regions. This in turn modifies cell behavior in predictable and therapeutic ways, producing potent anti-inflammatory effects.
4. What are challenges facing bioelectronic approaches?
Companies pursuing bioelectronic medicine face many of the same challenges as those working in drug discovery and development at growing companies – primarily securing funding. Other challenges in common include possible off-target effects and lack of historical data for new mechanisms of action. We do have additional challenges that come with forging a new field as well, including managing surgical procedures and determining the optimal location for implantation, along with device size, design and battery life. Also, because bioelectronic medicine is a new space, regulatory requirements and pathways are evolving along with new therapies.
5. What disease areas are emerging bioelectronic medicine targets?
There are a number of diseases that may be applicable for bioelectronic approaches. Scientists and researchers at NIH, the Northwell’s Feinstein Institute, GSK and other institutions believe bioelectronic medicines may have an important role to play in diseases like Alzheimer’s, asthma, multiple sclerosis and diabetes. At SetPoint, we are in the clinic with trials in rheumatoid arthritis and Crohn's disease. We recently had a paper published demonstrating positive results from a first-in-human open-label trial in rheumatoid arthritis in Proceedings of the National Academy of Sciences (PNAS) (available
) and presented positive results in Crohn’s disease at the 2016 United European Gastroenterology meeting.
6. Why do we need bioelectronic medicine?
While we have access to many effective drugs, there are patients with debilitating diseases who do not respond well to pharmacologic or biologic treatments and are left with few therapeutic options. We hope bioelectronic medicine will offer an alternative solution with improved quality of life where conventional treatments have failed – a solution that could provide fewer side-effects, lower cost and better compliance. While we don’t think bioelectronic medicine will replace traditional medicine, we believe it can provide an alternative therapy and serve as an important addition to the clinician’s arsenal for treating patients.
Anthony Arnold is CEO of SetPoint Medical, a biomedical technology company developing a bioelectronic therapy for inflammatory diseases. Anthony has more than 20 years of medical device industry experience, including leadership positions at Advanced Bionics/Boston Scientific Medtronic and Smith+Nephew. For more info: www.setpointmedical.com.