A radical new approach to treating a host of common diseases could soon benefit diabetics in the UAE.
In the search for potential miracle cures, electricity may seem an unlikely candidate. The mere mention of it conjures up images of psychiatric patients being “shocked” with electrodes on their skulls.
But now a raft of exciting results – and a hefty influx of money – look set to spark a revolution in the use of electricity to treat ailments.
It centres on the emergence of what are being called – somewhat misleadingly – “electroceuticals”.
You don’t swallow them, or take them intravenously, but instead have them implanted where they can monitor nerve impulses, detect problems – and then deliver jolts of electricity to affected organs to make them work properly.
Last week the US National Institutes of Health unveiled a quarter-billion dollar project to speed the development of electroceuticals.
Meanwhile, pharmaceutical giant GlaxoSmithKline (GSK) is offering a US$1 million prize for research into the technology, which could bring new hope in the fight against diseases ranging from diabetes and rheumatoid arthritis to cancer.
In retrospect, perhaps the biggest shock is that it has taken everyone so long to wake up to the idea behind electroceuticals.
It’s been known for centuries that living organisms are made from cells that respond to electrical impulses.
In 1780, the Italian physician Luigi Galvani famously discovered that a small electric voltage applied to the muscles of a frog’s legs make them twitch – even after the frog was dead.
We’re also familiar with the idea of our thoughts and memories being the product of electricity flowing between neurons in our brain.
Less well-known is the fact that the functioning of virtually every organ depends on electrical impulses known as “action potentials”. These spikes of voltage flow to and from organs across a network of nerves of astonishing complexity.
Our bodies are, in essence, collections of electrically-powered gadgets. But while the likes of smartphones rely on the flow of negatively-charged electrons, organisms exploit the flow of positively-charged fragments of atoms known as ions.
If this flow of ions goes wrong or stops altogether, the result can be anything from a flutter of the heart to chronic illness and even death.
Until now, attempts to exploit the link between electricity and organs have been pretty crude. For example, sizeable battery-powered pacemakers simply supply milliamps of electricity to a vast number of heart muscle cells.
But now researchers are taking a more subtle approach – and uncovering new ways of tackling more subtle disorders.
The excitement stems partly from the fact that – unlike drugs – implants can be very precisely targeted, with the impulses being applied just to miscreant cells, rather than the whole body. This should reduce the risk of side-effects.
It also comes from some early successes using this technique. EnteroMedics, based in Minnesota, recently published the results of a study in which over 100 obese patients were fitted with an electroceutical implant that stimulates the vagus nerve, which affects both hunger and satiety – the feeling of fullness that comes after a large meal.
The study found that over half lost at least 20 per cent of their excess weight – double the success rate achieved by patients in a comparison group. Blood pressure and heart rate also improved.
Earlier this month, a panel of experts recommended that the US Food and Drug Administration approve this electroceutical for use in treating obesity.
The vagus nerve and the so-called splenic nerve are also the focus of electroceutical therapy for rheumatoid arthritis, an autoimmune disease in which the body’s own defences turn against itself.
Exactly why and how these nerves affects the immune system isn’t clear, but early research has found that an implant can produce a dramatic reduction in symptoms.
At GSK, Dr Kristoffer Famm leads a team trying to identify electroceutical approaches to other diseases – including diabetes.
Caused by the failure of the pancreas to release the right level of insulin in response to blood sugar, so-called Type 2 diabetes affects almost one in five Emiratis. While it can be managed through a strict diet and exercise regime, a cure has never been found.
Now Dr Famm and his team believe a tiny implant could provide a permanent remedy. The idea is to develop a tiny implant that can detect the nerve signals calling for insulin to be released, and then generate their own signals ordering the pancreas to respond.
In a recent review paper for Nature, Dr Famm said the immediate challenge is to understand the circuitry of the body, to reveal the precise links between nerves and organs.
That’s unlikely to be easy. It’s already known that multiple nerves are involved in bladder function, while the vagus nerve has multiple functions.
According to Dr Famm, the other key challenge lies in bringing together teams with the right skill-sets to make the most of the emerging discoveries.
Clinicians will need to work with neuroscientists to map the circuitry and understand which impulses are linked to which disorders.
Then materials scientists and electronic engineers will have to create tiny devices capable of being left in the body for years without creating problems of their own.
To kick-start the process, GSK have set up a $50m subsidiary – Action Potential Venture Capital – to invest in start-ups in the field. It is also offering its prize of $1m to the first team to create a miniaturised, implantable wireless device that logs, stimulates and blocks electrical impulses to and from an organ over 60 days.
Researchers are already making serious progress. Work is currently underway on 20 electroceuticals for a range of disorders, and the first ones are starting to emerge.
Earlier this year the US Food and Drug Administration approved an electroceutical for treating sleep apnoea using an implant that delivers impulses to muscles to maintain steady breathing during sleep.
It could be the first step in a new direction for medicine whose impact on human health will prove – literally – electrifying.
Robert Matthews is visiting reader in science at Aston University, Birmingham
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10pm: Beyond Reason
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Stars: Nadine Labaki, Ziad Bakri, Zain Al Rafeea, Riman Al Rafeea
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Jordan cabinet changes
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Out
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- Hala Noaman “Basiso Lattouf”, Minister of Social Development
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- Yahya Moussa Kasbi, Minister of Public Works and Housing
- Nayef Hamidi Al Fayez, Minister of Environment
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- Khalid Moussa Al Huneifat, Minister of Agriculture
- Dr Awad Abu Jarad Al Mushakiba, Minister of Justice
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- Dr Azmi Mahmud Mohafaza, Minister of Education
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More from Neighbourhood Watch:
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”