Tag: Health

Artificial Intelligence becomes an essential part of future healthcare

In many developed countries, healthcare has become an unsustainable business in recent years, partly due to the aging population and prevalence of chronic diseases. In the US, healthcare spending grew 4.6 percent in 2019 alone, amounting to US$3.8 trillion, or 18 percent of the nation’s Gross Domestic Product (GDP). However, this increase in spending did not translate into better patient care, nor has it reduced resource scarcity and imbalance in the healthcare industry. How can we transform the healthcare sector to make it more efficient and sustainable? Artificial intelligence (AI) will play a critical role in the future of healthcare.  

The Seven Revolutions in Healthcare That Will Impact Your Life – Part 7

(Missed the previous one? You can read Part 6 here – Robots Become Reliable Assistants for Healthcare Professionals and Patients)

From fee-for-service to fee-for-value

In the current healthcare system, doctors and other healthcare providers are paid for the number of patients seen or procedures performed. This fee-for-service model means that healthcare providers are rewarded for volume rather than for value.

What is the biggest barrier to practicing medicine today?

“‘Production pressure’ – the requirement to see more patients in less time because of the misconception that the value of a physician is determined by the number of patients he/she sees”– Lucian Leape, physician and professor at Harvard School of Public Health, leader of patient safety movement.1

Value-based healthcare rewards healthcare providers based on the quality of care they provided. The implementation of AI can greatly improve the value of healthcare providers by making sense of medical data, automating routine procedures, and improving efficiency and effectiveness.

AI will reshape radiology

Machine learning is great at recognizing patterns, which has translated into fast progress in analyzing medical images.

While AI played no role at all in radiology as recently as 2015, 30 percent of radiologists had adopted the technology by 2020, according to a study by the American College of Radiology.2

One of the diseases where machine learning has proven its value in early diagnosis and prognosis is dementia, the leading cause of disability and dependency among the elderly. Diagnosing dementia in an early phase is a challenge due to the lack of symptoms and visible changes in brain images at the preclinical stage. By studying patterns in thousands of brain scans from dementia patients, scientists in the UK have developed an algorithm that can detect early signs of dementia in brain scans that are not visible even to radiologists. The algorithm has reduced the diagnosis procedure from several scans and tests across several weeks to just one single scan. 

Data experts believe that AI, rather than replacing radiologists Altogether, will automate redundancies, prevent mistakes, and optimize how radiologists practice, which will ultimately lead to better patient outcomes.3

AI and big data are advancing precision medicine

All humans are different from one another due to genetic, environmental, and lifestyle factors. But in conventional medicine, patients with the same disease are typically given the same standard treatment. This is often the reason for unreliable outcomes. In precision medicine, medical decisions are tailored to a subgroup of patients. Multidimensional datasets are used to train algorithms to identify subgroup patients with similar biological and other characteristics. Precision medicine offers clinicians the opportunity to prepare tailor-made preventative or therapeutic interventions. It has already led to promising results in AI-powered prognosis for cancer and cardiovascular disease.4

In 2018, Chiba University set up the first AI center in a medical school in Japan. The center uses AI to analyze genomic and clinic data such as gene expression, metabolism, gut microbiome, environmental exposures, and lifestyle factors. By doing so, researchers are able to predict the efficacy of treatments and future outcomes. In one of their studies, researchers used machine learning to identify a group of early-stage ovarian cancer patients who would respond poorly to a particular treatment beforehand. This finding gave the clinicians the opportunity to design a new treatment approach for the subgroup of patients.

“Predictive algorithms can help identify disease groups that haven’t been recognized by clinicians, as well as guide the selection of personalized treatment options for these patients.” – Eiryo Kawakami, professor of artificial intelligence medicine at Chiba University.5

Translate AI from labs to real-life patient care

To laypeople, the notion of an AI healthcare solution may sound like a complex one. But Professor Sebastien Ourselin, Head of the School of Biomedical Engineering & Imaging Sciences at King’s College London, says the new approach will make his work easier. Ourselin and a team of data scientists and clinicians at AI Centre for Value-Based Healthcare are working together with The National Health Service (NHS) and other partners to deploy AI solutions into real hospitals in the UK.

“AI is just a way to make sense of all of those data by training models which will hopefully be able to save us time in making the diagnosis, prognosis and be able as well to increase the effectiveness of the treatment.” – Professor Sebastien Ourselin, Head of School of Biomedical Engineering & Imaging Sciences at King’s College London6

The transformation of AI solutions from labs to real patient care is not an easy task. Medical data in the real world is often unstructured, comprehensive, and filled with various terms, abbreviations, and misspellings. The strategy of the AI Centre for Value Based Healthcare is to first convert static snapshots of clinical data into real-time, actionable analytics, then build an infrastructure to link data together and train the algorithm. Eventually, with the help of AI, actionable models are formulated that can be deployed in real hospitals. The NHS plans to deploy the first prototype in ten hospitals later this year. The full deployment of AI solutions will be carried out in the next two years.

Do you think we will see AI-powered healthcare solutions in real hospitals soon? Search “Future of healthcare” on the Supertrends Pro app and tell us about your thoughts on AI healthcare solutions:

This blog concludes our series on the future of healthcare. Thank you for following our ideas on what will happen in the future of healthcare and what it may mean to your life. Take advantage of the Supertrends Pro app’s free trial to make your voice heard on the “future of healthcare”. The final timeline will be revealed in November. Scroll down to the bottom of this page and sign up for our newsletter so you won’t miss it!

[1] Pittman D., 10 Questions: Lucian Leape, MD. MedPage Today. 12 January 2014. https://www.medpagetoday.com/PublicHealthPolicy/GeneralProfessionalIssues/43757

[2] Siwicki B., Mass General Brigham and the future of AI in radiology. Healthcare IT News. 10 May 2021. https://www.healthcareitnews.com/news/mass-general-brigham-and-future-ai-radiology

[3] Siwicki B., Mass General Brigham and the future of AI in radiology. Healthcare IT News. 2021.

[4] Uddin, M., Wang, Y. and Woodbury-Smith, M. Artificial intelligence for precision medicine in neurodevelopmental disorders. npj Digit. Med. 2, 112 (2019). https://doi.org/10.1038/s41746-019-0191-0

[5] Nature research custom media, Chiba University. Advancing precision medicine using AI and big data. Nature portfolio. Accessed on 27 August 2021. https://www.nature.com/articles/d42473-020-00349-9

[6] Ourselin S., The future of healthcare with artificial intelligence. 26 June 2021, Future of Healthcare (Webinar). NewScientistLive. https://app.konf.co/event/sJ0Vy6Kn/session/4499

Sepsis patients Sepsis patients Sepsis patients Sepsis patients

Four Supertrends Experts Share Their Insights on Sepsis

On 13 September 2021, World Sepsis Day will be observed for the tenth time. Sepsis, a disorder that is caused by infections, can lead to limb amputations and deaths in a matter of days. The condition kills at least 11 million people every year globally. However, the condition is still not well known, with only from 7 to 50 percent of respondents being familiar with the term, and many having an incorrect understanding of the condition. Supertrends asked four experts to comment on current sepsis-related trends and challenges. 

COVID-19 and viral sepsis

Traditionally, bacterial infections had been regarded as a leading cause of sepsis. The COVID-19 pandemic has revealed viral sepsis to be one of the characteristics of modern-day sepsis syndrome. Studies found that sepsis was the most frequently observed complication of COVID-19. The elevation of cytokine levels, an indicator of dysregulated immune response to the virus infection, was linked to viral sepsis and critically ill COVID-19 patients. 

Dr. Masab Moumneh, who has been an ICU physician in Abu Dhabi for the past ten years, still cannot believe how many lives COVID-19 took during the peak days of the pandemic. He told Supertrends that almost all COVID-19 patients are killed by the dysregulated immune response rather than the virus itself.

“I have never seen anything as bad as this. Patients typically develop a high fever, their Interleukin 6 (a type of cytokine) is high. If we can get them to pass the two-week mark, they will survive.”

– Masab Moumneh, MD, ICU physician, and Supertrends expert

Sepsis in contemporary healthcare 

Dr. Mads Koch Hansen, an intensive care specialist and hospital administrator, believes that we are facing a greater challenge from sepsis today due to shortened post-surgery hospital stay, emerging viral infections, antibiotic resistance crisis, and an aging population.

“Today, there are more elderly patients and more patients with chronic conditions. Another factor we should pay attention to is that we do more surgeries on elderly people, with fewer post-surgery staying days in the hospital. This means we will not be able to detect these patients early if they develop sepsis.”

– Mads Koch Hansen, MD, intensive care specialist, hospital administrator, and Supertrends expert

Currently, there is still no drug specifically targeting sepsis. Hansen felt that doctor’s hands were quite tied when it came to treating sepsis patients. 

A promising new approach

Aquaporin (AQP) is a channel protein found in plants, animals, and humans. The discovery of aquaporin won Dr. Peter Agre a Nobel Prize in 2013. However, despite having a profound physiological impact, aquaporin has not been transformed into practical applications. Dr. Michael Rutzler, CEO and founder of start-up Apoglyx, told Supertrends that aquaporin could be a potential treatment for sepsis. 

“We found strong evidence that the inhibition of AQP9 demonstrated a protective effect from sepsis in rodent models, especially on heart function. We are hoping to get similar results in humans.”

– Michael Rutzler, CEO and founder of Apoglyx, Supertrends expert

Rutzler has been collaborating with Professor Giuseppe Calamita of Bari University in Italy. Calamina’s team was the first in the world to study aquaporin’s involvement in sepsis in a living animal model. 

“We got a very promising result with more than 25 percent of the mice surviving sepsis […] The results proved that modulated AQP might offer a new approach for sepsis management.”

– Giuseppe Calamina, professor in biosciences and Supertrends expert

A new era for sepsis management

Advances in the field of biology and computer science are changing the way we prevent, diagnose, and treat diseases. Innovations in medicine mean we can understand and manage many health issues better than before. 

Aquaporin-based therapy or other innovative approaches one day will help clinicians to overcome the challenge of sepsis. Our report on Supertrends in Aquaporin and Sepsis describes how the future of aquaporin could be intertwined with the future management of sepsis. 

anti aging, longevity anti aging, longevity anti aging, longevity anti aging, longevity

Defy Aging and Stay Healthy for 100 Years

Although stories revolving around long life and eternal youth have always been told throughout human history, most of us accept aging as a completely natural process. But if it is possible for some species, such as a certain type of jellyfish, to be biologically “immortal”, why not humans? As our understanding of biological processes improve, scientists have started to take on aging from a whole different viewpoint.

The Seven Revolutions in Healthcare That Will Impact Your Life – Part 5

Read Part 4 – mRNA Vaccines Mark a New Era in Medicine

How long can we live?

Only the gods can never age, the gods can never die. All else in the world almighty Time obliterates, crushes all to nothing.

– Oedipus at Colonus

Before we discuss potential lifespans of the future, let’s first take a look at what has happened in the past century. The 20th century saw an unprecedented acceleration and growth of life expectancy. The world average life expectancy rose from 45.6 years in 1900 to 77.8 years in 2000. This means that our average longevity increased by 3.22 years every decade during the past century.  But this trend is slowing down. In the UK, from 2009 to 2019, male life expectancy only rose by 1.5 years, and female by 1.1 years.1 In the US, life expectancy plateaued at 78.9 years in 2014, dropped slightly for three consecutive years, and remained at below 79 years until 2020. Ironically, this deceleration trend has been accompanied by record spending increases in the healthcare sector.2

Another trend in aging is the separation of lifespan and healthspan. Healthspan is the period of lifespan free from any chronic, age-related diseases. In 2019, noncommunicable, chronic diseases contributed to seven of the world’s top ten causes of death. Cardiovascular disease, cancer, chronic obstructive pulmonary disease, Alzheimer’s disease, and type 2 diabetes, all age-related diseases, are leading causes of frailty and disability among the older population.3

There is no single answer yet to how long we can live.

Biomedical gerontologist Aubrey de Grey is well known for his rather radical theory of “longevity escape velocity”. He believes that at some point in the future, scientific progress will advance faster than the human body ages, potentially extending our life expectancy indefinitely.4

Other scientists have looked to statistic modeling to predict the trajectory of life expectancy. A recent study based on longitudinal monitoring and analysis of human blood markers concluded that the upper limit of the human lifespan is between 120 and 150 years.5

The question of lifespan and its potential limits is expected to be debated for a long time to come. However, despite different answers to this question, more and more scientists are coming to the understanding that aging is a fundamental biological process among the elderly. The key to all age-related diseases may lie in aging itself.

Why do we age?

One of the oldest theories about aging is the wear-and-tear theory. This theory argued that the human body will inevitably break down with use over the years, similar to a mechanical system.

Although the wear-and-tear theory fits with our observation, we know now that the human body is a biological system that is equipped with damage-repairing ability. In some studies, scientists have found that the aging process can be partially or completely reversed.

Scientists are only now beginning to understand the deeper underlying mechanisms at the cellular level. Anti-aging research now involves many very different ideas and approaches. The development of “The Nine Hallmarks of Aging” established a model that presents all the different factors that play a role in aging.6

In the 1970s, Elizabeth Blackburn discovered telomeres, the DNA sequences located at the end of all our chromosomes. During aging processes, the telomeres shorten, which also limits the number of times our cells can divide.7 Telomere attrition became one of the first hallmarks of aging to be identified. Other hallmarks are genomic instability, epigenetic alterations, loss of proteostasis, deregulated nutrient-sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication. If one of the hallmarks is aggravated, aging will accelerate; if it is ameliorated, aging will be prevented. The nine hallmarks of aging also showed us which areas anti-aging treatment should target.

What can we do about aging?

For many people, remaining healthy into older age is more important than having a longer life. Both for individuals and for society at large, the best outcome would be if the progressive disability of later life could be compressed into a shorter period. This goal, however, will be difficult to achieve if we treat age-related diseases separately. Aging not only affects nearly all our organs, but it is also the single most important risk factor for cancer, heart disease, diabetes, and Alzheimer’s disease. If we try to combat age-related diseases individually, we will only be replacing one problem with another one. The reasonable solution should be to prevent, delay, or reverse aging itself.

“If you live long enough, you will get cancer.” – Professor Robert Weinberg, a pioneer in cancer research8

Anti-aging medicine is still in its infancy. Many medical treatments targeting aging are still being tested on animals, which means we will likely not see any age-targeted treatment before the next decade. However, a few lifestyle-related approaches are already showing promising results in small-size human trials. Among these approaches are intermittent fasting and high-intensity interval training. Some supplements, such as NAD+ booster, resveratrol, and most recently spermidine, also are considered to be effective in preventing aging processes by bringing about rejuvenation on the cellular level. Last but not least, personal factors such as having a purpose in life, feeling healthy and satisfied, or becoming socially connected also play a role in healthy aging. The above actionable approaches are explained in detail in the Supertrends practical guide for longevity.

The future of healthy aging

Time waits for no one. For anti-aging interventions, sooner is better than later. The Supertrends in Anti-aging Report identified 150 companies that are working on anti-aging solutions. Most of the therapies are still in the pre-clinical stage. About 28 of them are currently being tested in human trials, including some of the existing drugs that were initially designed for other conditions, such as metformin and rapamycin. The re-purposed drugs could become some of the first available anti-aging treatments.

Anti-aging medicine is benefiting very much from the application of artificial intelligence (AI), machine learning, data analysis, and progress in genomic research. AI-assisted drug discovery has been implemented by a few start-ups. There are also some anti-aging start-ups that combine digital markers, biomarkers, and genetic markers to monitor the aging process and provide lifestyle recommendations.

Whether aging can be stopped or reversed is a question that will likely be debated for the foreseeable future. But there should be no doubt that even a few years’ delay in the aging process will have huge impacts on individuals and society.

The opinion on aging from some scientists is reflected in a tweet from the renowned biologist and professor of genetics, David Sinclair, “there is no biological law that says we must age.”

Share your thoughts on one of the most intriguing questions in human history – will we live longer and healthier?

Search “Future of healthcare” on the Supertrends Pro app and make your prediction for the following:

© 2021 Supertrends

[1] Life expectancy (from birth) in the United Kingdom from 1765 to 2020*. Statista. June 2019. https://www.statista.com/statistics/1040159/life-expectancy-united-kingdom-all-time/

[2] Christensen J., US life expectancy is still on the decline. Here’s why. CNN. November 26, 2019. https://edition.cnn.com/2019/11/26/health/us-life-expectancy-decline-study/index.html

[3] World Health Organization. The top 10 causes of death. 2020.  https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death

[4] Findlay C., Extreme longevity: Why Aubrey de Grey believes we may live to age 1,000. Supertrends. September 16, 2020. https://supertrends.com/extreme-longevity-why-we-may-live-to-age-1000/

[5] Pyrkov, T.V., Avchaciov, K., Tarkhov, A.E. et al. Longitudinal analysis of blood markers reveals progressive loss of resilience and predicts human lifespan limit. Nat Commun 12, 2765 (2021). https://doi.org/10.1038/s41467-021-23014-1

[6] López-Otín, C., Blasco, M.A., Partridge, L., et al. The Hallmarks of Aging, Cell, 2013, Volume 153, Issue 6, Pages 1194-1217, https://doi.org/10.1016/j.cell.2013.05.039.

[7] Supertrends in Anti-Aging, Supertrends, last updated 22 June 2021, https://supertrends.com/solutions/dynamic-reports/supertrends-in-anti-aging/

[8] Lents N., Why Everyone Will Eventually Get Cancer. Psychology Today. May 22, 2018. https://www.psychologytoday.com/us/blog/beastly-behavior/201805/why-everyone-will-eventually-get-cancer

Genomics Spells the End of ‘One Size Fits All’ Medicine

The same disease can cause different symptoms in different people. The same drug affects everyone differently.  COVID-19 has reminded us once again that medicine is not “one size fits all”.  Breakthroughs in genomics have made it possible to tailor prevention, diagnosis, and treatment to individual levels. 

The Seven Revolutions in Healthcare That Will Impact Your Life – Part 1

Within five to ten years, healthcare as we know it may be changed radically. Disruptive technologies such as genomics, artificial intelligence, or 3D printing have already started to have an impact on both patients and healthcare providers. These trends will grow exponentially and will affect our lives in important ways. At Supertrends, we’ve taken a closer look at the healthcare trends that may come to fruition in the near future. We will be describing these in a series of stories detailing how our lives will be changed by these new technologies – for the better. 

From the “US$1,000 genome” to the “US$100 genome”

“The $1,000 genome has long been considered the tipping point that would open the floodgates to this (personalized genomic medicine) revolution” – Kevin Davies, author, founding editor of Nature Genetics [1]

Genomics is the study of our genes, or DNA, and their interaction with our health. In 2003, The Human Genome Project completed the sequencing of the entire human genome. It took 15 years of international efforts and cost US$2.7 billion. The first direct-to-consumer whole human genome sequencing started in 2007 at the cost of UD$350,000. With the invention of Next-Generation Sequencing (NGS), prices fell to around US$4,000 by mid-2015, and below US$1,000 by 2017.[2] In 2020, Chinese genome sequencing company BGI announced that it was able to sequence the full human genome at a cost of US$100.[3]

DNA sequencing has never been so accessible. Fast and low-cost genome sequencing, combined with our expanding ability in data handling, is driving the shift to precision medicine, a medical approach based on a person’s unique genetic data and his lifestyle. This trend is reflected in disease prevention, diagnosis, prognosis, and treatment optimization.

Healthcare is moving from cure towards prevention

“The superior doctor prevents illness. The mediocre doctor attends to impending sickness. The inferior doctor treats actual illness.” – From a Traditional Chinese Medicine book

More than 2,000 years ago, one of the oldest Traditional Chinese Medicine textbooks already regarded prevention as the ultimate goal of medicine. Today, genomics enables us to take preventive measures long before a disease shows any symptoms. Certain genetic variations may be prone to causing particular health risks. Genomic information can help us to take the necessary steps in protecting our health. When symptoms do occur, genomics plays an increasingly important role in getting a definitive diagnosis and selecting the optimized treatment. Two of the areas where this is already happening are rare diseases and cancer.

A rare disease is a disease that affects fewer than one in 2,000 people. There are over 6,000 known rare diseases. In total, they affect one in 17 people. In the past, patients with a rare disease often spent years unsuccessfully seeking a diagnosis. Now, over 80 percent of rare diseases been found to have a known genetic origin. Genome sequencing has become the most useful tool for doctors to diagnose rare diseases.[4]

All cancers are the result of gene mutations. Doctors used to diagnose cancer by location and cellular type. Genome sequencing of cancer tissues means we can know the exact mutation, providing insight into how an individual patient’s cancer may progress, and how it might respond to treatment. Some inherited gene mutations, such as BRCA1 and BRCA2, are connected to a higher risk of developing breast, ovarian, and prostate cancer. Known carriers of these mutations will be able to take preventive measures and monitor the risk more closely.[5]

Pharmacogenomics and gene editing

Back to the issue of why a drug could be highly effective for some people, but toxic for others. The reason why different individuals have different responses to the same drug at the same dose is genetic variation. Some of us have genetic variations that influence the production of enzymes needed to metabolize certain medicines. In these cases, the particular drug may either not work or cause an adverse effect. By testing for these genetic variations, we can select a drug that will work as it should. Pharmacogenomics is a new field that studies how genes affect a person’s response to drugs. There are already more than 250 drugs labeled with pharmacogenomic information. With both pharmacogenomic and gene sequencing becoming accessible, medicines will be prescribed based on our genes in the near future. The ideal would be for each patient to get the drug that works most effectively for them, with the least side effects.  

“Armed with the complete CRISPR toolkit, scientists can now exert nearly complete control over both the composition of the genome and its output.”
― Jennifer A. Doudna, winner of 2020 Nobel Prize in Chemistry

Adapted from a genome editing system that occurs naturally in bacteria, CRISPR-Cas9 has quickly become a key technology in gene editing. CRISPR technology is often described as a pair of “scissors” that can cut out a precise segment of malfunctioning DNA and replace it with a piece of good DNA. Gene editing has the potential to treat many genetic diseases and is regarded by some researchers as the ultimate precision medicine.

On 28 June 2021, the first clinical trial of a CRISPR-Cas9 drug infused directly into patients’ bloodstream to treat a rare disease was announced to be successful. This means that in the future, many medical conditions related to genetic mutations can be treated with a single highly effective gene therapy, possibly at a reasonable price.[6]

Will whole genome sequencing be included in newborn screening tests?

Newborn babies are tested before they leave the hospital for serious and often genetic diseases. With gene sequencing and gene therapy becoming increasingly accessible and scalable, it is logical to imagine that in the future a genome file will be established for each newborn baby. The genetic information in this file will be used to design a personalized health plan to prevent future diseases, establish accurate diagnoses and optimize treatment plans. At Supertrends, we believe this personalized, preventive healthcare model based on genomics will happen within the next 10 years in developed countries.

There will be, however, ethical, social, and legal challenges in how we use genomic information. Will genetic testing be one of the newborn screening tests? You can share your thoughts about this question and more on the Supertrends Pro app. Click here to trial the app for free and search “Future of Healthcare” on the Supertrends timeline to join the discussion.  

© 2021 Supertrends

[1] Kevin Davies, The $1,000 Genome: The Revolution in DNA Sequencing and the New Era of Personalized Medicine, (Free Press, 2010)

[2] National Human Genome Research Institute, “Human Genome Project FAQ,” accessed June 29, 2021, https://www.genome.gov/human-genome-project/Completion-FAQ

[3] Antonio Regalado, “China’s BGI says it can sequence a genome for just $100,” MIT Technology Review, February 26, 2020, https://www.technologyreview.com/2020/02/26/905658/china-bgi-100-dollar-genome/

[4] NHS Genomics Education Programme, “Rare Disease, genomics and the future,” February 26, 2018, https://www.genomicseducation.hee.nhs.uk/blog/rare-disease-genomics-and-the-future/

[5] Bianca Nogrady, How cancer genomics is transforming diagnosis and treatment, Nature 579, S10-S11 (2020), doi: https://doi.org/10.1038/d41586-020-00845-4

[6] Karen Weintraub, “‘It’s a wow’: New CRISPR gene-editing success holds promise for treating many genetic diseases with a single dose”, USA Today, June 28, 2021, https://eu.usatoday.com/story/news/health/2021/06/26/new-crispr-gene-editing-success-holds-promise-genetic-diseases/5343114001/

aqua drop aqua drop aqua drop aqua drop

Finding the elusive aquaporin modulators

Aquaporins are channel proteins that facilitate the transport of water across cells. The discovery of aquaporins in 1992, for which researcher Peter Agre received the Nobel Prize in Chemistry, opened the door to a new therapeutic approach for treating many health conditions. On one particular start-up’s journey in finding applicable aquaporin modulators, the student has become the master.

Water is one of the substances that are essential for life on Earth and for the survival of all plants and animals. Although the importance of water transport has been recognized since ancient times, the precise mechanism by which water is transported in and out of cells remained elusive until aquaporins were discovered by Peter Agre in 1992. These proteins form pores in the cell membrane to allow water to be transported between cells. 

The importance of this fundamental discovery and its potential impacts was acknowledged in 2003, when Agre won the Nobel Prize in Chemistry for “discoveries concerning channels in cell membranes”. However, nearly 30 years after the discovery of aquaporins, the only practical application is in the understanding and treatment of water balance disorders. Despite their pervasive presence in human organs, aquaporins have not featured in any new medical therapies. To understand the mystery surrounding these elusive proteins, Supertrends approached Apoglyx, a Swedish start-up leading the development of aquaporin-based treatments, for a joint interview with Michael Rutzler (CEO and founder of Apoglyx), Søren Nielsen (co-founder and shareholder), and Kristina Nyzell (investor).

Tiny water channels

Søren Nielsen, a professor at the Department of Biomedicine, Aarhus University and the Department of Health Science and Technology, Aalborg University in Denmark, worked very closely with Peter Agre for many years. Both have always believed in the magic of aquaporins. “Aquaporins exist globally in animals, plants, and microbes. These channels are fundamental for life. We are one of the leading groups in identifying different aquaporins and exploring their roles in physiology and medicine. From a biotech perspective, Apoglyx’s approach is to identify inhibitors of aquaporins to exploit their medical importance. This is a new approach, and a very challenging one due to the molecular structure of aquaporins,” Nielsen told Supertrends. 

Nielsen is a firm believer in the importance and clinical potential of aquaporins: “It is fundamental. Take the kidney as an example. Aquaporins have a critical role in kidney function and a variety of kidney and cardiovascular diseases. Another example is the brain, where AQP4 has an important role in water transport and in brain edema. It has recently also been shown that aquaporins as glymphatics have additional roles in facilitating brain function. Identifying aquaporins that serve as channels for water transport and in regulation of water balance and water balance disorders was relatively straightforward conceptionally. It is much more difficult to understand the roles of aquaglyceroporins that also serve other functions in addition to water transport. That has turned our focus to AQP7 and AQP9, which play a role in metabolic diseases and sepsis.” 

The student has become the master

aquaporin-9 inhibitors

In 2007, Michael Rutzler met Nielsen at Aarhus University. By then, Rutzler had already done some well-received research on olfactory receptors in insects in identifying potential inhibitors. With the support of many leading scientists like Nielsen, Rutzler now devotes his time to finding aquaporins modulators to treat medical conditions in humans. 

“Aquaporins are channels or holes in the cell membrane. They selectively let water and some other small molecules pass. The channels have enormous capacities to let water and other molecules through. That is one reason why it is difficult to find blockers that can stop all these molecules from going through.”  

The aquaporin modulators have proven difficult to identify, but Rutzler has successfully identified aquaporin-9 inhibitors and demonstrated promising applications on metabolic diseases and later sepsis. 

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Despite modern medical advances, it remains a global public health emergency affecting millions of people worldwide and one of the main causes of death across the world. It is also a medical condition for which no effective treatments exist. The COVID-19 crisis has brought this ancient condition into the spotlight again. Developing new treatments for sepsis has always been a difficult task; now, it is even more urgent.

With due caution, Rutzler lays out a possible pathway to success: “In sepsis, the dysfunction of the immune system starts to damage vital organs. The global effects also have an impact on blood circulation. Vital organs, including the brain and kidneys, become impaired. This, in turn, causes further damages to other organs. Through our collaboration with other universities, we found strong evidence that the inhibition of AQP9 demonstrated a protective effect from sepsis in rodent models, especially on heart function. We are hoping to get similar results in humans.” Rutzler and Nyzell are quite excited regarding the promising results of this potential treatment. Nyzell explains in layman’s terms: “Impaired blood flow can cause long-term consequences in vital organ functions. The current COVID-19 debate has been very much focused on keeping patients alive without thinking about long-term complications. I think it is important to look into new ways of treatments from a broader view in sepsis.” And Nielsen adds: “We are working on the role of AQP9 in sepsis and other conditions. Many aisles in finding new efficient treatments have been closed. It is crucial to develop something new based on this preliminary evidence.”

The path to a promising future

In conclusion, Supertrends asked the question that is on everybody’s mind: When will an aquaporin-based treatment be available for sepsis patients?

Starting from humble beginnings in 2012, after Rutzler discovered aquaporin inhibitors, Apoglyx has managed with a small amount of financial support and a great team of scientists to become one of the leaders in developing aquaporin modulators for therapeutic applications. After many years of hard work, Apoglyx now is ready for its breakthrough.

“It also depends on funding. Sepsis is a medical condition, not a disease. Aquaporins and sepsis are under-funded. What Michael and Søren are doing is much more difficult than developing the COVID tracking app,” Nyzell adds, supplying the investor’s perspective.  

Apoglyx is planning to submit its Investigational New Drug (IND) application to the FDA and start a Phase 1 clinical trial in 2022; whether alone or potentially in partnerships with larger pharmaceutical companies, it is looking at potentially gaining approval and entering the market in less than ten years.

Apoglyx's planned milestones
Apoglyx’s planned milestones

Before the end of the decade, we may finally be able to lift the veil of mystery that still obscures the path towards aquaporins-based therapies.

This article only scratched the surface of the implications of aquaporins in healthcare. With the support of experts like Michael Rutzler and Søren Nielsen, Supertrends has created an extensive report on aquaporins (AQP) in healthcare, particularly with regard to the challenges and opportunities we face in sepsis and the potential role that AQPs could play in sepsis management. For investors, policymakers, healthcare providers, and entrepreneurs, this report offers insights into both topics and a novel approach in combining the two concepts to explore new solutions. Click here to learn more about it.
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