With each passing day, technology continues to advance. With technological advances comes advances in healthcare. In the past few years alone, there have been major breakthroughs in treating and detecting diseases in ways that we’ve never been able to before. Machine-learning, smart devices, and artificial intelligence (AI) are rising in the biomedical field ranks, and its implementation in healthcare has only just begun. Below is a list of a few of the biggest health industry news of 2022 (so far!):
Deep-Learning AI Tool Helps Detect Pancreatic Cancer
Among the various types of cancer, pancreatic cancer has the lowest five-year survival rate. It’s projected to become the second leading cause of cancerous death in the US by 2030. As with all types of cancer, early detection can be key in successfully treating the disease. Computed tomography (CT) is the method most commonly used in detecting pancreatic cancers, but it is not without its drawbacks. CT scans have only modest sensitivity in detecting small tumors; they miss approximately 40% of tumors smaller than 2 cm. CT scanning is also interpreter-dependent, which may be limited by availability and expertise of radiologists.
A nationwide, population-based study, published in the September issue of Radiology, sought to develop a tool to combat the acknowledged inefficiencies in CT scanning. Researchers in Taiwan developed a computer-aided detection (CAD) tool which included a segmentation convolutional neural network (CNN) to identify the pancreas on CT scans. Researchers also created an ensemble classifier, comprising five classification CNNs that predict whether pancreatic cancer is present. Researchers tested this tool on 669 patients with pancreatic cancer and a control group of 804 patients without pancreatic cancer. The deep learning–based tool demonstrated 90% sensitivity and 93% specificity in real-world subjects. Furthermore, tests showed satisfactory sensitivity for tumors smaller than 2 cm at around 75%. “The CAD tool may serve as a supplement for radiologists to enhance the detection of pancreatic cancer,” said co-senior author, Wei-Chi Liao, MD, PhD, from National Taiwan University and National Taiwan University Hospital.
Sources: https://www.eurekalert.org/news-releases/963876 ; https://pubs.rsna.org/doi/10.1148/radiol.220152
Advancements in mRNA Immunology and Vaccinology
Messenger RNA (mRNA) is a single-stranded RNA molecule that complements DNA. The mechanisms of mRNA within the cell are complex and vitally important, but put simply, mRNA is genetic material that tells your body how to make proteins. The growth of mRNA technology has been monitored and reported on due to its prominent role in the creation of COVID-19 vaccines. mRNA is emerging as a promising alternative to previously implemented vaccination methods as it offers several advantages. mRNA vaccines have proven to be safe for immunocompromised patients, are relatively cheap and easy to produce, and have demonstrated upwards of 95% efficacy.
As is the way with almost all technological advances, development of mRNA technology has captured the attention of leading biotech companies around the world. mRNA technology seems to be ushering in a new era of vaccinology and the future of medical advancements is exciting. Because of its success in combating COVID-19, there is a lot of clinical research being done to develop mRNA therapies to treat other viruses, such as HIV, Lyme disease, Ebola, Zika virus, and many more. Moreover, researchers are studying mRNA’s effect in the production of proteins and how they may be able to combat diseases in which proteins are missing (e.g., cystic fibrosis, diabetes, sickle cell anemia) which would radically alter costly treatments that are associated with care.
Sources: https://www.atlantichealthpartners.com/immunization-insights-1/the-rise-of-mrna-vaccines-a-new-era-of-vaccinology ; https://www.yalemedicine.org/news/covid-19-vaccine-comparison
Gene Expression Profiles Could Pave the Way for Personalized Immunotherapy
Adoptive cell therapy is a method of treatment for many types of cancers. It is a type of immunotherapy in which an individual’s immune system is “trained” to destroy their tumor. Adoptive cell therapy involves genetically engineering T cells, which are lymphocytes that act in the immune response. The problem, however, is that it’s challenging to even identify T cell receptors that can recognize cancer-specific alterations.
Researchers at the National Institutes of Health tackled this challenge, identifying unique expression profiles in 55 genes that help identify rare anti-tumor lymphocytes that can infiltrate and destroy metastatic epithelial tumors. Researchers designed sensitive assays that identify tumor-infiltrating lymphocytes (TILs) which recognize the products of mutations that can cause cancer. By identifying these TILs, researchers can develop personalized and effective cancer immunotherapies for patients who don’t respond to standard treatments.
Steven Rosenberg, MD, PhD, chief of the Surgery Branch at the Center for Cancer Research and National Cancer Institute, spearheaded a study published in the February issue of Science. Researchers looked at every potential mutation in a tumor that could be a target. Over the course of several years, Dr. Rosenberg’s study team developed this new assay that identifies the gene expression profiles of a few rare lymphocytes that recognize mutated cell surface proteins of cancerous cells. This development in cell-based immunotherapy encourages tumor shrinkage in patients with stomach, esophageal, ovarian, and breast cancers, among other types of metastatic cancers.
Sources: https://www.cancer.gov/news-events/press-releases/2022/gene-expression-profile-personalized-immunotherapy ; https://www.science.org/doi/10.1126/science.abl5447
Novel Epidural Electrical Stimulation Technology Helps Paralyzed Patients Walk, Cycle, and Swim
In a study published in the February issue of Nature Medicine, researchers at the Swiss Federal Institute of Technology, Lausanne, hypothesized that an arrangement of specialized epidural electrical stimulation targeting a cluster of dorsal roots involved in leg and trunk movements would result in superior effectiveness after severe spinal cord injury (SCI). To test their hypothesis, researchers developed software supporting the rapid configuration of activity-specific stimulation programs. The stimulation programs reproduced the natural activation of motor neurons that make activities such as standing, walking, cycling, and swimming possible.
Included in the study were three paralyzed patients, men who had no sensation or control over their legs after suffering SCIs in motorcycle accidents. In the ongoing clinical trial, the men were able to take supported steps after one day. After a few months, they were able to walk on their own with a walker. Researchers reported that neurorehabilitation supported sufficient improvement to restore these activities in community settings. While this nerve-stimulating device doesn’t cure SCIs, it nevertheless provides patients and medical professionals hope and excitement for further developments in this kind of assistive technology.
Sources: https://www.science.org/content/article/next-generation-spinal-implants-help-people-severe-paralysis-walk-cycle-and-swim ; https://www.nature.com/articles/s41591-021-01663-5
FDA Approves Novel Treatment for Type 2 Diabetes
Type 2 diabetes, the most common type, is a chronic and progressive condition in which the body cannot make or utilize insulin normally. This leads to high levels of glucose in the blood (hyperglycemia) and can damage the vessels that supply blood to vital organs, which in turn increases the risk of heart disease, stroke, kidney disease, vision problems, and nerve problems. While there are many types of medications to treat type 2 diabetes, many people still have difficulties maintaining normal blood sugar levels. In May, the U.S. Food and Drug Administration (FDA) approved tirzepatide (brand name Mounjaro) injections to improve blood sugar control in adults with type 2 diabetes, in addition to a healthy diet and regular exercise. According to the FDA, tirzepatide was proven to be more effective in improving blood sugar levels than other diabetic therapies when compared in clinical trials.
In five separate clinical trials, three different doses of tirzepatide (5mg, 10mg, and 15mg) were evaluated as either a stand-alone therapy or as an add-on to other diabetic medicines. The outcome measurement in the studies was the measure of blood control, otherwise known as hemoglobin A1c (HbA1c) levels. Used as a stand-alone therapy, patients that were randomized to 15mg of tirzepatide had an average lowering of their HbA1c level 1.6% more than placebos. When compared to other commercially used diabetes medications, tirzepatide resulted in a lowering of HbA1c up to 1.0%. Additionally, as many individuals with type 2 diabetes are obese, tirzepatide resulted in more weight lost in patients when compared with placebo and other diabetes medications.
AI-Powered Early Detection of Sepsis in Patients
Sepsis is a life-threatening medical emergency that results from the body’s extreme chain reaction to an infection already in the body, most often originating in the lungs, urinary tract, skin, or gastrointestinal tract. If not treated quickly, sepsis can swiftly lead to tissue damage, organ failure, and even death. Sepsis is easy to miss because symptoms, such as fever and confusion, are common in other conditions. According to the CDC, 1 in 3 people who die in a hospital had sepsis sometime during that hospitalization. Traditional methods of testing for sepsis can include blood cultures looking for bacterial infections or testing for viral infections.
A team of researchers at Johns Hopkins University have developed a new AI system to detect sepsis nearly six hours earlier in patients when compared with traditional methods. Their findings suggest patients are 20% less likely to die thanks in part to this early detection. Published in the July issue of Nature Medicine, the study’s early detection tool boasted a high sensitivity rate; among the 9,805 retrospectively identified sepsis cases, over 80% of were identified. The adaptive technology has even been tailored to identify patients at risk for pressure injuries (i.e., bed sores), bleeding, acute respiratory failure, and cardiac arrest. “It’s adaptive and takes into consideration the diversity of the patient population, the unique ways in which doctors and nurses deliver care across different sites, and the unique characteristics of each health system, allowing it to be significantly more accurate and to gain provider trust and adoption,” Suchi Saria, research director of the Malone Center for Engineering in Healthcare at Johns Hopkins University and lead author of the study, said.
Sources: https://www.nature.com/articles/s41591-022-01895-z ; https://hub.jhu.edu/2022/07/21/artificial-intelligence-sepsis-detection/ ; https://www.cdc.gov/sepsis/what-is-sepsis.html#:~:text=Sepsis%20is%20the%20body%27s%20extreme,%2C%20skin%2C%20or%20gastrointestinal%20tract.