What is Bioelectronic Medicine?
Pharmacological therapies that target molecular mechanisms take a long time to develop, are expensive for patients, and may be difficult to administer. These therapies are often toxic and may be accompanied by many adverse side effects.
An alternative may be bioelectronic medicine, an emerging field combining expertise across multiple scientific disciplines, including molecular medicine, bioengineering, and neuroscience. Together, this new field seeks to develop cures that don’t require drugs – or rely on them less heavily. Bioelectronic medicine harnesses nerve-stimulating and -sensing technologies to specifically target the biological processes underlying disease.
The technology behind bioelectronic medicine adapts electrical signals used by the nervous system to communicate information through painless, imperceptible pulses of electricity delivered through implants or patches. Targeted peripheral neuromodulation is already being assessed for a wide variety of conditions including autoimmune diseases such as lupus and rheumatoid arthritis.
Bioelectronic Medicine for Lupus Treatment
Lupus causes the immune system to lose the ability to differentiate between foreign agents and healthy tissue. This causes the immune system to become hyperactive, attacking healthy tissue while causing inflammation and damage to joints, skin, and internal organs.
Musculoskeletal pain is one of the most common lupus symptoms, affecting up to 95% of patients and contributing to a reduced quality of life. While there are immune-suppressing drugs that decrease disease flare-ups and inflammation, these drugs are not effective for all patients and can be associated with side effects.
Recent advances for bioelectronic devices to combat musculoskeletal lupus pain were presented at the American College of Rheumatology/Association of Rheumatology Professional’s (ACR/ARHP) Annual Meeting. Professor Cynthia Aranow MD, from the Feinstein Institute for Medical Research, presented pilot clinical trial results showing that a bioelectronic device was effective in reducing pain and fatigue for lupus patients.
Targeting the Vagus Nerve
Dr. Aranow's trial interrogated the safety and efficacy of vagus nerve stimulation with a device developed by the Feinstein Institute's Center for Bioelectronic Medicine.
The vagus nerve is part of the peripheral nervous system. Starting in the brain, it becomes a network of 80,000 branches throughout the body and is highly involved in immune system function. Previous studies have already shown that the vagus nerve is involved in reducing inflammation.
While this device is not a cure for lupus, it demonstrates that targeting the vagus nerve can significantly reduce the pain and other symptoms associated with the disease. The initial results are a significant advancement for the 5 million people globally who suffer from lupus.
Bioelectronic Medicine for Rheumatoid Arthritis
An additional clinical trial is underway using a bioelectronics device for rheumatoid arthritis. The study is being conducted by SetPoint Medical, a start-up in Santa Clarita, California.
The device being tested is based upon research which indicates that active stimulation of the vagus nerve reduced tumor necrosis factor (TNF) levels in RA patients, resulting in significantly reduced disease severity. SetPoint also has an active program looking to use a similar device for Crohn’s disease.
These trials demonstrate possible treatments for autoimmune disease without drug targeting and with very few adverse side effects. They also highlight the importance of partnerships between researchers, clinicians, and engineers to bridge the gap between technology and treatment.