The term "bioelectronic medicine" may seem to be more science fiction than medical reality, but this field of science has recently made significant strides in translating research from the lab to the clinic with promising results. From implantable devices to treat autoimmune diseases without medication to microchips to help quadriplegics regain movement, bioelectronic medicine is quickly moving into the forefront of scientific applications.
The premise of bioelectronic medicine is that nearly all cells in the human body are in some way regulated via information communicated from electrical signals from the nervous system. Similar to how implantable artificial pacemakers emit electrical impulses to regulate a heartbeat, various technologies have been developed to block, stimulate, or regulate the body's neural signals to control the underlying molecular targets of many diseases.
Bioelectronic medicine would not have emerged as a viable therapeutic field without the work of Kevin J. Tracey, MD, President and CEO of The Feinstein Institute for Medical Research-specifically, a key discovery in May of 1998. At the time it was believed that there was no communication between the nervous system and the immune system, but Tracey devised an experiment to test his own hypothesis on a link between the two systems. Tracey predicted that stimulation of the vagus nerve with electrical impulses would reduce production of tumor necrosis factor (TNF), a cell signaling protein linked to inflammation. Electrical impulses were delivered to an exposed vagus nerve in a rat and after the cut was closed, Tracey administered endotoxin to trigger inflammation. Seventy-five percent of TNF production was blocked, through activation of what Tracey coined as "the inflammatory reflex." Since these research findings were published in Nature in 2000, Tracey has co-founded SetPoint Medical to develop an implantable device to stimulate the vagus nerve as a treatment for rheumatoid arthritis (RA) that is intended to last for 10 years. Results from a pilot study reported that patients with this implant experienced symptom improvements comparable to those taking medications for RA and a long-term study is currently underway.
Chad Bouton, also from The Feinstein Institute for Medical Research, was recently the lead author in a landmark study appearing in Nature on a neuroprosthetic device that, for the first time in a 24-year-old man with quadriplegia, allowed a paralyzed man to move his hand using only his brain. First, functional magnetic resonance imaging (fMRI) scans of Ian Burkhart's brain were taken while he attempted to complete a range of hand movements; once Bouton and his team identified from the fMRI the areas of the motor cortex associated with the movement attempts, a chip was implanted in Burkhart's brain. This chip is designed to note the electrical activity from the motor cortex that is linked to movement and to transmit this information to a computer, which eventually translates these signals and sends them to a flexible sleeve on Burkhart's arm. The result? Burkhart's muscles were stimulated, and over time with training he has been able to make isolated finger movements and complete six different wrist and hand motions. There are limitations to the technology, as it can currently only be used in a laboratory for a limited amount of time and requires recalibration before each use.
Regardless, Burkhart sees great value in bioelectronic medicine. "Even if it's something that I can never take home in my lifetime, I'm glad I've had the opportunity to take part in this study. I've had lots of fun with it. I know that I've done a lot of work to help other people as well," Burkhart told Nature.
Hear more about bioelectronic medicine from Kevin J. Tracey, MD, Chad Bouton, and others at the 13th Key Symposium 2016: Bioelectronic Medicine - Technology Targeting Molecular Mechanisms from September 21-23, 2016 at the New York Academy of Sciences. Click here to register.