A great year for healthinnovations with exciting discoveries, verifications, validations and breakthroughs. The big disease areas are still cancer, heart disease, diabetes and Alzheimer’s, however, it’s the methodology of detection, imaging, and the descriptive diagnostics that have been innovated this year. In some cases these disciplines and techniques bleed through to multiple disease areas as other teams pick up the technology. A common thread running through all of these areas however, is the all important biomarker. And with each newly discovered biomarker comes the benchmark and standardisation. A new receptor, more inroads in stem cell technology and regenerative medicine, all leading back to control and revamping of our own DNA and a big push in immunology.
We saw the definitive breakthrough that is precision genetics with the evolution of personalised medicine into precision medicine; becoming more precise and honed, moving into master regulator genes as opposed to the confusing multiple loci and the personal immunity simulation of the past. The medical community theorising and validating that the mass of loci being targeted were in fact the resulting cascade of these precisely hit master genes. This big push in genetics with researchers giving clarification, gaining a clear direction in sequencing and beginning to classify epigenetic methylation.
With epigenetic methylation research teams are now beginning to map and classify cancer via the epigenome. Reaching the source of all disease, that moment of mutation, the moment of epigenetic methylation; that clear crystalline moment when disease is born. Medical teams around the world have summised that all disease comes from nuclei, is ordered by the gene and transcribed through the MiRNA; still an important area, to the moment of epigenetic methylation. The moment that our DNA is changed forever and the cascade of disease-causing loci and proteins begin.
Health innovators have also taken a step back even further in the source and began to chip away at the facade of neurogenetics. The genetic code held in our brain, the regulator of not only diseases and disorders of the brain but also disease within the body. This leads on nicely to the great inroads being made in neuroinnovations, standardised and medicalised, this area holds many answers to the questions the medical community have been asking for decades. When we finally map every circuit, every pathway, all neurogenetics, it is expected to lead to the man-made regulation of all disease. And with neuroscience this need not always be invasive.
Neuroinnovations have been astounding this year with multiple validated studies medicalising diagnostics, representing disease of the brain in terms in which all disease should be presented, in scans, in blood work, in genetic terms. We have also witnessed a big drive to uncover more about the role the lesser-known cells, such as Astrocytes, play in the brain as well as the surrounding microglia in the hope this will lead to a crack in the looming blood-brain-barrier. And most importantly the medical community has been given more control over the disorders we now understand to be more than emotive figments of imagination; more control to help with tangible and very real mental disorders which have now been imaged, seen with the naked eye in blood work and designated the correct biomarkers.
So, what were the biggest healthinnovations of 2014? What did health innovators concur on this year? Which disease areas, disciplines and techniques were of the most interest to health innovators across the globe and were seen as the biggest breakthroughs, raising the most interest?
So here you go health innovators, here are the Top 10 Healthinnovations of 2014 based on the total number of views and shares:
1. At number one we have the Karolinska Institutet of Sweden, whose breakthrough neuroscientific human study lays the foundation for neurogenetic study in neuroplasticity. This study identified the cells responsible for the superior plasticity of the human brain, the oligodendrocyte otherwise known as myelin. Here we saw researchers modulate myelin production, with potential to fight TBI, MS, enhance plasticity, enhance brain processes, memory, fight dementia, whilst opening a door to neuroprotection. Neurologically-wise this study has it all. We are seeing a sharp increase in non-neuronal studies in the brain with researchers investigating the role of these lesser-known brain cells. The number one study also provides detailled knowledge on the brain cell in question, oligodendrocytes. They were able to establish, through, histological studies that at birth most oligodendrocytes are immature. The study then goes on to tell us what age we are when oligodendrocytes reach maturity and their turnover rate thereafter. The researchers were even able to carbon-date the cells and determine their age which is why this is the most viewed and shared Healthinnovations of 2014.
2. At number two is the National University of Singapore of Singapore, who found a new type of immune cell that is expected to help in the development of a future treatment for Multiple Sclerosis (MS). The study also explores the role of the all-important interleukin pathway, a very hot area at the moment, in the immune system. The team found that a new type of immune T helper cells named TH-GM cells play a crucial role in the immune system and pathogenesis of neuronal inflammation. The team showed that STAT5, a member of the STAT family of proteins, programs TH-GM and initiates the immune response to an auto-antigen in responding to a signal from an interleukin, IL-7, causing neuroinflammation, pathogenesis and damage in the central nervous system. Thus blocking IL-7 or STAT5 would provide a significant therapeutic benefit for Multiple Sclerosis (MS).
3. Coming in next at number three St Vincent’s Hospital and the Victor Chang Cardiac Research Institute of Australia, who transplanted an already dead heart in a world’s first. This breakthrough firmly pushed the human race out of the age of regeneration hurtling into the aeon of reanimation. Surgeon’s developed a technique which means hearts that had been still for 20 minutes can be resuscitated and transplanted into a patient. The technique involves donor hearts being transferred to a portable machine known as a ‘heart in a box’ in which they were placed in a preservation solution, resuscitated and kept warm. So far three people have received hearts in this way, with this novel transplant system expected to save 30 percent more lives by providing more hearts, which were in the past deemed unsuitable and/or too starved of oxygen to transplant.
4. At number four is the Hebrew University of Jerusalem of Israel and the Max Dellbruck Institute of Germany. The team not only discovered how the recently discovered circular RNA is formed they also identified a key muscular dystrophy link. Unlike all other known RNAs, this molecule is circular, and is labelled circular RNA. The team found that circRNAs not only compete with normal RNAs, but the body actually produces them at the expense of normal RNA. The researchers observed that circRNAs play an important role in brain function, and likely in brain disease. In addition, the researchers identified the protein ‘muscleblind’ as a factor involved in circRNA biogenesis, and showed that muscleblind can enhance and regulate the production of a subset of circular RNAs. Importantly, defects in muscleblind function are known to cause a severe degenerative disease called myotonic dystrophy. Characterized by progressive muscle wasting and weakness, this is the most common form of muscular dystrophy that begins in adulthood.
5. At the midway mark, at number five, we have the University of California, Los Angeles (UCLA), of the United States of America. The team utilized a novel technology called electric field-induced release and measurement (EFIRM) to test lung cancer patients’ saliva for epidermal growth factor receptor (EGFR) gene mutations, a sign of lung cancer, which can be treated by medication such as thymidine kinase inhibitors. The total detection time is less than 10 minutes and only requires a small saliva sample. EFIRM is a multiplexible electrochemical sensor which uses electrode chips to enable exosomes in saliva to rapidly release molecular constituents (DNA, RNA and proteins) while simultaneously detecting any mutations in tumour-causing DNA sequences. So here is a cancer detection study hitting all the marks, precision genetics, non-invasive testing, epigenetic mutation/methylation markers for cancer and a new spectra method. And of course that all important new biomarker.
6. Coming in at number six we have a multi-centre study led by the University of California of the United States of America. This study reminded the medical community how important verification and building on initial discovery is in making past findings standardised for usage in mass clinical settings. Here the team provided the first evidence of the medium- to long-term safety and tolerability of transplanting human embryonic stem cells (hESCs) in humans. This important benchmark also provided set hESCs dosages when treating human macular degeneration with stem cell therapy.
7. At number seven we have the University of Connecticut, of the United States of America. The team found a new way to identify protein mutations in cancer cells to develop the first precision medical vaccine to treat patients with ovarian cancer. This vaccine is so precise that it can recognise tiny differences and mistakes on a cancer cell’s surface epitopes, thus allowing the cancer ‘vaccine’ to attack and kill the cancer cell. In this way the surrounding healthy cells with normal epitope sequences are ignored and left intact. These subtle epitope mutations come from incorrect epigenetic methylation when cancer cells proliferate, making this a best-in-class when it comes to precision genetics and medicine.
8. Nearing the end of this great list we have the Lund University of Sweden, McGill University of Canada and the Heart and Stroke Foundation of Canada at number eight. This large-scale study linked the genetic predisposition to elevated low-density lipoprotein cholesterol (LDL-C) to aortic valve calcium and narrowing of the aortic valve. This study was also valuable due to the fact there are 35,000 participants providing strong, instant validation for this new discovery. Any team in the future will find validation an easy job with this study giving it an easy path into clinical procedure. The data suggests that, in addition to the established risks for myocardial infarction and other vascular diseases, increases in low-density lipoprotein cholesterol are also associated with increased risk for aortic stenosis. The team now plan to investigate whether intervention to reduce low-density lipoprotein cholesterol could prevent aortic valve disease.
9. At number nine of the Top Ten Healthinnovations of 2014 we have the Salk Institute and Harvard Medical School of the United States of America. Very few studies assimilate the spinal chord and brain as one entity let alone map new spinal chord-to-brain neural mechanisms and receptors for chronic pain. The researchers set out to precisely identify the spinal neurons involved in these circuits. They deciphered the role each of the two neuronal cell types, pain receptors and touch receptors, play in the processing of pain signals in the dorsal horn, the location where the sensory neurons connect with the spinal chord. The findings of this study are expected to help find new targets and treatments for the people who suffer from chronic pain as well as allodynia, fibromyalgia and nerve damage caused by diseases such as diabetes, cancer and autoimmune disorders as well as physical trauma. As new technology and diagnostics become more available to the neuroscientific community these rich neurobiological studies, whereby more vital neuroanatomy is discovered, are greatly anticipated and received.
10. And at number ten we have Boston University of the United States of America and the United States Army, with a genetically-based breakthrough for Ebola. One of the greatest concerns about this killer disease is the conjecture over the time of contagion. The general consensus is that Ebola only becomes contagious once a fever breaks with opponents stating that this is only because the fever is the onset of vomiting, unexplained bleeding and/or diarrhea, ie. excessive bodily fluid-loss. Thus the existing argument is that although the incubation period of Ebola can be as long as three weeks, this excessive loss of Ebola-infected bodily fluid grossly raises the level of potential contamination and infection. The researchers put paid to this argument by providing an RNA-based assay which can distinguish between different hemorrhagic fevers, including Marburg (Ebola cousin) and Lassa before the person becomes symptomatic, at the point the virus enters the blood stream. As the test includes the cousin of the Ebola hemorrhagic virus, the Marburg hemorrhagic virus, it is hoped that the test can be tweaked to include Ebola.
So we have come to the end of our masterclass. A massive well done to all listed above for these great healthinnovations and groundbreaking discoveries. This is a marker of the respect and excitement these teams have garnered from their peers around the globe. People all over the world will have read and admired these achievements and work. And a big congratulations to the medical community worldwide who’s findings healthinnovations has reported due to sheer excellence throughout the year, the standard of research has been truly great. See you all in 2015!
Michelle is a health industry veteran who taught and worked in the field before training as a science journalist.
Featured by numerous prestigious brands and publishers, she specializes in clinical trial innovation--expertise she gained while working in multiple positions within the private sector, the NHS, and Oxford University.