The Top 10 Healthinnovations of 2018.

Welcome to the Top 10 Healthinnovations of 2018, the fifth-year in this highly popular series.  This is where the most exciting discoveries, verification, validation and breakthroughs for the year are decided by you, the reader.  It has been another truly great year for healthinnovations, with health innovators picking up and running with the baton in regards to manual body regulation, the theory of neuron-like cells and neuronal colonies throughout the body waiting to be tapped into, a backdoor to the brain, to control disease, metabolism and homeostasis.

This has been brought within the grasp of the global medical community by way of the microbiome, trillions of symbiotic microorganisms living on and in human beings, and synthetic biology (synbio), the design and construction of minimised artificial biological entities which previously did not exist, and the combining of these areas.  Synthetic biology also blows the door off nanotechnology providing a way to easily design and program DNA-based nanobots.  It is predicted that synthetic biology has the potential to provide constructs for any device imaginable,  including self-aware bio-computers and hybrid bionics.   Both the microbiome and synbio have been causing much excitement around the globe, commanding tens of billions of dollars by way of investment from pharmaceutical companies to silicon valley alike.

The medical disciplines are now truly being tied together, a marker of the rise in the multi-disciplinary approach of clinical research, with teams from many different specialities collaborating on projects together.  This in turn is moving scientist closer to achieving full body manual regulation as aforementioned, with neuroscience meshing seamlessly with the microbiome due to the unavoidable similarities being noted between microbiota and neuronal activity, including the regulation of homeostasis, metabolism and genetics; which makes sense as health innovators are still identifying new neurons and neuron-like colonies in the gut ultimately being linked and regulated by the microbiota.

Work has also begun on the theoretical synthetic microbiome, the holy grail, a synthetic entity made up of artificial bacteria which can communicate within itself, and to the natural microbiome surrounding them to manually control all bodily processes, whether that be disease, metabolism or homeostasis, keeping the host system balanced and healthy; and encompassing all disease areas.  It is theorised that these artificial symbiotes will also have the capacity to communicate with wearable technology providing data to the biomonitoring systems.

So buckle up health innovators, here’s the Top 10 Healthinnovations of 2018 as decided by you, the readers:

Microglia filmed shaping synapses for the first time by researchers at the European Molecular Biology Laboratory (EMBL). The image shows multiple synapse heads send out filopodia (green) converging on one microglia (red), as seen by focused ion beam scanning electron microscopy (FIBSEM). Credit: L. Weinhard, EMBL Rome.

1.  Number one in the Top Healthinnovations for 2018 is from the European Molecular Biology Laboratory (EMBL).  For the fifth year running a neuroscientific based study is in the top slot.  In a world’s first, this heavily slanted immunology study saw researchers film microglia shaping synapses, showing that the glial cells help synapses grow and rearrange, demonstrating the essential role of microglia in brain development. Microglia are an immune cell occurring in the central nervous system of invertebrates and vertebrates.  These cells act as macrophages clearing cellular debris, and are proposed to mediate synaptic pruning during neuronal circuit formation, however, up until this healthinnovations no one had witnessed them shaping synapses. 

This amazing tipping point combines electron microscopy and light sheet fluorescence microscopy to make the first movie of microglia eating synapses, with footage revealing  microglia contacting synapses to induce their growth, and the synapses head sending out thin projections, known as filopodia, to greet them.  It was discovered that it is in this way microglia can support connectivity between neurons, and that they are broadly involved in structural plasticity, the ability of the brain to change throughout a person’s life.  This game-changer forms the proposition for the role of microglia in the remodeling and evolution of brain circuits during development, and may provide a possible link to the onset of schizophrenia and depression.

2.  The second most popular study of 2018 came courtesy of Flinders University who identified previously unknown neuronal activity in the gut.  The enteric nervous system (ENS) is known as the second brain, or the brain in the gut, due to the fact it can operate independently of the CNS to generate motor activity in the colon, however, up until this leading edge healthinnovations the CNS was thought to influence the ENS. The next ground-breaking discovery used a novel high-tech technique to accurately record the nerve activities of the second brain in the body to show that the gut has a mind of its own, and does in fact act independently of the CNS.ft-gut-second-brain-manual-body-regulation-healthnnovations-twitter

It is well-known that myogenic pacemaker cells in the gastrointestinal tract generate contractions, however, the mechanisms underlying contractions of smooth muscle in the gastrointestinal tract remained unknown. This breakout study was able to precisely see how tens of thousands of individual neurons in the ENS are activated to cause smooth muscle contractions which underlie propulsion of colonic content, a feat never before achieved.  Thus a previously unknown pattern of neuronal activity in the gut has been identified to provide a blueprint to understand how dysfunctional motor patterns may arise along the colon.

ft-mind-reading-algorithm-uses-eeg-data-to-reconstruct-images-based-on-what-we-perceive3.  Number three in our Top 10 is University of Toronto Scarborough with an Artificial Intelligence (AI) platform which can use electroencephalography (EEG) data to reconstruct images based on what the participant perceives.  The growth and theoretical applications for AI increases daily with plans becoming reality in record time as hardware becomes more powerful, and software becomes more readily available.  One desirable application for AI in neuroscience is the brain-computer interface, where the disabled patient can be given a new bionic limb linked to their nervous system or a communication system for those who are unable to move or speak.  This novel crucial link to the world in this pivotal study for the impaired person consists of an AI care assistant which can gather and reconstruct images perceived by a person on a computer screen using an EEG.

The team predict that not only will their deep-learning technique provide a means of communication for people who are unable to verbally communicate, it could also have forensic uses for law enforcement in gathering eyewitness information on potential suspects rather than relying on verbal descriptions provided to a sketch artist.  Breaking  ground in the use of the brain-computer interface, participant’s brain activity was recorded and then used to digitally recreate the image in the subject’s mind using a technique based on machine learning algorithms.  Work is currently underway to test how image reconstruction based on EEG data could be done using memory and applied to a wider range of objects beyond faces, which could eventually have wide-ranging clinical applications as well.

4. The fourth top Healthinnovations as decided by you is from Universitat de Barcelona who identified a previously unknown anatomical structure.  These studies always understandably garner a lot of excitement as it becomes clearer that so much more is still to be uncovered in our own bodies.  The next trailblazing healthinnovations identifies a new structure within the ankle, the lateral fibulotalocalcaneal ligament (LFTCL) complex, connecting the inferior anterior talofibular ligament (ATFL) fascicle and the calcaneofibular ligament (CFL) to make up the lateral collateral ligament complex.  It is known that injury to the lateral collateral ligament complex of the ankle is a common finding in ankle sprains, frequently leading to ankle instability.

ft-ankle-biology-twitter-healthinnovations-scienceMoreover, many people who suffer from this injury complain about pain in the ankle which lingers, with them at high risk of gaining another sprain, which has not been explained in medicine yet.  This  pathbreaker explains why many sprains cause pain after the patient follows the treatment the doctor suggests, and even identifies the fact the intra-articular LTFCL ligament does not heal by scar formation, and that the resultant instability of the joint produces pain so these patients are likely to suffer from another sprain and develop other injuries in the weakened ankle.  This newly discovered complex, originally identified in animal research and transferred to human trials, may now allow repair between the inferior ATFL fascicle and the CFL in recurrent sprains.

5. At the halfway point in this journey of discovery is the Queen’s Human Media Lab with the world’s first truly holographic telepresence system.  Both continuous motion parallax and stereoscopy are easily supported in augmented or virtual reality systems, however, this comes at a cost of requiring a head-worn apparatus which obscures capturing of facial expressions and eye contact.  The next critical point in healthinnovations is the TeleHuman 2, the world’s first truly holographic video-conferencing system which allows people in different locations to appear before one another in life-size 3D from every angle, as if they were in the same room.

ft-life-size-holograms-set-to-revolutionize-videoconferencingThis healthinnovations is a holographic telepresence system capable of conveying stereoscopy and continuous motion parallax around a cylindrical light field display without glasses or head-tracking, and can teleport images from one room to another.  This technology uses a ring of intelligent projectors mounted above and around a retro-reflective, human-sized cylindrical pod, to project objects as light fields which can be walked around and viewed from all sides simultaneously by multiple users, much like Star Trek’s famed, fictional ‘holodeck’.   This technological advancement is expected to mitigate environmental impacts of business travel, enabling organizations to conduct more engaging and effective meetings from a distance, rather than having to appear in person.

6. Number six in these watermark moments is from the Spanish National Cancer Research Centre (CNIO) who succeeded in curing lung fibrosis in mice by lengthening telomeres.  Idiopathic pulmonary fibrosis is a potentially lethal disease associated with the presence of critically short telomeres, and currently lacking effective treatment. Telomeres are located at the ends of each chromosome to protect the integrity of the chromosome when the cell divides. However, telomeres only fulfill their protective function if they are long enough; when they shorten too much, the damaged cells cease to divide preventing tissue regeneration which is associated with ageing and several diseases such as pulmonary fibrosis, the subject of our study. telomere pulmonary fibrosis

This impactful healthinnovations cured this disease in mice using a gene therapy which lengthens the telomeres, and constituted a proof of concept in which telomerase activation represents an effective treatment against pulmonary fibrosis; this was the first time that pulmonary fibrosis has been treated as an age-related disease by rejuvenating affected tissues.  The tiltpoint treatment in this healthinnovations consists of introducing the telomerase gene into the lung cells of mice using gene therapy.  The telomerase gene therapy was shown to reverse the fibrotic process in mice, which suggests that it could be effective in human patients, opening a new therapeutic opportunity towards the treatment of this disease.

ft-jurrasic-world-synthetic-biology-perfume-healthinnovations-extinct-flower7. The seventh spot in this hot list of innovations is from Gingko Bioworks who used synthetic biology to de-extinct plants to manufacture perfume.  In the film Jurassic Park scientists revive dinosaurs by extracting DNA from drops of blood fossilized within insects trapped in amber. They then decode the genetic sequence, fill in gaps using the frog genome, injecting the genetic material into ostrich eggs to make long extinct dinosaurs.  This kairotic moment, bringing Jurassic Park to life, saw perfume manufactured using floral scents that had been missing from nature for over a century. Damaged samples were to reconstruct DNA from the long-extinct Hawaiian mountain hibiscus, using modern plant DNA to fill in the missing pieces, and yeast cells as stand-ins for eggs.

To date researchers have expressed DNA from Neanderthal remains in monkey cells to better understand hair and skin pigmentation in our long-lost hominid cousins, and inserted woolly mammoth genes into human cells to study how the extinct Siberian beast survived so well in the extreme cold. A quickly moving area, most recently researchers de-exincted billion-year old bacteria in a synthetic evolutionary biology study, mapping the early evolution of genetic material via e. coli bacteria.  In this quantum-leap healthinnovations synthetic biology was used to reconstruct terpenes utilising yeast cells to successfully trigger gene expression, which in turn produce terpene molecules, the compounds responsible for odor, from Falls-of-the-Ohio scurfpea, the Wynberg conebush, and the Hawaiian mountain hibiscus, which all disappeared from the planet in the 19th and early 20th centuries.  The terpene profiles were then mixed and matched into a few pleasant-smelling arrangements, and the engineered yeast cells responsible for making those desired terpenes were then fermented in vats for mass production, showing the immense potential of synthetic biology and genome engineering.

8. At number eight in this list of inflection points in healthinnovations is Ruhr-Universität Bochum with a impactful manual body regulation study which identified a previously unknown olfactory receptor in the human bladder and bladder cancer.  As previously mentioned there has been a strong and steady flow of great studies regarding manual body regulation, where great interest is placed in neurons, and neuron-like cells scattered (or so it would appear) throughout the body, with future plans to control and regulate the whole system.  Olfactory receptors are usually found in the nose and are responsible for the detection of odours. When olfactory receptors are activated they trigger nerve impulses which transmit information about the odour to the brain. Thus, they are easily activated by odours and are found all over the human body meaning they warrant a great deal of investigation.ft-olfactory-receptor-as-therapeutic-target-in-bladder-cancer-neuroinnovations

This crucial point in healthinnovations detected a previously unknown olfactory receptor in the human bladder and in bladder cancer tissue, and accordingly, significant higher amounts of the olfactory receptor could be found in the urine samples of patients.  Olfactory receptors are a large group of G-protein coupled receptors predominantly found in the olfactory epithelium. Many olfactory receptors are, however, ectopically expressed in other tissues and involved in several diseases including cancer, making them an easily controlled target. In this drastic watershed, after application of Sandranol, the bladder cancer cells altered their shape; they became rounder, with cell division occurring less frequently and cell motility poorer, showing the presence of olfactory cells and inhibiting tumour growth.  Ultimately this healthinnovations shows that olfactory receptors will play an important role in the diagnosis of diseases and provide novel approaches in tumour therapy.

9. At number nine of these crunchpoint healthinnovations is University of Michigan with a non-invasive ‘diagnostic pill’ which detected breast cancer in mice. In the past mammograms have been shown to be uncomfortable and imprecise with roughly a third of breast cancer patients treated with surgery or chemotherapy where the tumors were found to be benign.  In women, dense breast tissue also hides the presence of lumps and results in deaths from treatable cancers.  Showing that sometimes the best innovations are the most simplistic, this sweeping change saw a pill developed which makes tumors light up when exposed to infrared light in mice, and could also catch cancers that would have previously gone undetected.

ft-healthinnovations-twitter-cancerThis advancement consists of a cheap diagnostic pill, made up of negatively charged sulfate groups, which improves solubility of fluorophores, to enable sufficient oral absorption and targeting of fluorescent molecular imaging agents for completely noninvasive detection of diseased tissue such as breast cancer. The diagnostic pill also distinguished aggressive tumors from benign, preventing unnecessary breast cancer treatments.  This approach should be adaptable to other molecular targets and diseases for use as a new class of screening agents.

10. In at number ten of the most viewed Healthinnovations of 2018 is the Boston Children’s Hospital who developed a programmable, implantable medical robot which can gradually lengthen tubular organs by applying traction forces without interfering with organ function.  Robots which reside inside the body to restore or enhance biological function have long been a hope for the future. Developing such robotic implants poses challenges both in signaling between the implant and the biological host, as well as in implant design.  This breakout study developed miniature robots which induced organ growth inside a pig, whilst avoiding the sedation and paralysis currently required for the most difficult cases of esophageal atresia, a condition where part of the esophagus is missing.  ft-robotic-implants-spur-tissue-regeneration-inside-the-body-healthinnovations

The robot induced cell proliferation and lengthened part of the esophagus in a large animal by approximately 75%, while the animal remained awake, comfortable and mobile.  The robotic system is now being tested in a large animal model of short bowel syndrome.

So it is the end this year’s list of evolutions.  Well done to everyone who made it into the Top 10 Healthinnovations site of 2018, see you all in 2019.





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