Welcome to the Top 10 Healthinnovations of 2018, the fifth-year in this highly popular series. This is where the most exciting discoveries 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, the design, and construction of minimized artificial biological entities that previously did not exist. Synthetic biology also blows the door off nanotechnology providing a way to easily design and program DNA-based nanobots. It is predicted 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 specialties collaborating on projects together. This, in turn, is moving scientists 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. This would make 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 possessing the ability to communicate within itself, and to the natural microbiome surrounding them to manually control all bodily processes, such as disease, metabolism or homeostasis, keeping the host system balanced and healthy. It is theorized 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:
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 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 study 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 established this is how microglia supports connectivity between neurons, with them 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 research 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 the gut has a mind of its own, and does, in fact, act independently of the CNS.
Myogenic pacemaker cells in the gastrointestinal tract are capable of generating 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 as to how dysfunctional motor patterns may arise along the colon.
3. Number three in our Top 10 is the University of Toronto Scarborough with an Artificial Intelligence (AI) platform with the ability to 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 crucial link to the world for the impaired person consists of an AI care assistant who can gather and reconstruct images perceived by a person on a computer screen using an EEG.
The team predicts their deep-learning technique provides a means of communication for people who are unable to verbally communicate and 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, the participant’s brain activity was recorded and then used to digitally recreate the image the subject has imagined or pictured in their 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, possibly providing wide-ranging clinical applications in the future.
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 there is still much to be uncovered in our own bodies. The next trailblazer 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 injury to the lateral collateral ligament complex of the ankle is a common finding in ankle sprains, frequently leading to ankle instability.
Moreover, many people who suffer from this injury complain about lingering pain in the ankle presenting with a high risk of gaining another sprain in the ankle. However, this lingering pain and weakness to the ankle has not yet been explained in medicine. This pathbreaker explains why many sprains cause pain after the patient follows the treatment the doctor suggests, establishing the intra-articular LTFCL ligament does not heal by scar formation. It was shown this lack of scarring results in instability of the joint producing pain so these patients are likely to suffer from another sprain and develop other ankle injuries. 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, obscuring facial expressions and eye contact. The next study describes the TeleHuman 2, the world’s first truly holographic video-conferencing system allowing people in different locations to appear before one another in life-size 3D from every angle as if they were in the same room.
This holographic telepresence system is 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 that 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 the 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 The Top 10 Healthinnovations of 2018 is 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 protecting 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 associated with aging and several diseases such as pulmonary fibrosis, the subject of this study.
This work cured pulmonary fibrosis in mice using a gene therapy with the ability to lengthen the telomeres. The study also constitutes a proof of concept where telomerase activation represents an effective treatment against pulmonary fibrosis. This was the first time pulmonary fibrosis has been treated as an age-related disease by rejuvenating affected tissues via the introduction of 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, suggesting it could be effective in human patients, opening a new therapeutic opportunity towards the treatment of this disease.
7. 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 engineer long-extinct dinosaurs. This galvanizing moment brings Jurassic Park to life through the manufacture of perfume using floral scents that had been missing from nature for over a century. Damaged samples were used 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 the field saw researchers de-extinct billion-year-old bacteria in a synthetic evolutionary biology study, mapping the early evolution of genetic material via e. Coli bacteria. In the newest study on our list synthetic biology was used to reconstruct terpenes utilizing yeast cells to successfully trigger gene expression, which in turn produce terpene molecules, the compounds responsible for odor. The synthesized odors are based on those of the Falls-of-the-Ohio scurfpea, the Wynberg conebush, and the Hawaiian mountain hibiscus, all of which 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 on your chosen list is Ruhr-Universität Bochum with an impactful manual body regulation study identifying a previously unknown olfactory receptor in the human bladder, also found to be present in 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 placed 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 odors that trigger nerve impulses responsible for transmitting information about the odor to the brain. Thus, they are easily activated by odors and are found all over the human body meaning they warrant a great deal of investigation.
This discovery detected a previously unknown olfactory receptor in the human bladder and in bladder cancer tissue, and accordingly, significantly 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. The study shows after the application of Sandranol, bladder cancer cells altered their shape to become rounder, with cell division occurring less frequently and cell motility poorer, inhibiting tumor growth and indicating the presence of olfactory cells. Ultimately the data shows olfactory receptors will play an important role in the diagnosis of diseases and provide novel approaches in tumor therapy.
9. At number nine is the University of Michigan with a non-invasive ‘diagnostic pill’ shown to detect 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. Compounding the fact the best innovations are sometimes the most simplistic, a pill was developed capable of making tumors glow in mice when exposed to infrared light, possessing the ability to identify previously undetected cancers.
This advancement consists of a cheap diagnostic pill, made up of negatively charged sulfate groups to improve the solubility of fluorophores, enabling 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 tissue, 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 capable of gradually lengthening tubular organs by applying traction forces without interfering with organ function. Robots residing inside the body to restore or enhance biological function have long been a hope for the future, however, 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.
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 of 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.
Michelle Petersen is the founder of Healthinnovations, having worked in the health and science industry for over 21 years, which includes tenure within the NHS and Oxford University. Healthinnovations is a publication that has reported on, influenced, and researched current and future innovations in health for the past decade.
Michelle has been picked up as an expert writer for Informa publisher’s Clinical Trials community, as well as being listed as a blog source by the world’s leading medical journals, including the acclaimed Nature-Springer journal series.
Healthinnovations is currently indexed by the trusted Altmetric and PlumX metrics systems, respectively, as a blog source for published research globally. Healthinnovations is also featured in the world-renowned BioPortfolio, BioPortfolio.com, the life science, pharmaceutical and healthcare portal.
Most recently the Texas A&M University covered The Top 10 Healthinnovations series on their site with distinguished Professor Stephen Maren calling the inclusion of himself and his team on the list a reflection of “the hard work and dedication of my students and trainees”.
Michelle Petersen’s copy was used in the highly successful marketing campaign for the mega-hit film ‘Jumanji: The Next Level, starring Jack Black, Karen Gilian, Kevin Hart and Dwayne ‘The Rock’ Johnson. Michelle Petersen’s copywriting was part of the film’s coverage by the Republic TV network. Republic TV is the most-watched English language TV channel in India since its inception in 2017.
An avid campaigner in the fight against child sex abuse and trafficking, Michelle is a passionate humanist striving for a better quality of life for all humans by helping to provide traction for new technologies and techniques within healthcare.