an introduction to bioelectrics: part 1

A “shocking” new treatment for autoimmune diseases

Over the last 20 years, researchers have gained novel insight into connections between our nervous and immune systems. This is expanding the treatment possibilities for autoimmune disorders such as Crohn’s disease, Rheumatoid Arthritis, Lupus and Type 1 Diabetes. One technique called vagus-nerve stimulation has captivated researchers across the globe.

“Vagus-nerve stimulation” explained

  • The vagus nerve is the longest, most complex cranial nerve containing around 100k individual nerve fibers that branch out to various organs to regulate involuntary bodily functions like our breathing and heart rate. Researchers also discovered it can control inflammation, a classic sign of autoimmune diseases.
  • Electrical stimulation sends a signal down the vagus nerve into the abdomen and through to the spleen, where the nerve releases noradrenaline, a neurotransmitter that stimulates white blood cells (or T cells) in the spleen.
  • These stimulated T cells release another neurotransmitter, acetylcholine, which then binds to macrophages in the spleen to reduce their production of an inflammatory protein called TNF into the bloodstream.
  • The result is reduced inflammation.

From rodent models to clinical practice

  • A 2019 study used hyperglycemic and type 2 diabetic rodent models to investigate how the effects of vagus nerve stimulation (VNS) could be optimized through changing parameters like the stimulation frequency, pulse width and stimulation pattern.
  • The researchers found that the following VNS parameters were most effective at reducing blood glucose levels:
    • A low frequency of 5 Hz (compared to higher frequencies)
    • Short pulses of 0.3 ms (compared to wide pulses of 3 ms)
    • An intermittent stimulation pattern of 10 seconds on and 90 seconds off (compared to continuous stimulation)
  • Why this matters: VNS has already been approved by the FDA to treat depression and epilepsy, and studies like this are helping to validate the effectiveness of VNS to treat diabetes.

A few research players

The field of “electroceuticals”, or devices that modulate nerves, is growing, and there are many clinical trials underway.

  • The NIH announced the SPARC (Stimulating Peripheral Activity to Relieve Conditions) program in late 2016, which provides $238 million in funding until 2021 for research into how these electrical signals control organ function.
  • SetPoint Medical is a California-based bioelectronic medicine company that has raised over $80 million to run clinical trials testing an implantable electroceutical device to treat Rheumatoid Arthritis and Crohn’s disease.
  • Galvani Bioelectronics is a $713 million bioelectronics joint venture between Google’s Verily and GlaxoKlineSmith.

Bottom line: Offering the possibility of more customized treatments, bioelectronics have stirred excitement among researchers, the pharma industry and patients.