The Regeneration Center would like to highlight the nine most innovative medical advances in healthcare and regenerative medicine. Last year was filled with newer, smaller, faster methods of creating genetic tests, editing genetic code, and even bloodless sensors for diabetics, children, and the elderly. New breakthroughs in drug manufacturing and delivery mechanisms were generally the fastest to market, followed by enhancement. In no particular order, these are nine notable medical advances from recent years.
#1 – Gene Editing / Manipulation Using CRISPR
Clustered Regularly Interspaced Short Palindromic Repeats or CRISPR allow us to alter human DNA (or any organisms) in an attempt to correct defective genetic coding. What seems like science fiction from space movies is now a reality. Compared with older gene editing methods, CRISPR is relatively inexpensive to use in the laboratory and has been widely adopted in research labs around the world. The CRISPR sequence is a naturally-occurring defense mechanism found in many bacteria.
CRISPR is part of bacteria’s immune system, which stores short fragments of DNA from viruses that previously infected the bacteria, so it can recognize and defend against those viruses the next time they try to attack. The other defense mechanism these bacteria possess is a set of enzymes known as CRISPR-associated proteins (CAS). CAS enzymes allow us to cut and replace sections of DNA with great accuracy, as well as from invading viruses.
CRISPR-based treatment has begun to reach patients: in late 2023 and early 2024, regulators in the UK and the United States approved the first CRISPR therapy for sickle cell disease and beta-thalassemia. Research is ongoing for other genetically based diseases, such as Inherited Ataxia, Duchenne Muscular Dystrophy, and Hemochromatosis.
#2 – Clinical Trials Based on Race/Ethnicity-Based Genetic Profiles
Some people, particularly those of Thai descent, are genetically more susceptible to certain diseases, such as Thalassemia. At the same time, many of East Asian descent are prone to getting a skin disease known as Stevens-Johnson syndrome mainly due to genetics.
Current research models are decades behind modern needs, with the majority of participants’ epigenetic profiling originating from North America. New genomic-based testing models being used in Asia are increasing in number, bringing much-needed hope to families suffering from typically fatal diseases. Science and regenerative medicine are only now beginning to understand genetic strongholds for some diseases so we can find new ways to develop personalized therapies based on factors such as race and ethnic background.
#3 – Non-Invasive Fetal DNA Tests – NIPD & NIPT DNA Sampling
Invasive prenatal diagnostic tests, such as CVS and amniocentesis, carry a small risk of miscarriage. As a result, researchers have developed non-invasive prenatal tests that analyze cell-free fetal DNA, which comes mostly from the placenta and circulates in the mother’s blood. NIPT screens cell-free fetal DNA in the mother’s blood for chromosomal conditions such as Down syndrome, while NIPD can be used in some families to test for specific single-gene conditions, such as beta-thalassemia, sickle cell anemia, cystic fibrosis, spinal muscular atrophy, Duchenne muscular dystrophy, and hemophilia. Separate non-invasive prenatal paternity tests use a similar blood sample to compare the baby’s DNA profile with that of the alleged father. The exact same tests can also be used to determine the baby’s gender and blood type.
Studies show that cell-free fetal DNA screening detects Down syndrome more accurately than traditional blood screening tests, but it remains a screening test: a positive result should be confirmed with a diagnostic test such as CVS or amniocentesis before any decisions are made, and it does not replace routine ultrasound scans. This testing is available in Bangkok, Thailand, and brings more certainty to expecting parents everywhere.
#4 – Neurovascular Stent Retrievers for Strokes
Time can be a stroke patient’s best friend or worst enemy. Since time kills brain cells, restoring blood flow to the brain is critical. Treatment should start as soon as possible: clot-busting medication is usually given within 4.5 hours of symptom onset, and mechanical clot removal (thrombectomy) can be offered up to 24 hours after onset in selected patients. Anyone with signs of a stroke should call emergency services immediately. Until now, brain clot-busting medications have not always been effective, leading to a new technology known as neurovascular stent retrievers. The latest technology uses a micro-sized catheter inserted through an incision in the patient’s leg and then threaded through the bloodstream. The microscopic devices are guided through the body until they reach the blood clot and quickly remove the blockage to restore normal blood flow.
Researchers found that victims of brain strokes whose blood clots were removed the same day via stent retriever have significantly faster recoveries and improve their chances of regaining a normal, independent life. For patients who previously suffered from strokes, the chances for recovery can be improved using neural stem cells for brain strokes. Neurovascular stent retrievers were approved in the 2010s and are now a standard treatment for selected patients with large vessel strokes at specialist stroke centers.
#5 – Early Detection & Screening via Protein Biomarker Analysis
Starting in 2019, a new biomarker exam will be available to offer high-risk individuals accurate screening for cancer with significantly higher chances of early detection. The new testing protocol, known as PLA or proximity ligation assays, allows clinicians to measure and visualize protein complexes. The new biomarkers will help doctors detect, diagnose, and treat patients using a special class of pharmaceuticals known as receptor tyrosine kinase inhibitors. The early Protein biomarker analysis primarily focuses on any structure of specific proteins circulating in the blood circulatory system.
In contrast to previous exams that looked at genetic mutations after the fact, the new tests allow doctors early warnings using real-time information of any cancerous presence in the patient’s body. An estimated 2100 anticancer medications are in development or approved, but only around 29 cancer biomarkers have been approved for use in humans. Lung cancer biomarkers are especially helpful in identifying and validating diagnosis, allowing for new approaches to understanding and fighting lung diseases such as COPD.
#6 – Neuro Sensor Feedback to Control Artificial Limbs
The ability to control prosthetic limbs using neural implants has been a reality for about five years now, but in 2019, researchers found a new and significantly smoother method of controlling limbs for patients with spinal cord injuries and/or traumatic brain damage without the need for neurogenesis.
The new method uses neural cell signals associated with the movement of limbs to be decoded by a computer, allowing them to control artificial limbs with a simple thought. Sensors implanted in the brain’s motor cortex or premotor cortex can be ‘hacked’ to allow the patient total control over prosthetic arms/legs, wheelchair movement, or even full-body exoskeleton control. Researchers are now working on special brain-machine interface algorithms that are easier to control, safer, and cheaper using low-cost robotic components. Combining several techniques could make having bionic arms and legs a reality for millions of patients worldwide.
#7 – Treatment for Female Hypoactive Sexual Desire Disorder – HSDD
It is estimated that nearly 2 out of 10 women are affected by hypoactive sexual desire disorder, which often goes undiagnosed by doctors who are not sure how to adequately address the condition, leading to the under-diagnosed and under-treated condition.
While treatments for male sexual dysfunction have been around for decades, there were no treatments available for women with a loss of sexual desire. Last year, the American Food and Drug Administration approved the first medication ever to treat female hypoactive sexual desire disorder. The medication called flibanserin can boost natural stem cells, address the loss of sexual desire in premenopausal women, and help restore sexual desire for women diagnosed with HSDD. Doctors do caution that the medication is intended to treat women with diagnosed conditions only and cannot be used as an aphrodisiac.
#8 – Non-Invasive Remote Glucose Monitoring for Diabetics
The World Health Organization reports that diabetes affects hundreds of millions of adults worldwide and is a leading cause of death, both directly and through complications such as heart disease and kidney failure. People with diabetes require constant and invasive blood samples to monitor their glucose levels. Researchers are developing non-invasive skin sensors that aim to measure glucose levels without breaking the skin and report the results in real time to the patient and their doctors, but these are not yet a validated replacement for finger-stick tests or approved continuous glucose monitors.
Needle-free glucose monitoring is one of many new remote health monitoring technologies considered “frictionless” and “painless” since it requires virtually no actions from the patient. Treatment for diabetes should be the primary goal for diabetics, as uncontrolled glucose levels can cause significant health complications and even death. The new system of continuous glucose monitoring offers patients a uniquely proactive approach to preventing the condition from getting worse by making sure glucose levels stay close to the advised reference range found in people without diabetes.
#9 – Innovative Approach to Blood Clot Removal
Pulmonary embolism (PE) is often described as the third most common cardiovascular condition in the United States, after heart attacks and strokes. Each year, venous blood clots, including PEs, affect hundreds of thousands of people in the United States and cause tens of thousands of deaths. Typically, these clots originate in the deep veins of the legs before migrating to the lungs, necessitating prompt and intensive treatment to avert damage to the heart and lungs.
A groundbreaking device in this treatment arsenal is the Endovascular Catheter. This device is delicately maneuvered through the bloodstream to the lungs, which deploys an expandable infusion basket directly into the clot. This mechanism creates multiple pathways for blood circulation while simultaneously dispensing a clot-busting medication directly into the clot itself.
Since its introduction in 2023, the use of Endovascular Catheters has emerged as a key option in the arsenal against pulmonary embolisms, particularly for medium-risk cases, which constitute up to 60% of PE incidences. This method represents a significant advancement in managing and treating this critical condition.
Endovascular catheters can be used for a wide range of applications, including:
- Embolization: To deliver materials that can block off blood vessels feeding tumors or to stop bleeding.
- Coronary Angiography: To inject contrast dye into the heart’s arteries, making them visible on X-ray imaging (fluoroscopy), helping to diagnose conditions like blockages or aneurysms. A separate test shows the arteries on CT Scans.
- Aneurysm repair: Endovascular stent grafts are placed to reinforce weakened areas of an artery (aneurysms) and prevent rupture.
- Stent placement: To deploy stents (small, mesh-like tubes) to open up narrowed or blocked blood vessels and improve blood flow.
- Thrombectomy: To remove blood clots from the blood vessels.
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