Electroceuticals: swapping drugs for devices

Bioelectronics is the field of developing medicines that use electrical impulses to modulate the body’s neural circuits as an alternative to drug-based interventions. How far away are we from having these very targeted “electroceuticals”?

electroceuticals

Twenty years ago, neurosurgeon and researcher Kevin Tracey was studying whether an experimental molecule called CNI-1493 could limit damage to the brain after a stroke. His team was injecting the molecule into the brains of rats during a stroke to see how successfully it prevented swelling — an immune system response — of the brain.

To Tracey’s surprise the drug not only prevented swelling locally, but it shut down the immune response in the whole body. The drug was having an impact on the vagus nerve — a long, thin nerve that snakes its way from the brain through the abdomen. Stimulating the vagus nerve seemed to reduce the production of cytokines — immune system mediators — and block inflammation.

“The drug was stimulating the vagus nerve and turning the brake on the immune system,” Tracey, who is president of the Feinstein Institute, told Wired.co.uk. “Once we understood that, it was a ‘eureka’ moment. We realised you didn’t need the drugs, you could just manipulate the nerve itself.”

This accidental discovery has led Tracey to focus his research efforts into the field of bioelectronics. This is, broadly, the field of developing medicines that use electrical impulses to modulate the body’s neural circuits. Virtually all of the body’s organs and functions are regulated through circuits of neurons communicating through electrical impulses. The theory is that if you can accurately map the neural signatures of certain diseases, you could then stimulate or inhibit the malfunctioning pathways with tiny electrodes in order to restore health, without having to flood the system with molecular medicines.

The fruits of Tracey’s efforts were encapsulated in 2012, when he travelled to Bosnia to implant a vagus nerve stimulator into the neck of a human patient with disabling rheumatoid arthritis. After years of debilitating pain in his joints, the patient is now in clinical remission. Eight weeks after the surgery he returned to work, performed manual labour and drove a delivery truck. The theory was, at least in this case, confirmed. Edited from Electroceuticals: swapping drugs for devices

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