Electrogenetics May Offer New Therapy for Type I Diabetes
by Sharena Rice, contributing editor
September 2023, BioElectRx Business Report
The interface between technology and medicine has reached a milestone with the development of DART (Direct Current-Actuated Regulatory Technology), an electrogenetic interface that integrates wearable devices with gene-based therapies. This has potential in real-time medical adaptations, specifically in the management of type 1 diabetes—a condition that requires meticulous monitoring and immediate therapeutic interventions.
Traditionally, biomedical engineering faces inherent limitations concerning the compatibility of electronic devices with biological systems, especially at the cellular and molecular levels. In a proof-of-concept study, a team at ETH Zurich demonstrated that DART normalized blood glucose levels in a mouse model of type 1 diabetes. The study instigated the release of insulin, showcasing the immediate, targeted therapeutic intervention that DART can provide. They used World Health Organization-approved FDA-licensed acupuncture needle electrodes to stimulate engineered human cells implanted under the skin of the mice. This was a wireless-powered system.
According to Martin Fussenegger, whose group conducted the study, “We do not do a surgical implant. We microencapsulate the designer cells in alginate beads and inject those via a needle under the skin. Thereby there is no wound and the acupuncture needles do not produce any wound either.”
This stimulation at 4.5 volts of direct current for 10 seconds once per day was able to induce enough insulin to be produced to restore blood sugar to normal levels. These findings hold great implications for human healthcare, particularly for chronic conditions like type 1 diabetes that necessitate vigilant monitoring and treatments. As mice and humans do not simply scale volumetrically, the system will likely need to be tuned for humans based on the level of insulin needed. One pain point for diabetics is when flying on airplanes, pressure changes interfere with the function of the insulin pumps. DART has the potential to be used in cases like this, where traditional insulin pumps fall short.
For patients with type 1 diabetes, DART’s promise extends beyond simple glucose monitoring, reaching into the realm of proactive and real-time medical care. For example, integrating DART with intelligent wearables could create a system that not only continuously measures blood glucose levels but also triggers insulin release whenever blood glucose levels are too high. This would fundamentally transform the management of type 1 diabetes, potentially reducing the frequency of hypo- and hyperglycemic episodes, minimizing long-term complications, and substantially improving the quality of life for patients.
DART has potential beyond diabetes, as well. Fussenegger noted, “In principle, any cell type could be engineered for electrosensitivity since the ROS [reactive oxygen species] used as an interface is a universal metabolic response network that exists in all cells. As always, the sensitivity of cells to ROS may vary, but our electrogenetic interface has a lot of tuning opportunities.” The tuning may be done through overexpressing genes involved in the molecular pathway, changing the sensitivity of the synthetic promoter, and adjusting the electrical voltage and induction parameters.
Combining engineered cells with electrical stimulation paradigms may allow actionable, personalized medical interventions that can help patients better manage their conditions. As bioelectronic medicine gains traction and reshapes healthcare paradigms, real-time, adaptable electrogenetic technologies like DART stand to become cornerstones in healthcare systems.