The Simple Sensor that Can Save Millions of Lives

[Music]

hello everyone

i’m here today to talk about the reed

platform technology

it’s a handheld point of care technology

for

rapidly assessing a patient’s response

to sepsis

towards enhancing sepsis outcomes

through

clinical evidence-based management

and how do we go about doing this this

is an extremely complex idea and i’m

going to

unpack this for you and in order to do

that i have to take you back

to the very beginning this is back in

2005

where i was a young assistant professor

trying to set up my own research

lab and portland oregon and i was trying

to

find problems that could transform the

way the human

experience went and to enhance the

quality

of care for life i kept thinking about

this

consistently and as i was a sensor

designer

thought about problems where my sensor

design

would change the way human life

interacted with technology

i found a group of clinicians and they

were very much

interested in looking at designing a

blood test

that could help them screen for patients

who come to them with arteriosclerosis

prior to surgery to figure out if the

patient

had vulnerable cardiovascular plaque or

whether it was

stable arthrosclerotic plaque what

exactly am i talking about

our arteries are the major blood vessels

that carry

oxygen-rich blood from our heart to the

rest of the body

and like plumbing of water pipes

they get sometimes clogged they get

coated with material

which is basically made of lipids

cholesterol proteins

which basically clog those pipes so

the way to treat it through surgery is

basically

what’s known as an angioplasty or you

have a stent

so to clean up those pipes but before

the surgery

you want to know if you’re if you are

the physician

whether that arterial wall is going to

remain stable

post-surgery or is going to collapse or

deform

and this depended on the type of plaque

that formed

so if it was stable black then the wall

would stay the way it was

the patient would have a good surgery

and nothing would happen which was

adverse

but if that plaque was unstable then

that wall would collapse

and the patient would die and have an

adverse outcome

so clearly figuring out the proteins

that would help us do this blood test

very quickly before the patient went

into surgery

would help with the outcome so we spent

about three years trying to figure out

what proteins to look

for and we tried quite a few things we

never could find

the exact ones which work like the

indicators on our automobiles

that tell us to turn left or right

similarly we could never find the

proteins here

that told us okay if you measure these

and these are elevated

then you have vulnerable plaque versus

stable black

so we had to abandon the problem after

three years with a bunch of publications

but no technology

to boast about so now fast forward to

2008

and here i am now in phoenix arizona

and met a bioengineer and he had

developed

the single chain fragments which are

again

proteins engineered proteins and we were

trying to look

to distinguish between three different

types of proteins that could be there

in our brain to distinguish between

alzheimer’s disease

parkinson’s disease and dementia with

the lewy body

so now again mostly these proteins would

be prevalent

within the brain and then it would seep

down

through the cerebrospinal fluid which

goes around the brain and the spinal

cord

cord and you’d be trying to look for

them

so we thought we engineered a very

sensitive test

that could look at one part of the y

that you see there

binding to the proteins and different

proteins on the same sensor

now the problem is the following getting

access to the cerebrospinal fluid

is tough so getting access is going to

require you to do a spinal tap for a

patient

no one likes that it’s very difficult to

do

and it’s painful it can have adverse

outcomes to the patient

so clearly that’s not going to work the

second thing is we couldn’t access this

in healthy or in human subjects we could

only get them

in postmortem so dead people so no point

building a test

on that for dead people so you have to

do it for people who are alive

where you can change their life so two

lessons learned first from the

study in portland and here in arizona

you have to

find the right protein or the right bio

marker to go after

second you have to build an ultra

sensitive test

on fluids or body fluids that are easily

accessible

like your blood through a finger prick

so with both these ideas in mind

i decided to go for the next generation

of the sensor technology

to address this but before i could do

any of that my professional and personal

life

hit a major roadblock and the year was

2010

and the month was april i was a new mom

and i was trying to just get used to the

fact that i had a young baby to take

care of

figure out breastfeeding and all the

rest and

my application to permanent residency to

the united states got denied

so here i was in an academic job and

i didn’t have a legal petition at this

point so i had to renew or redo the

regal

petition at the same time figure out how

to stay legally in the united states

and the only way i could do that was to

find myself another

academic job so quick primer on how

academic jobs work

in the tenure track here in the united

states so all

the various job postings come up in the

fall semester of a school year

all the applicants get interviewed and

then of course the decisions are made

and the job offer is given to you pretty

much early spring so by

may every job is taken and most likely

the decisions

are made in march and april of the year

so in april if i’m going to look for an

academic job

the chances of me finding them are

pretty slim

but there were two job openings that was

matching to my background

my expertise and i applied to them

one was in wichita kansas and the other

was here in ut dallas

i interviewed in both places the job in

dallas

they told me they didn’t have the

research funding to help me

start up my research lab here so they

couldn’t make me a job

offer that year so they had to decline

and then the only job for which i’m very

grateful to

is the one that i got in wichita kansas

so the interesting here

is that between phoenix and wichita

there was no direct flight at that point

of time

so i had to fly phoenix denver denver

wichita

or phoenix houston houston wichita back

and forth

for a family we felt the best thing

would be but i would commute

leave baby dad and everybody else back

in phoenix

and we’d keep doing this till we figured

out what would happen next

you know there were too many variables

at that point to process

so when i was doing this i was carrying

my breast pump

all the milk that the babe the breast

milk that you can see out there

up and down on these planes i started

observing a very curious phenomena

that milk that you see there in those

bags so

when i came back home to phoenix after

the flight

or the two long plane rides i’d see that

very clear

structures kind of like the pictures

that you see out there in green

so where the proteins the fat all

separated out

and these designs and shapes look like

how snowflakes look

and it happened consistently then when i

reconstituted the milk

and fed it to my son he didn’t complain

and he seemed fine didn’t get sick so

this was a very curious phenomenon

if i could now replicate a sensor

surface

that could do that where i could

separate out those

proteins in a very clear manner at the

same time

not mess up the body fluid in which they

were which was what i was going after

was blood remember

so if i could do that consistently

then maybe i could build that

revolutionary blood test that i was

interested

in from the very beginning so i

found and partnered with a material

scientist and he

helped me think through this problem and

he

designed a material system that which we

call the designer material

kind of like a designer sorry and which

could do the same thing

on proteins and then i figured out how

to re

constitute that material into a sensor

platform

and we had now a sensor now that was how

in 2014 and license was formed

and we founded this company towards the

idea

for enabling life science technologies

and now we built this really efficient

mousetrap we’re feeling very proud of

ourselves

what is the mouse we were going to go

and catch

so in my experience having worked with

cardiologists before

i knew that there was this big problem

which existed

which was this idea about quickly

triaging patients

who had myocardial infarction or heart

attacks

so very often in emergency departments

around the country and around the world

you see people coming in with chest

pains and other symptoms and sometimes

with no symptoms at all

how do you figure out that that

particular patient is having

a myocardial infarction is very

challenging

so if we could do a single fingerprint

blood test

and rapidly screen out these people then

we could actually

process clinical care faster

evidence-based clinical management

so we talked to a bunch of physicians

clinicians in the emergency room

departments

around the dallas fort worth area and we

wrote up this non-dilutive equity

proposal to the small business

innovation research network

funded by the national institute of

health how we thought that this idea had

merit

imagine to our surprise nobody liked it

they kept turning us down we kept

wondering why

here it is we built the sensing test

which can

be thousand times more sensitive than

what’s commercially available

why don’t we have any takers

so the reason is this they’re two

competing major players

in the market while the test may be

thousand times less sensitive

the regulatory outcome the amount of

resources that has to be invested

to make this clinically viable was so

significant

that everybody thought the risk

outweighed the reward

and they didn’t think that this idea had

any

commercial merit not technical merit but

commercial merit

so this was a lesson to us this is not a

problem

for which we could put out a

commercially viable product

so we were back to the drawing board

what do we do next

in talking to the same emergency

departments as well as to critical care

physicians

we became quickly aware of this one

major problem

that’s there in all hospitals all around

the world

one in three hospital deaths happen due

to sepsis

today more likely in many of the states

its one in two hospital deaths

happen because of sepsis so what

is sepsis sepsis is the body’s

unusually severe response to infection

now infection can have two triggers it

can be bacterial

in nature it can be viral and sometimes

it can also be fungal

in nature so if the bug that’s attacking

the human

who’s the host is bacterial or viral

or fungal it will trigger a very

an inflammatory response within the body

and what that does

is tells the body to release a bunch of

chemicals

that’s going to enhance the inflammation

which is known as the pro-inflammatory

response the little

spike you see on the top and the body is

putting out all these messenger

molecules

the problem is sometimes when the body

gets into this

hyper inflamed state it gives the body

the wrong clue to attack its own organs

and start shutting them down

so this looks like a train wreck

happening in slow motion

and you can’t stop it so generally for

the person

to recover and pro-inflammatory response

a hyper-inflamed response

has to be modulated with the downward

trajectory

which is going to be the complementary

anti-inflammatory response of the

compensatory anti-inflammatory response

generally things don’t work so much in

sync sometimes

people who have no underlying health

conditions can have such a severe

hyper inflamed response that everything

shuts down

and you don’t know why you can’t get

them to recover

and sometimes people with relatively

compromised immune systems might recover

this is even more critical today because

the kovit 19 pandemic

has done this you see of the over 500

million people who died in the hospitals

today

they’re having this messenger molecule

which is known as a cytokine response

term

that’s driving these deaths so now if

you could match or figure

out as this is happening every three

hours

what’s happening to that patient you can

modulate

the care that you’re giving to the

patient because

most likely the way the sepsis is dealt

with is you give a broad spectrum

antibiotic

and you give an anti-inflammatory but it

does matter

when you give it and how you give it for

the body to recover

because and it’s different for different

people and if you don’t do this

then the outcomes are not going to be

good and you’re never going to know why

one person recovers and the other

doesn’t

so now this particular blood test that

we are building

has the ability to be designed in this

manner that you do a simple fingerprint

in that you’re looking for that

pro-inflammatory hyper-response

and the anti-inflammatory response in

conjunction to figuring out

whether it is a bacterial trigger or a

viral trigger

that’s causing this response now if

you’re able to do this

every three hours to the patient you can

modulate

the care in real time for that patient

and again this problem is not just a

problem in north america

it’s true as a global problem so we

partnered with a queso which was a group

with the henry jackson foundation of

military medicine

and what we did was we looked at

patients

from across the globe from north america

from africa and from asia

and we looked at their responses and we

demonstrated that this platform

technology that we built

could map out or map the sepsis

endotyping out

which is the ability to figure out how a

person is responding

and to enhance sepsis outcomes so

now here we have this wonderful little

platform

that can sit on the palm of our hands

and that little cartridge which tests

every single time for this combination

of these proteins

and tells you how the body is doing the

host or the human is doing

and your individualized response to your

therapy

with the intention and the hope that we

can

recover more people and not one in two

or one in three deaths in the hospital

is going to be because of sepsis this

can also then be transported

outside a hospital into areas which are

highly austere

you know such as in rural areas in

remote settings

where the countries that wore all of

this towards

assessing and treating people in real

time

so this technology now is ready for

prime time

it requires funding it requires

randomized clinical trials it requires

the regulatory approval

and we’re working towards achieving all

of this

so i hope to come back another time to

tell you

the story of the impact of the read

platform technology

on human life and i thank you for your

attention