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