The Frontier Of Bioelectronic Medicine

The nervous system connects to all of our main organs (Image credit: GSK)

GSK is quietly building a new treatment pipeline, in parallel to its established work on molecular medicines, that hopes to use peoples’ nerves to treat disease. If successful, it could not only revolutionize its product offering, but change the very way we think of medicine.

“There are fewer players looking at it,” said Kris Famm, who leads the dedicated R&D unit at GSK.

“We’ve gone out on a limb to capture what we believe is a game-changing therapeutic opportunity.”

The area is known as bioelectronic medicine, which looks at reading and then modulating the neural signals that pass between organs and the brain, and thereby treating a broad range of diseases, from arthritis and asthma, to hypertension and heart disease.

Think of it as a way to program the Internet of your body, using the nerve cables that go to and from an organ to tell it what to do instead of relying on a molecule to do it.

“It could be exquisitely specific and therefore both more efficacious and safer than most medicines used today,” said Famm. “Instead of taking a traditional drug that binds to multiple targets throughout your body, imagine a device that attaches to an organ-specific neural circuit in the body, records and analyzes the electric signals it trades with your brain, and then rewrites the disease out of the code.”

It sounds like science fiction, but there are already basic and somewhat clunky applications coming from startups to treat sleep apnea and hypertension. Comedian Jerry Lewis famously treats his chronic back pain with the jolts from a palm-sized electronic device called a spinal cord stimulator that he had implanted over a decade ago.

“We’re developing devices that don’t exist today.”

“We envision a device the size of a grain of rice that can be implanted or even injected,” Famm explained, “and possesses the intelligence to subtly modulate neural signals in real time.”

“Those final manifestations may be twenty years in the future before they have broad patient use.”

GSK is in general taking a novel approach to innovation, with over half of its R&D happening outside its walls. For bioelectronics this is even stronger, with 95% of the experimental work in the last 2 years happening via 50+ research collaborations around the world (half are in the US).

Famm explained: “Our molecular experience is directly relevant to how we understand disease, organ function, and manage this development pipeline, but there are a number of skills we don’t possess internally. So we’ve spent the time to craft an open, interdisciplinary approach to innovation that marries expertise in neural signaling, materials and electrical engineering, signal analysis, and surgical techniques.”

GSK is also riding a wave of external innovation in some of the basic tools that bioelectronic medicine requires, such as microfabrication, that simply didn’t exist even a few years ago.

“We’re trying to open up neuromodulation to treat chronic diseases that aren’t considered neurological or psychiatric,” Famm said. “We’re walking a fine line with our academic partners to encourage them to publish, while also filing patents on technologies that will help deliver it.”

What about possible patient reaction to the idea that their nerve signals could be somewhat reprogrammed by a tiny computer in their bodies?

Famm recounted a recent clinical trial in Amsterdam of a nerve stimulator for treating rheumatoid arthritis, and fears that there’d be no volunteers because the Dutch media uncharitably labeled the tech “the neck chip.” Yet volunteers swamped the trial.

“What attracted them is the idea of a treatment using the natural controls of their bodies,” Famm said.