Cleveland Clinic's Top 10 Medical Innovations for 2016

Cleveland Clinic Innovations hosts the Medical Innovation Summit every Fall to bring together all stakeholders in healthcare industry to advance the conversation of medical innovation. They not only discuss the medical breakthroughs in the current year and but also sketch the blueprint for forthcoming innovations in the coming year.

The stakeholders in the summit includes investors, entrepreneurs, researchers, scientists and government personnel and policy makers that will influence the development and marketing of the new discoveries.

This year the summit was held from October 24-26,2016 at Cleveland, Ohio.

The top ten medical innovations for the year 2016 are:

1)      Vaccines to Prevent Public Health Epidemics.

The top spot in the top ten medical innovation list goes to researchers, scientists and public health personnel who are working tirelessly to develop safe, efficient and effective vaccines to prevent disease epidemics. These efforts were geared up by the 2014 Ebola epidemic in Africa and of bacterial meningococcal (Meningococcal B) outbreaks in the United States. The most promising Ebola vaccines was fast-tracked in less just a year. The researchers incorporated a small fragment of surface protein into a harmless cattle vaccine, which retains its capacity to generate a full blown immune response, but loses its ability to cause disease.  Phase-3 clinical trials in population with full exposure to Ebola virus has shown 100% efficacy in just 10 days.

Similarly, the Meningococcal B vaccine is freely available to all in the year 2016.[1]

2)      Genomic Directed Clinical Trials

Identification of essential tumor growth drivers has initiated a new era of targeted genomic cancer therapy. It gives cancer patients a higher chance of survival, longevity and best chance of cure when they need it most. Patients are waiting too long to enter clinical trials which may decrease their chances of cure or survival. RCT which has long been the gold standard of clinical trials are not keeping in pace with rapid expanding world of gene based and genomic therapy. Genomic based clinical trials can help identify the molecular profile of patient cancer cells and help getting them faster into clinical trials. Those patients with rare type of cancers can also hope for a cure due to genomic trials.

3)       Gene Editing Using CRISPR

CRISPR or clustered, regularly interspaced, short palindromic repeat (CRISPR) is a versatile tool for genome engineering used to generating RNA-guided nucleases, such as Cas9, with customizable specificities. It has many innovative application from treating diseases to editing the genes of human embryos to eliminate many genetic diseases. [2]

4)       Water Purification Systems for Prevention of Infectious Diseases.

Developing countries all over the world are struggling to provide clean drinking water to its majority of population. Sewage often pile up and eventually end up contaminating the drinking water. This contributes to more than 10% of disease in the world
An estimated 700million people in the world are drinking contaminated water
According to the world health organization - more than a million children under the age of five (in developing countries) die each year as a result to contaminated water and poor sanitation [3] LifeStraw has developed a system which transforms sewage into safe drinking water, not for a small group of people but larger communities for extended period of time. The machine collects the waste from the sewage then boils it and collects the condensed water vapor and process it into clean and safe drinking water. One processor is said to generate enough water for 100,000 people.[4]

5)      Cell-Free Fetal DNA Testing

In USA, cell-free DNA analysis became clinically available in 2011 and the American College of Obstetricians and Gynecologists and the Society for Maternal–Fetal Medicine recommended it as a screening option for women at increased risk of fetal aneuploidy. Its use has since been expanded as a screening tool in general obstetric population.Fetal circulating cell free DNA is derived mostly from placenta and is present in maternal blood for testing as early as 10 weeks of gestation. Different laboratories have validated different techniques and mainly rely on next-generation sequencing technologies and advanced bioinformatic analyses.Cell free DNA is commonly used to screen for only the common trisomies and, if requested, sex chromosome composition. The sensitivity and specificity as well as the negative predictive value of the method is >99% for trisomy 21 (Down syndrome), with slightly lower performance for trisomy 13 and 18.

6)      Cancer Screening via Protein Biomarker Analysis

Scientist and researchers have long focused on detection of change in concentration of single protein in biological fluids such as blood or urine to screen for cancer. But, the tests have been of limited use due to low sensitivity and specificity. Currently Studying cancer proteomics holds promise in near future to detect tell-tale proteins that provides insight into biological process of alteration in protein due to cancer. This is very true for detection of prostate cancer and colorectal cancers.

The Lerner Research Institute (LRI) of the Cleveland Clinic maintains the Proteomics Core, a protein-sequencing facility that uses tandem mass spectrometry methods to sequence and identify proteins. [5]

In an Australian study published in PLOS one Fung KYC et al identified three biomarkers that discriminated between the controls and the colorectal cancer patients with 73 percent sensitivity at 95 percent specificity.[6] Similarly tests for prostate cancer showed 100 percent sensitivity with no false negatives and approximately 80 percent specificity.  

7)       Naturally Controlled Artificial Limbs

Numerous innovations in prosthetics over the last decade have improved quality of life for numerous amputees and paraplegics in United States. Researchers have discovered that neural signals for limb movements can be de-coded by computers. This advance was made possible by technologies developed under Defense Advanced Research Projects Agency. Now people living with missing or paralyzed limbs will be able to get a feel of the objects they are touching via prosthesis but also will be able to send signals to the robotic prosthesis device form brain.

“We’ve completed the circuit,” said DARPA program manager Justin Sanchez. “Prosthetic limbs that can be controlled by thoughts are showing great promise, but without feedback from signals traveling back to the brain it can be difficult to achieve the level of control needed to perform precise movements. By wiring a sense of touch from a mechanical hand directly into the brain, this work shows the potential for seamless bio-technological restoration of near-natural function.”[7]

8)      First-ever Treatment For HSDD

The little pink pill or Flibanserin (Addyi, Sprout Pharmaceuticals) also dubbed  as the "Female Viagra" was approved by the US Food and Drug Administration (FDA) for the treatment of  hypoactive sexual desire disorder (HSDD) in premenopausal women,  in August 2015, despite  being unsure  about suboptimal risk-benefit trade-offs.

Flibanserin, a 5-HT1A agonist, a 5-HT2A antagonist, and a very weak partial agonist on dopamine D4 receptors, increases levels of dopamine and norepinephrine and decreases serotonin in animal brain areas. Therefore, since dopamine and norepinephrine are thought to promote and serotonin is thought to inhibit sexual desire and arousal, it was suggested that flibanserin enhances sexual desire in HSDD.

9)      Frictionless Remote Monitoring

Monitoring the blood glucose by pricking the finger will soon be a thing of past.

Wearable  biosensors now measure glucose levels using tissue fluids like tears and sweat and not blood. The WBS transmits data over WiFi to the mobile receiver. The patient hence will be able to continuously monitor his or her glucose level and share the results with healthcare providers. Other frictionless remote monitoring devices in development include a bandage that reads sweat molecules to diagnose pregnancy, hypertension or hydration.[8]

10)  Neurovascular Stent Retriever

Neurovascular stent retrievers are a crucial type of medical equipment used in the treatment of strokes. They are used to clear up intracranial arteries and restore normal blood flow following a stroke. Their rapid action in clearing arteries and retrieving clots in large arteries has been noted by health-care authorities after preliminary trials showed promising results. In June, the American Heart Association and American Stroke Association updated its guidelines and added the use of stent retrievers in conjunction with tPA for first-line treatment in some patients with acute ischemic stroke. The stent retrievers are the Solitaire (Medtronic) or Trevo ProVue (Stryker).

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[1] http://innovations.clevelandclinic.org/Summit/Top-10-Medical-Innovations/Top-10-for-2016/1-Vaccines-to-Prevent-Public-Health-Epidemics.aspx

[2] http://www.nature.com/news/crispr-gene-editing-is-just-the-beginning-1.19510

[3] https://prezi.com/crxawgoncdfn/water-purification-systems-for-prevention-of-infectious-dise/

[4] http://www.ippinka.com/blog/lifestraw-water-purification-project-for-millions/

[5] http://journals.lww.com/oncology-times/blog/onlinefirst/Pages/post.aspx?PostID=1352

[6] Fung KYC, Tabor B, Buckley MJ, Priebe IK, Purins L, Pompeia C, et al. (2015) Blood-Based Protein Biomarker Panel for the Detection of Colorectal Cancer. PLoS ONE 10(3): e0120425. doi:10.1371/journal.pone.0120425

[7] http://www.darpa.mil/news-events/2015-09-11

[8] https://www.mepits.com/tutorial/180/Biomedical/Wearable-Biosensors