The new medical innovations that could change everything - The Engineers, BBC World Service

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Summary

This episode of The Engineers, hosted by Caroline Steel, brings together three leading experts in biomedicine: Tom Oxley, a neural engineer and CEO of Synchron; Eleanor Stride, Professor of Biomaterials at the University of Oxford; and Khalil Ramadi, Assistant Professor of Bioengineering at New York University. They discuss their groundbreaking work in brain-computer interfaces, targeted drug delivery, and electroceutical pills, highlighting how these innovations are addressing major medical challenges and exploring their potential future impacts and ethical considerations.

Highlights

Introduction to Pioneering Engineers and Their Work
00:00:22

Caroline Steel introduces three leading engineers: Tom Oxley, CEO of Synchron, who develops brain-computer interfaces; Eleanor Stride from the University of Oxford, specializing in targeted drug delivery via microbubbles; and Khalil Ramadi from New York University, creating electroceutical pills. They aim to revolutionize medicine by leveraging neural pathways, precise drug delivery, and gut-brain communication to treat conditions like MS, diabetes, and paralysis.

Tom Oxley's Inspiration: Brain-Computer Interfaces for Locked-in Syndrome
00:02:18

Tom Oxley, a neural engineer, shares his inspiration for developing implantable brain-computer interfaces (BCI). His early clinical experience with a young stroke patient suffering from locked-in syndrome highlighted the desperate need for technology that bypasses a failed body, allowing the brain to still communicate and interact with the world. He aims to deliver electronics to the brain without disturbing its natural architecture.

Eleanor Stride's Targeted Drug Delivery Using Bubbles
00:03:53

Eleanor Stride explains her innovative approach to drug delivery using tiny, gas-filled microbubbles. Unlike conventional pills or injections that distribute drugs indiscriminately, her method encapsulates drugs within these bubbles. Using focused ultrasound, the bubbles are precisely burst at the target site, releasing the drug only where needed. This minimizes side effects, particularly for toxic drugs like chemotherapy, and increases drug efficacy.

Khalil Ramadi's Electroceutical Pill Leverages the Gut-Brain Axis
00:05:21

Khalil Ramadi discusses his focus on the gut, often called the 'little brain,' due to its vast network of neurons. His electroceutical pill, 'Flash,' is designed to deliver electrical nudges from the gut to the brain. This oral device, similar in size to a fish oil capsule, contains electronics that emit micro-zaps to influence hormone levels, such as ghrelin, which regulates hunger. This non-invasive approach taps into the body's internal communication systems.

Stentrode: A Minimally Invasive Brain Implant
00:06:12

Tom Oxley details his brain implant, Stentrode, which detects changes in brain activity to interpret commands. This device is inserted via the jugular vein in the neck and threaded up to the superior sagittal sinus in the brain, making it less invasive than traditional brain surgery. It allows patients to control external devices, like a cursor on a screen, by interpreting motor cortex signals. Tom also mentions the development of a new Bluetooth profile (HID) for brain control, expanding possibilities beyond simulating keyboard or mouse functions.

Overcoming Challenges: Incorporating Oxygen into Drug Delivery Bubbles
00:09:26

Eleanor Stride explains the challenge of incorporating oxygen into her drug-delivery bubbles. Oxygen-starved cancer cells behave strangely and are difficult to kill with drugs or radiotherapy. Delivering oxygen simultaneously with chemotherapy could temporarily reverse this and make cancer cells more susceptible to treatment. The difficulty lay in oxygen's small, soluble nature, requiring a complete redesign of the bubble coating to make it gas-tight and a method of gradual oxygen substitution.

Patient Progress and Human Trials for Stentrode
00:11:21

Tom Oxley discusses the progress of Stentrode, which has received approval for human trials. He highlights key patients like Rodney, who uses the latest Bluetooth profile (Human Interface Device for brain control) to communicate with technology. Previously, BCI signals had to 'trick' computers into thinking they were keyboard or mouse inputs; now, truly brain-derived features can be developed.

Audience Questions: Expanding Applications of Bubble Technology and Biodegradable Pills
00:12:30

Eleanor Stride responds to an audience question about using bubble technology for conditions other than cancer. She mentions ongoing work in treating stroke with clot-busting drugs and developing targeted antibiotic delivery for chronic wounds, which will be trialed next year. Khalil Ramadi addresses the issue of his electroceutical pill's retrieval, noting that current electronics are inorganic. He highlights a parallel effort to create edible, food-grade electronics to eliminate the need for retrieval, suggesting convergence between these two fields.

Future Impact and Availability of the Innovations
00:14:14

Eleanor Stride, whose bubble technology is slated for human trials in October (subject to paperwork), hopes to quantify increased drug delivery and cancer cell death in breast cancer patients. She estimates widespread public availability of her technology in about ten years. Khalil Ramadi discusses the vast potential of his electroceutical pill across various conditions, including metabolic disorders, eating disorders, obesity, and diabetes, due to the gut's central role in multiple bodily systems.

Expanding Applications of Stentrode and Ethical Considerations
00:16:04

Tom Oxley envisions Stentrode expanding beyond motor control for conditions like neurodegeneration, MS, and spinal cord injuries. He sees future possibilities in controlling speech, vision, hearing, and even emotional communication for conditions like autism. Regarding ethical concerns about brainwave interpretation and privacy, Tom acknowledges the dystopian narratives but points out that for paralyzed patients, BCI can restore privacy often lost due to dependence. He addresses concerns about technology becoming unsupported, drawing parallels to pacemakers and issues faced by other neurotech companies, emphasizing the importance of informed consent in trials. He also touches on societal implications, such as potential discrimination for those who cannot access or choose not to use augmentation technology.

Interdisciplinary Collaboration and Future Prospects
00:21:42

The panel discusses the potential for collaboration between their distinct technologies. Khalil Ramadi expresses enthusiasm for working together on unsolved problems. An audience member asks if neural implants could be used for more realistic VR gaming. Tom Oxley confirms that gamers would likely be early adopters of BCI, as the technology can reduce reaction times for system engagement, a concept initially explored by US defense for prosthetic control and understanding conditions like PTSD.

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