By Pratiksha Baliga
Published 6:39 PM EST, Sat July 17, 2021
Bioelectronic Medicine consists of implantable devices that will use electricity to regulate biological processes, treat diseases, and restore lost functionality. These devices would work in a manner in which they will induce, block, and sense electrical activity by taking into account the Peripheral Nervous System at the centre to progress with advances mainly concerned with chronic diseases and their control. It will be attached to individual peripheral nerves, thereby deciphering and modulating neural signaling patterns, achieving a therapeutic effect targeting the signal function of a specific organ. These miniaturized device components will create flexible and biocompatible materials. The biggest problem with drugs is that, although they cure diseased cells, they also result in adverse reactions. Bioelectronic Medicine, as compared to drugs, will be designed with more efficiency and will comprise of expandable components for computation and power, thus reducing the side-effects and costs. It will focus on precision to reach specific targeted locations.
The research is ongoing to discover a particular methodology of harnessing the body’s peripheral wiring, which might help in the treatment of acute and chronic diseases. Dysfunctional neural circuits give rise to dysfunctional organs. The aim of bioelectronic medicine is to counteract this condition by restoring electronic impulses with adjustments of neuron firings, thereby changing the neurotransmitter concentrations traveling through those circuits. An alternative way is emerging including neuromodulation, biostimulation, or electroceuticals to deteriorate the expense of costly chemical and biological drugs.
The human body is electric. Peripheral nerves connect all organs to the central nervous system These nerves are packaged in bundles and carry about 100,000 nerve fibers. A peripheral nerve is also the longest nerve in the body, linking the brain to the organs and controlling breathing and heart rate. It goes everywhere to gain access to a bunch of different targets. Some of the researchers believe that this is the greatest promise for bioelectronic medicine, which, by manipulating the vagus nerve, can control inflammation and the immune response and drive most chronic disease. Also, acetylcholine, the principal neurotransmitter that stems from the vagus nerve, inhibits the production of cytokines such as the tumor necrosis factor, an inflammatory molecule involved in rheumatoid arthritis.
These implants are very small in size. Researchers and engineers are into a mindset of not blindly zapping a large bundle of nerves. Instead, they are collaborating on the basic physiology and high-tech tools needed to zero in on the specific subset of fibers known to innervate the organ of interest. Further changes are thought to personalize this device in such a manner as changing the pulse, width, amplitude, or frequency of stimulation. Unlike as with many pharmacologic agents, a plan is executed to be selective with therapeutic effects along with its reduced side effects as well.
Such a device would not only develop connections with the nerves, but also with the rest of the body to decipher and develop the best response in real-time by stimulating or blocking nerve signals. For example, diabetes might involve the pancreas to make more insulin when it’s needed. In the gastrointestinal system, an electrode might sense the motility rate of the gut and then determine the optimal frequency of pulses to speed it up or slow it down. The ultimate goal is to restore a healthy pattern of electrical pulses.
In the upcoming future, the vision of revolutionizing the system of medicines will come to fruition. Bioelectronic medicines hold the promise in achieving the therapeutic intervention by modulating the signalling patterns of the nerves’ impulses. These medicines include devices which are implanted anywhere in the viscera and record the neural activity. However, the upcoming research is thought to focus on three principal areas. Firstly, making of an instinctive nerve atlas is pivotal as this focuses on mapping the innervation of visceral organs such as the lungs, heart, liver, pancreas, kidney, bladder, gastrointestinal tract, lymphoid organs, and reproductive organs. The objective is achieving resolution at the level of nerve fibers and action potentials. Secondly, neural interfacing technology helps in mapping neural signals, which includes ultrasonic and tomography techniques for recording and modulation. Thirdly, when the particular signaling pattern is characterized, the focus drifts towards confirmation of rule, which implies characterizing which neural circuit exerts impact over which disease in the representative animal model. After that, an experimental phase is sought after, which includes developing the correlation of neural signals and biomarkers patterns and also investigating the effect of blocking and stimulating neural activity during established disease. Thus, altogether this revolution in the medical fraternity might bring a change in the society introducing a new class of precision medicine to patients.
Pratiksha Baliga, Youth Medical Journal 2021
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