This Could Be You
Illustration by Julie Vitkovskaya
For months Americans have watched politicians engage in tumultuous debates on the future of health care. But after all the political back and forth, the same problem underpins current health care plans: a fundamentally unsustainable economic system that is entirely reactive. If you’re sick, you to go the doctor. If you’re really sick, you go to the hospital.
But HealthTell LLC, an ASU spinoff company at the Biodesign Institute, might be changing the conversation between sickness and health, patient and doctor, and politician and citizen altogether.
The company has developed a technology that can provide information about a patient’s health without high costs or invasive procedures. With it HealthTell hopes to significantly affect the move from “sick care” to health care.
1) To find what is going wrong before it actually goes wrong.
2) To “create a world without patients.”
What it does
In 2012, ASU professor Stephen Johnston, Ph.D, invented immunosignaturing, which profiles circulating antibodies in the blood that act as the body’s army against disease.
Thousands of peptides, or small pieces of protein, are put in a specific order on either a glass microscope slide or the surface of a silicon wafer, both of which are called an array. Then an almost microscopic drop — almost a millionth of a liter — of blood is taken, diluted, and added to the array. Then the blood’s antibodies bind to the peptides where they are needed.
A high-resolution laser scanner reads the array of the antibodies attached to the peptides, similar to how a scanner on a printer works. Currently, the scientists and computers process the information it gathers, but eventually the entire process will be automated. So far, the new invention detects more than 30 different infectious diseases and cancers, from Alzheimers to valley fever to the common flu.
Johnston says that when he first invented the technology, he thought he would only be able to scrape the surface of detecting disease early on. But as the research continued, he realized his technology was much more powerful than he expected.
“That was really fun because a lot of the time you do something and it degrades in how good it is as you go along,” Johnston says. “This has been just the opposite. It’s gotten better and better. It surprised us with a lot of things.”
What it can do
While ASU professor Neal Woodbury, Ph.D., focuses on the chemistry of the technology (such as building the peptides), Johnston is concerned with the biology — seeing how disease relates directly to the patterns of how the antibodies and peptides attach.
Now that the scientists have developed the technology, the next step is to offer it to the public. Woodbury and Johnston hope that its use will be widespread since it could change the entire context of health care.
But for that to happen, people need time to familiarize themselves with the idea and feel confident in the technology
Woodbury says the company would ideally like for people to use the device with a very small needle — similar to what a diabetic uses. The person would draw a few microliters of blood once a month, put it on filter paper, mail it to the lab for analysis and receive a health status soon after.
Immunosignaturing can determine a personal diagnostic when people are monitored on a regular basis. With this new system, it’s not a far-fetched idea for people to test themselves for cancer after their morning coffee.
Another beauty of this technology: it’s not dependent on disease.
The data can obtain a person’s baseline, or normal immune system activity.
This is not a test for HIV or colon cancer, but a test that measures what a person’s immune system is reacting to. When the antibody binds to a peptide in the array, the scientists can detect a level of fluorescence from that connection, which will create a visible molecular structure.
The lab gets an image of that molecular structure that matches the possible disease.
Blood, sweat and hopefully no tears
Because of their close affiliation with and funding from the Defense Threat Reduction Agency (DTRA), the scientists have focused on certain infectious diseases such as anthrax. To some extent they have worked with the Department of Homeland Security, though it is not directly funding the research.
“They are still trying to decide which diseases are most important to them, but certainly they’re interested in diseases that a soldier might come into contact with,” Woodbury says. “Basically, people are worried about anthrax and smallpox, and those types of things that people have been concerned about in the past as being a biothreat agent.”
DTRA also worries about more common sicknesses among soldiers, such as the flu or respiratory infections, because they can compromise a person’s physical ability in combat.
Photo by Noemi Gonzalez
“You can’t do what you have to do, like dodge bullets and other things when you’re sick, so they don’t want to send you out on a seven day mission if three days into it you’re going to have the flu,” Woodbury says. “They’re interested in screening that type of situation."
Making the connection
When Johnston and Woodbury realized that the results of a test correlate with a person’s disease, the question then became how to manufacture this technology inexpensively for a large population.
And that’s where Bill Colston, Ph.D., came in.
Previous to being the CEO of HealthTell, Colston was the CEO and scientific founder of QuantaLife Inc., a successful biotechnology startup company that developed the most accurate genetic analyzer in the world. The company started with a team of four scientists in 2008 and grew to over 50 employees by October 2011 when Colston sold it to BioRad, which now sells QX100 Droplet Digital PCR System, the system created by the QuantaLife scientists.
After Colston finished transferring operations to the acquiring company in March, he contacted Johnston to see what he was up to. The two had known each other and collaborated at points over the past 10 years.
“(Bill) was looking for a new venture, and he was just like, ‘Well, let me go see what Johnston is doing, if he’s invented anything since the last time I talked with him,” Johnston says with a laugh. “And we had, so we told him what we were up to, and he got really excited about it.”
And there was a good reason for him to be.
On Nov. 8, the 2012 Governor’s Celebration of Innovation Awards announced HealthTell as the Innovator of the Year – Startup Company. Woodbury says even if it doesn’t win, it’s great to be part of the running. “It’s good for ASU that an ASU spinout company is being considered highly innovative technology,” he adds.
Though other companies conduct research using antibodies as detectors for disease, they do not use immunosignaturing to do a profile of the entire immune system.
Woodbury says he is surprised how powerful the technology is: “I thought we would never get enough. An antibody has a billion molecules associated with it, and when we started we couldn’t put a billion different molecules on a surface to test it. I thought it would all get washed out because there are so many they would bind to so many. But it turns out, that just isn’t true at all.”
Johnston compares the technology to Moore’s Law. In 1965 George Moore, the co-founder of Intel, predicted that computing power of a chip would double every two years.
However, just because the power of the technology doubles does not mean the price does. In fact, technology becomes cheaper. HealthTell’s aim is for access to its technology to be less expensive than a cup of coffee.
As Johnston says, with Colston on board, the company went from two academic geeks running the operation as best they could to a corporation with connections run by an experienced businessman.
Taking care of business
HealthTell is now in the process of starting the true commercialization phase for a company where they can translate completed research and development into something tailored for the general market.
How this technology will be introduced to people is currently unclear.
“We are still forming the basis for our business model,” Colston says. “There are several avenues open to us, including one that is direct to consumer marketing, but we still have to deal with all the regulatory issues associated with a new medical diagnostic.”
Woodbury acknowledges the serious constraints from a commercial point of view. The technology has to be comprehensive and inexpensive. Healthy people are not likely to pay money to find out they are still healthy.
Woodbury says he also realizes the company will need to address a number of political, regulatory and practical barriers in order to achieve the ultimate goal.
Several determinations need to be made, such as how to decide if someone is sick, how this information should be shared with the person, and what help needs to be offered so the information can be interpreted in a meaningful way.
The biggest challenge remains choosing a commercially viable path for a technology that is so disruptive and has so many applications, Colston says.
Woodbury hopes clinicians will start using the prototype within the next 12 to 18 months.
“That will be limited because we’ll be working with a set of clinicians, and they would be using it to profile individuals,” Woodbury says. “Those are all a matter of building confidence amongst the clinicians.”
The doctors would also use their previous technology along with the HealthTell technology to see that the two correlate and offer the same answers. This monitored information will go to the FDA for approval to use the technology on a broad scale.
What it comes down to
Technology is only one facet to a much more complicated problem. For Woodbury, an important aspect of being part of the ASU science community is creating a technology to help society not only by collaborating with others scientists, but by working with sociologists, clinicians and the community to answer the questions:
What are the benefits? What are the detractors? How might it be used right? How might it be used wrong?
These are the concepts our leaders need to incorporate into their views of technology and the future. The health care system is one of the most difficult problems the U.S. faces, and using technology as the underlying force for change in that system may offer answers.
But ultimately the solution to this complex issue belongs to the community.
Reach the writer at firstname.lastname@example.org and via Twitter @MG_Richardson