HERE’S TO A FUTURE WITHOUT PILLS

A radical new procedure spells new hope in fight against cancer, diabetes and Alzheimer’s and hyper-tension

Imagine a future where, instead of reaching for a pill to soothe your pain or offset a disease symptom, you press a button (or more likely, an app on your phone) that triggers a tiny, implantable device in your body, stimulating a nerve, which targets the same molecular pathway as a medication — correcting the problem without drugs.

That future is much closer than it may appear. This new field of medicine, known as bioelectronics, has many pioneers, but none are so well-known as neurosurgeon Kevin Tracey, who is founder and CEO of the Feinstein Institute for Medical Research. He has been studying inflammation and the nervous system for most of his career and has contributed to several major breakthroughs in the field.

His most lauded discovery was that by interfering with, or stimulating, nerves in the central nervous system, they could instigate the body’s inflammatory reflex, in which acetylcholine (a neurotransmitter) is released, inhibiting the proinflammatory cytokines (a type of immune cell) that cause inflammation in the body. He specifically homed in on the Vagus nerve—the widely reaching nerve bundle considered the “captain” of the central nervous system, which communicates directly to the brain and with all organ systems via nerve impulses called action potentials.

THE FIRST DEVICE

In

bioelectronic medicine, “you begin with a molecular mechanism — such as the inflammatory response in an autoimmune disease — and build a device to control that mechanism,” Tracey explains to Mental Floss. Instead of screening for chemicals that control the target, you screen for nerves. Every organ in the body is under the control of a nerve. Tracey points out that the nervous system and the immune system “co-evolved, not one before the other”. As one became more complicated, so did the other.

He says, “If we can develop devices that restore the healthy balance between the two, there won’t be any side effects.”

Tracey’s research with rheumatoid arthritis (RA) patients led to the creation of a small, implantable Vagal nerve stimulator that dramatically reduced inflammation in patients. Clinical trials on humans have been so successful that several of the 18 patients in the trial have seen complete remission of their RA, allowing them to go off all medications. However, it may still be another three to five years before you can obtain one of these devices in the U.S. “I conceived these trials on the back of a napkin in 1998 using materials that were FDA-approved at the time,” Tracey laments. “It shouldn’t take this long, but that’s another story.”

The problem with drugs, when swallowed or injected, is that they “go everywhere, and even the best drugs have side effects,” he says. “Nerves go to a specific place and deliver a specific payload that lasts for a short period of time without side effects.”

HITTING THE TARGET

If

targeting nerve cells seems like an unlikely way to treat many diseases, Tracey points to research by Paul Frenette, a stem-cell researcher at the Albert Einstein College of Medicine, done on prostate and breast cancer. Frenette’s study showed in mouse models that nerve cells release molecules that “control the ability of the cancer cells to grow or metastasize,” says Tracey.

Research of this kind is guiding the direction of the bioelec- tronics field, Tracey says: “What are the diseases where we either have data or a good hypothesis that we can hit the target of the disease through a nerve?” He believes that such diseases as cancer, diabetes, inflammatory bowel disease, hypertension, Alzheimer’s, and even hypertensive shock may all be treatable one day through bioelectronic medicine.

At the press of a button (or an app on your phone) a tiny, implantable device in your body stimulates a nerve that corrects the problem without

drugs