Unique Ocu­lar Scan­ner to De­tect Early Signs of Alzheimer’s Dis­ease

Is­raeli startup RetiSpec plans to build and be­gin test­ing its unique Alzheimer’s ocu­lar scan­ner in the next 12 months

The Jewish Voice - - HEALTH - By: Brian Blum

Ro­man­tics claim that you can see a per­son’s soul through their eyes. Ap­par­ently, you can also see whether they will be suf­fer­ing in the fu­ture from Alzheimer’s dis­ease. The same biomark­ers that ac­cu­mu­late in the brain – pro­teins called beta-amy­loids that clump to­gether into sticky “plaque” that are the signs of Alzheimer’s dis­ease – ap­pear in the retina of the eyes up to 15 years be­fore the on­set of any symp­toms. Di­ag­nos­ing Alzheimer’s to­day is an ex­pen­sive, in­va­sive and not al­ways read­ily avail­able process, mainly uti­liz­ing PET brain imag­ing and lum­bar punc­tur­ing. But what if all a physi­cian had to do was plug in a por­ta­ble scan­ner and train it on a patient’s eyes? That would save money, min­i­mize patient dis­com­fort and make ear­lier test­ing much more com­mon. That’s what ex­cites Eliav Shaked, the founder and CEO of RetiSpec, an Is­raeli startup that hopes to build and be­gin test­ing its unique Alzheimer’s ocu­lar scan­ner in the next 12 months. RetiSpec’s scan­ner is hoped to iden­tify the spec­tral sig­na­ture of neu­ropatho­log­i­cal changes in­di­cat­ing Alzheimer’s dis­ease in a mat­ter of sec­onds, Shaked says.

Early de­tec­tion

The bur­den (or for RetiSpec, the op­por­tu­nity) of treat­ing Alzheimer’s is clear: It is the most ex­pen­sive dis­ease in North Amer­ica, cost­ing an es­ti­mated $247 bil­lion in health­care sys­tem and out-of-pocket costs in 2016. (Glob­ally, it’s over $800 bil­lion.) The num­ber of pa­tients world­wide is ex­pected to dou­ble to 75 mil­lion by 2030 and nearly dou­ble again to 130 mil­lion by 2050. There is no cure for Alzheimer’s dis­ease. But early de­tec­tion would en­able peo­ple to try diet and life­style mod­i­fi­ca­tions that may slow the pace or on­set of de­men­tia. And they can get pre­pared fi­nan­cially and emo­tion­ally. “If you knew you could spend more lu­cid time with your loved ones, if you could ex­tend that even by one year, there’s no way to put a price on that,” Shaked says. “The prob­lem is, by the time we di­ag­nose the dis­ease to­day, it’s al­ready too late. The Alzheimer’s patient doesn’t un­der­stand why they’re in the doc­tor’s of­fice or who he or she is talk­ing with. It’s dev­as­tat­ing.” There’s an­other ad­van­tage to early test­ing: Alzheimer’s dis­ease may not be in­cur­able for­ever. There are dozens of new drugs in the phar­ma­ceu­ti­cal pipe­line, Shaked says, and true pre­ven­ta­tive treat­ment may reach the mar­ket as early as 2025. “The big­gest need phar­ma­ceu­ti­cal com­pa­nies have is to iden­tify peo­ple in need of these new drugs be­fore they start to show symp­toms,” Shaked ex­plains. “But to screen a large pre-symp­to­matic pop­u­la­tion is too ex­pen­sive. No doc­tor will send a healthy 50-year-old for an in­va­sive PET scan or stick a nee­dle in his spine just be­cause there’s a his­tory of Alzheimer’s in the fam­ily. We can stream­line the process and iden­tify peo­ple truly at risk.”

On­tario Brain In­sti­tute Col­lab­o­ra­tion

RetiSpec started in Is­rael, but tem­po­rar­ily re­lo­cated ear­lier this year to Bos­ton to join the Mass-Chal­lenge ac­cel­er­a­tor. Mass-Chal­lenge has a branch in Jerusalem, but “we chose Bos­ton to be closer to the large med­i­cal re­search com­mu­nity there,” Shaked ex­plains. RetiSpec won first place at the 2016 Part­ners Con­nected Health and AARP startup com­pe­ti­tion in Bos­ton. The team now is in Toronto col­lab­o­rat­ing with the On­tario Brain In­sti­tute, which in July in­vested $50,000 in RetiSpec. “There’s no reti­nal eye bank in Is­rael,” Shaked says. “Be­fore we build the scan­ner, we needed to first col­lect the data. We feel very for­tu­nate to be part of 2017 On­tario Brain In­sti­tute pro­gram and to tap into the in­cred­i­ble re­search com­mu­nity in Toronto.” The com­pany is rais­ing a seed round and ex­pects to re­turn to Is­rael in the fu­ture. Shaked, a biomed­i­cal en­gi­neer with de­grees from Tel Aviv Univer­sity, was in­spired to start RetiSpec af­ter he was ac­cepted to a pro­gram funded by NASA and Google un­der the aus­pices of Sin­gu­lar­ity Univer­sity. The pro­gram brings 80 en­trepreneurs from around the world to Sil­i­con Val­ley for a 10-week sem­i­nar “to ed­u­cate, in­spire, and em­power lead­ers to ap­ply ex­po­nen­tial tech­nolo­gies to address hu­man­ity’s grand chal­lenges.” For Shaked, that was Alzheimer’s dis­ease. When he was in a Jewish Agency-spon­sored sum­mer camp as a teenager, he be­came close to his adopted “Amer­i­can mother.” She now has Alzheimer’s dis­ease. “I asked her daugh­ter if I could come and visit her, and she said her mother wouldn’t even rec­og­nize me,” Shaked re­calls. “That res­onated a lot and im­pacted me to iden­tify a need.”

“The big­gest need phar­ma­ceu­ti­cal com­pa­nies have is to iden­tify peo­ple in need of these new drugs be­fore they start to show symp­toms,” Shaked ex­plains

RetiSpec is not alone in look­ing into the eyes of pa­tients to di­ag­nose Alzheimer’s dis­ease. The retina-brain con­nec­tion was dis­cov­ered more than a decade ago and there are other com­pa­nies that track the cog­ni­tive and mus­cu­lar move­ment of the eye or use con­ven­tional oph­thal­mo­log­i­cal tech­nol­ogy.

For ex­am­ple, Neuro-Vi­sion Imag­ing in Cal­i­for­nia re­quires pa­tients to in­gest cur­cumin, a com­po­nent of the spice turmeric, which can pen­e­trate the blood­brain bar­rier. There it bonds to beta amy­loid, the biomarker for Alzheimer’s. A physi­cian can then use a flu­o­res­cent imag­ing scan­ner to see if the turmeric has made its way to the retina.

Shaked isn’t wor­ried. “Com­pe­ti­tion is great,” he says. “It paves the way to the mar­ket and changes the mind­set about early Alzheimer’s de­tec­tion. It helps us build our value propo­si­tion and moves us for­ward to clin­i­cal stud­ies.”

Shaked adds that he feels “deeply driven” to help find a cure for Alzheimer’s dis­ease and likens the process to what we know now about pre­vent­ing heart dis­ease.

“Imag­ine some­one gets a heart at­tack and only then the doc­tor says, ‘OK, now we’re go­ing to start low­er­ing your choles­terol level,’” he says.

Just as we can proac­tively test for high choles­terol, Shaked hopes the same will ul­ti­mately be true for Alzheimer’s dis­ease. “Early de­tec­tion is what will drive pre­ven­tion.”

Photo by Christo­pher Huang

Eliav Shaked of RetiSpec at the 2016 Part­ners Con­nected Health Sym­po­sium in Bos­ton.

Retina im­age by Lukas Go­jda/Shutterstock.com

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