Astrazeneca Gets It Electroceuticals: emerging
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Posted On: 04/23/2024 2:10:22 PM
Astrazeneca Gets It
Electroceuticals: emerging applications beyond the nervous system and excitable tissues
Published:April 18, 2024
Application of electroceuticals is expanding beyond the nervous system
The nervous system has a central role in controlling functional and homeostatic processes in the body through system-wide communication via electric impulses. Directly manipulating neuronal signaling using electric pulses and targeting bioelectric properties of relevant nonexcitable cells in body tissues with ion channel drugs have emerged recently as a novel class of treatment called electroceuticals (see Glossary). Despite their high therapeutic potential, strong initial industry interest, and major initiatives from the US government (National Institutes of Health Stimulating Peripheral Activity to Relieve Conditions and Defense Advanced Research Projects Agency Electrical Prescriptions), electroceuticals have only begun to be explored [1.]. However, with many devices in clinical trials and new research delving into the interplay between electroceuticals and bioelectricity, the field is poised to make a significant impact in not just neurological disorders but also inflammation, cancer, and regeneration [2., 3., 4.]. We discuss the evolution of electroceuticals in the past decade to inform future directions.
Electroceuticals are becoming precise and disease modulating
‘Electroceuticals’, a portmanteau of ‘electronic’ and ‘pharmaceuticals’, was coined over a decade ago to describe the manipulation of neuronal signaling using devices for therapeutic effect [1.]. Since their initial description, the sophistication and application of electroceuticals have deepened and widened respectively, providing an emerging ecosystem of interventions to target a wide range of diseases [5.]. The first generation of electroceuticals cover a set of established therapeutic interventions, such as pacemakers, cardiac defibrillators, cochlear and retinal implants, transcutaneous electrical nerve stimulation, spinal cord stimulation, and deep brain stimulation, that utilize electric current to cause an effect (Figure 1) [5.,6.]. While undoubtedly clinically successful, these interventions are relatively broad acting and target excitable tissues (as opposed to individual nerve fibers or bundles) [6.]. They use simple waveforms that are not calibrated based on the mechanism of action and mediate symptoms in a nonspecific manner without full understanding of the underlying biological effect [6.].
The second generation of electroceuticals aims for a more targeted electromodulation for disease modification. This includes utilizing miniaturized devices that target a subset of nerve fibers or bundles, underpinned by a more thorough mechanistic understanding of biology [2.]. The clinical trials of these devices align more closely to pharmaceutical drug development, with the scope extending beyond neurological disorders (Figure 1) [2.]. SetPoint’s MicroRegulator system [2.] and Galvani’s splenic stimulation system [7.] are good examples of this category. Although vagus nerve stimulation (VNS) has been around for more than 30 years, and some of the VNS devices (such as transcutaneous vagus nerve stimulators) would be considered first generation, these two devices target the vagus nerve with increasing precision and are built on a deeper understanding of the neural–molecular–inflammatory pathways [2.,7.].
https://www.cell.com/trends/pharmacological-s...24)00049-X
Electroceuticals: emerging applications beyond the nervous system and excitable tissues
Published:April 18, 2024
Application of electroceuticals is expanding beyond the nervous system
The nervous system has a central role in controlling functional and homeostatic processes in the body through system-wide communication via electric impulses. Directly manipulating neuronal signaling using electric pulses and targeting bioelectric properties of relevant nonexcitable cells in body tissues with ion channel drugs have emerged recently as a novel class of treatment called electroceuticals (see Glossary). Despite their high therapeutic potential, strong initial industry interest, and major initiatives from the US government (National Institutes of Health Stimulating Peripheral Activity to Relieve Conditions and Defense Advanced Research Projects Agency Electrical Prescriptions), electroceuticals have only begun to be explored [1.]. However, with many devices in clinical trials and new research delving into the interplay between electroceuticals and bioelectricity, the field is poised to make a significant impact in not just neurological disorders but also inflammation, cancer, and regeneration [2., 3., 4.]. We discuss the evolution of electroceuticals in the past decade to inform future directions.
Electroceuticals are becoming precise and disease modulating
‘Electroceuticals’, a portmanteau of ‘electronic’ and ‘pharmaceuticals’, was coined over a decade ago to describe the manipulation of neuronal signaling using devices for therapeutic effect [1.]. Since their initial description, the sophistication and application of electroceuticals have deepened and widened respectively, providing an emerging ecosystem of interventions to target a wide range of diseases [5.]. The first generation of electroceuticals cover a set of established therapeutic interventions, such as pacemakers, cardiac defibrillators, cochlear and retinal implants, transcutaneous electrical nerve stimulation, spinal cord stimulation, and deep brain stimulation, that utilize electric current to cause an effect (Figure 1) [5.,6.]. While undoubtedly clinically successful, these interventions are relatively broad acting and target excitable tissues (as opposed to individual nerve fibers or bundles) [6.]. They use simple waveforms that are not calibrated based on the mechanism of action and mediate symptoms in a nonspecific manner without full understanding of the underlying biological effect [6.].
The second generation of electroceuticals aims for a more targeted electromodulation for disease modification. This includes utilizing miniaturized devices that target a subset of nerve fibers or bundles, underpinned by a more thorough mechanistic understanding of biology [2.]. The clinical trials of these devices align more closely to pharmaceutical drug development, with the scope extending beyond neurological disorders (Figure 1) [2.]. SetPoint’s MicroRegulator system [2.] and Galvani’s splenic stimulation system [7.] are good examples of this category. Although vagus nerve stimulation (VNS) has been around for more than 30 years, and some of the VNS devices (such as transcutaneous vagus nerve stimulators) would be considered first generation, these two devices target the vagus nerve with increasing precision and are built on a deeper understanding of the neural–molecular–inflammatory pathways [2.,7.].
https://www.cell.com/trends/pharmacological-s...24)00049-X
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