What surprises may this year hold?
Although I’m not a professional forecaster, I’ve had the good fortune to personally interact with hundreds of life sciences companies last year. In fact, Prime Movers Lab saw more than 3,000 opportunities last year, an astonishing number of deals. While it sounds intense (it is!), it did give me a little bit of perspective on the overall life sciences landscape. This flow of deals has also given me hope, very optimistic hope, as I see the amazing progress that is happening in biotechnology. It is so inspiring to interact with and interact with these founders every day as we strive to impact the lives of billions of people together. As others have declared, we are truly in the golden age of biotechnology and I am so grateful to the teams working on these challenging issues to improve our whole lives. Although it’s certainly not an exhaustive list – here are ten things to watch in 2022.
Cancer should definitely be scared – after 4 decades (!) since the “war on cancer” was declared in 1971, it finally appears that science has this scourge under control. Most of us are familiar with the advent of immuno-oncology – harnessing the body’s immune system to attack cancerous tumors – with amazing results. But there are now emerging technologies to turn “cold” tumors – those the immune system can’t reach – into “hot” tumors so they can. This opens a whole new line of attack on some of the most aggressive types of cancer. And if that doesn’t work – like those bad glioblastomas – we can send tiny nanobots to swim to a site in the brain and deliver chemotherapy drugs directly to the tumor or its remains. Take this! And a little bit of good news, because this subject can use everything he can get, in 2022 we should see more widespread use of GRAIL’s Galleri test, which was introduced in 2021. With a single blood draw, he can detect more than 50 A different type of cancer – and even predict the location. Imagine the lives that would be saved. Cancer, your days are numbered.
General Breakthrough for Narcotic Medicine
I’ve been writing enthusiastically about psychedelic medicine for the past year, so you wouldn’t be surprised to see this on my list. Check out my thoughts sheet on the topic if you haven’t seen it yet. This year, I’m excited for Different Reason. If you check your calendars, several emerging “next wave” psychedelic startups making new molecules started between 2018-2020. This means that those programmes, if they pass their IND to enable pharmacology and toxicology, will start entering the clinic. I anticipate that 2022 will usher in a wave of announcements about Phase 1 and 2 readings that will further revitalize this inspiring work. This will be a massive shift from many pre-clinical companies to premium clinical stage companies and will be reflected in both program development and evaluations. It would be helpful to keep track of what worked and what was missing.
Bioelectronic medicine will give drugs a run for their money
I always liked the phrase “run for money” because I grew up in a family that loved horse racing. And let me tell you, bioelectronic medicine will be one option to bet on in 2022. The Feinstein Institute defines it as “we (we) are the hardware technology to read and modulate electrical activity within the body’s nervous system.” This modulation can be delivered through electricity, magnetic pulses, and ultrasound to both the central nervous system (brain) and the peripheral nervous system. Most, if not nearly all, of these devices are completely non-surgical and are located outside the body. I see devices in neuromodulation – for sleep, migraines, pain and even depression. In 2021, a landmark study showed that transcranial magnetic stimulation can be used to successfully treat intractable depression. Similarly – the stimulation is directed to the rest of the body including the spleen, peripheral nerves, and cranial nerves, targeting rheumatoid arthritis, neuropathic pain, sleep apnea, tinnitus, and opioid use disorder. I am definitely curious which horse will win this race!
A thriving year for mushrooms, not just magic mushrooms
If you haven’t seen Fantastic Fungi yet – you must watch it. seriously. Stop reading now and go watch it! The splendor of fungi constantly reveals itself. While “magic” mushrooms got a lot of press last year, clever companies have been turning mushrooms into exquisite high-end leather products that could render the traditional leather trade obsolete. And on the food front, many startups have focused on fungi-based proteins – mycoproteins – which turn out to be exciting and delicious. They can be used as ingredients – adding weight to other vegetable proteins or grown as “cuts” with a greater meat texture. The functional mushroom aspect also came on its own—with reishi, turkey tail, chaga, black mane, and more being used as food products (tacos!) and nutritional supplements. There is some very compelling research on its use in strengthening the human immune system and improving cognition. I’ll admit I love mushroom coffee in the morning! And touching the climate front – it turns out that the fungi communicate with each other underground and support the healthy growth of forests and connections between trees. What else will we learn from our eukaryotes this year?
The world is within us (and upon us)
You can’t scan the headlines these days without hearing about your microbiome. These are the trillions of microbes inside and on us that help make us who we are. They are found inside us, in our digestive system, and outside of us on our skin. As a gift to myself for the New Year (yes, that’s just a weirdo), I got my gut microbiome sequenced by a commercially available company. I have at least 407 strains of my fellow inner travelers (detectable by RNA sequencing) and we are just beginning to get to know each other. I did so out of scientific curiosity and in the context of a growing focus on the role of our gut in overall health – not just digestive health. First, there is mounting evidence for the role of the gut microbiota in inflammation. It’s not just the digestive system — but general inflammation in the body that scientists are now targeting for its potential role in autoimmune disorders and even neurodegenerative diseases. Then there’s the gut axis – “the bidirectional biochemical signals that occur between the gastrointestinal (GI) tract and the central nervous system (CNS).” The gut actually produces a range of neuroactive compounds and this system may play a role in relieving stress and depression. Will 2022 be the year you get to know your inner microbial team?
Telehealth and home diagnostic services
If there’s one positive aspect of COVID, it’s that it has finally pushed telehealth into mainstream acceptance. It has gone from being a convenience to an important part of our healthcare system over the past two years. This opens a whole new mechanism for the dissemination of health care in the home and on a large scale. For telehealth to be transformative, it must also integrate with new treatments and services. 2021 may have been the year most people touch their noses in all of history. This increase in home testing reflects what I’ve been seeing in terms of diagnosis and health monitoring opportunities traveling from the clinic to the home. I suspect a wave of home testing devices is hitting the market, including quality PCR results. As part of my New Year’s self-discovery, I also purchased a few home test kits for several vital signs. I hadn’t yet worked up the courage to poke my fingers hard enough required but I ended up hiring a blood draw specialist to come to my house – which was a lot more difficult than it should have been. I think we’re at the beginning of what could happen here — and I think lab testing companies should take notice.
Neuroscience data, artificial intelligence, and middleware
I’m still dealing with the terms I want to use here. I invoke neuroscience middleware to distinguish it from the hardware focus that has been dominated by neurotechnology over the past decade. I’m exaggerating, but it’s as if the neuroscience community has woken up and realized that the data stores we’ve all been sitting on are the real treasure. These are the processes that can be performed on the data and how disparate data sources (behavioral observations, cognitive tests, tissue and blood samples, CSF) can be grouped together and that is the “big aha”. We can now use these aggregated data sets to answer questions that have profound diagnostic and clinical outcomes. I’ve seen a wave of companies working to use neuroscience data to stratify patients in clinical trials to salvage compounds that have been abandoned by big drug companies and begin a complex but exciting journey toward early diagnosis of many neurodegenerative diseases. I expect that neuroscience measurement devices (EEGs, MRI, NIRS, etc.) will continue to move toward commodification and that data and AI/machine learning transformations in these data sets will be the driver of neuroscience value in the coming years.
Biology on the blockchain
Well, this caught my eye at the end of last year. I used to think of blockchain in a lot of different contexts. But it is not just about cryptocurrency anymore! Blockchain makes a lot of meaning for biology. Sure, sure – medical records might first come to mind – and that would be an important application. But I’m talking about tissues, umbilical cord blood, organs, stem cells, embryos, eggs, sperm… biological Material on the blockchain. This is an area ripe for disruption, especially with increased fertility treatments and egg freezing. Did you know that, in part due to a lack of regulation in the fertility market, embryos and reproductive tissues can be (permanently) misplaced? Yikes! This is exactly the type of application that a tamper resistant ledger system is suitable for. Are you putting a little of yourself on the blockchain?
Vaccines are not just for infectious diseases anymore!
Clearly, a dominant positive aspect of the COVID pandemic is the quality and speed with which the global scientific community has been able to produce vaccines against SARS-CoV-2. From traditional vaccine methods to emerging mRNA and peptide vaccines, our toolkit has opened up greatly. This toolkit is now being turned against some other bad targets that are not “traditional” infectious pathogens. Cancer vaccines and vaccines against neurodegenerative diseases, such as Alzheimer’s disease and Parkinson’s disease. For example, now that we know that HPV can cause cervical cancer – a vaccine against HPV has been developed. There is also a list of cancers that are currently being tested as a candidate vaccine, and I expect this to continue and expand. Although applications for non-communicable diseases are newer on the scene – it is interesting to think about them through the lens of aging and the relative strength of the human immune system. The argument is that a healthy young immune system can protect us from these infectious insults – but as we age our immune system loses potency – which is why these are usually the diseases of aging. As we age, can we be vaccinated against Alzheimer’s disease? It is worth discovering.
I’ll admit, I’ve finally left the topic I was so excited about. Within our topic of human enhancement at Prime Movers Lab – we have a special interest in longevity – which includes regenerative medicine. Regenerative medicine, to me, is one of the next big frontiers in how we think about living with, improving our human biology and its limitations. From tissue regeneration, organ replacement, and using gene therapy to give old tissues new functions – the potential is huge. I’ve already seen exciting work in wound healing and limb regeneration and the 3D printed scaffolding of tissues that totally amazed me. Have you ever thought about changing the purpose of a tissue in your body, for example a lymph node, and turning it into a second liver? me too! Unfortunately, my time in the Ministry of Defense coincided with a spike in casualties from IEDs. Working on limb-loss prosthetics was one of the most important work I think the Department of Defense did in biology. However, it was still just a replacement for what he had lost. Seeing our bodies repair themselves to complete the job through these technologies is the biggest dream and hope of this year.