Jaydeep Unni, Ph.D.
Sr. Project Manager, Robert Bosch Healthcare Systems, Palo Alto, CA
Remote Patient Monitoring – Challenges and Opportunities
Remote Patient Monitoring (RPM) is gaining importance and acceptance with rising number of chronic disease conditions and with increase in the aging population. As instances of Heart diseases, Diabetes etc are increasing the demand for these technologies are increasing. RPM devices typically collect patient vital sign data and in some case also patient responses to health related questions. Thus collected data is then transmitted through various modalities (wireless/Bluetooth/cellular) to Hospitals/Doctor’s office for clinical evaluation. With these solutions Doctors are able to access patient’s vital data ‘any time any where’ thus enabling them to intervene on a timely and effective manner. For older adult population chronic disease management, post-acute care management and safety monitoring are areas were RPM finds application. That said, there are significant challenges in adoption of Remote Patient Monitoring including patient willingness and compliance for adoption, affordability, availability of simpler/smarter technology to mention a few. But experts contend that if implemented correctly Remote Patient Monitoring can contain healthcare expenditure by reducing avoidable hospitalization while greatly improving quality of care.
Pandiaraj Manickam, Niroj Kumar Sethy, Kalpana Bhargava, Vepa Kameswararao and Karunakaran Chandran
Designing electrochemical label free immunosensors for cytochrome c using nanocomposites functionalized screen printed electrodes
Release of cytochrome c (cyt c) from mitochondria into cytosol is a hallmark of apoptosis, used as a biomarker of mitochondrial dependent pathway of cell death (Kluck et al. 1997; Green et al. 1998). We have previously reported cytochrome c reductase (CcR) based biosensors for the measurement of mitochondrial cyt c release (Pandiaraj et al. 2013). Here, we describe the development of novel label-free, immunosensor for cyt c utilizing its specific monoclonal antibody. Two types of nanocomposite modified immunosensing platforms were used for the immobilization of anti-cyt c; (i) Self-assembled monolayer (SAM) functionalized gold nanoparticles (GNP) in conducting polypyrrole (PPy) modified screen printed electrodes (SPE) (ii) Carbon nanotubes (CNT) incorporated PPy on SPE. The nanotopologies of the modified electrodes were confirmed by scanning electron microscopy (SEM). Cyclic voltammetry, electrochemical impedance spectroscopy (EIS) were used for probing the electrochemical properties of the nanocomposite modified electrodes. Method for cyt c quantification is based on the direct electron transfer between Fe3+/Fe2+-heme of cyt c selectively bound to anti-cyt c modified electrode. The Faradaic current response of these nanoimmunosensor increases with increase in cyt c concentration. The procedure for cyt c detection was also optimized (pH, incubation times, and characteristics of electrodes) to improve the analytical characteristics of immunosensors. The analytical performance of anti-cyt c biofunctionalized GNP-PPy nanocomposite platform (detection limit 0.5 nM; linear range: 0.5 nM–2 μM) was better than the CNT-PPy (detection limit 2 nM; linear range: 2 nM-500nM). The detection limits were well below the normal physiological concentration range (Karunakaran et al. 2008). The proposed method does not require any signal amplification or labeled secondary antibodies contrast to widespread ELISA and Western blot. The immunosensors results in simple and rapid measurement of cyt c and has great potential to become an inexpensive and portable device for conventional clinical immunoassays.
Bodo Eickhoff, Ph.D.
Senior Vice-President, Head of Sales and Marketing for Roche Applied Science, Germany
New paths for treatment of complex diseases: target combinatorial drug therapy
Several types of diseases show a complex pathogenesis and require targeted as well as combinatorial drug treatment. A classical example, Tuberculosis, was thought for decades to be managable by triple therapy, however now requiring new therapeutic approaches due to multi drug resistant strains. HIV and AIDS can only be kept under control by combinations of specific, virus-protein targeted drugs, requiring constant monitoring of resistance patterns and modulation of drug combinations during life-long therapy. As a third example, Cancer in all its different variations, requires detailled molecular understanding to enable targeted therapy. New technologies provide more and in depths molecular insights into pathomechanisms and resulting treatment options. However, is there an alternative way to approach complex diseases by holistic models? Can restoring of apoptosis-capabilities of transformed cells be an example of such an alternative path? How do we in future adress major unresolved topics like increasing drug resistance in bacterial infections, lack of anti-viral drugs, treatment of parasite diseases like Malaria, and newly emerging infectious diseases in research and fast translation of these results into diagnosis and treatment?