July 19, 2010
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Two UCSF Scientists Put Their Discoveries to Work

By Andrew Schwartz

Tejal Desai, PhD, is working to develop an implantable pump for type 1 diabetes.

Together, diabetes and end-stage renal disease (ESRD) drive billions of dollars in health care costs each year, while hampering quality of life and causing premature death in millions of people worldwide. Existing therapies, while helpful, are flawed.

Now two projects funded by the National Institutes of Health at UCSF’s Department of Bioengineering and Therapeutic Sciences – one for an insulin pump, another for a wearable, artificial kidney – promise innovative therapies for both conditions.

The projects’ principal investigators – Tejal Desai, PhD, and Shuvo Roy, PhD – believe they are about five years away from clinical trials. Equally important, the advances in biomedical micro-electro-mechanical systems (bioMEMS) and nanotechnologies their projects represent have the potential to transform medicine in the same way that semiconductors transformed electronics.

Shuvo Roy, PhD, is developing nanopore membranes to improve treatment for end-stage renal disease.

Both projects speak to the importance that Chancellor Susan Desmond-Hellmann, MD, MPH, places on translational science. They are excellent examples of projects whose ultimate goal is to bring vital products to the marketplace – and to patients.

Both projects are highly collaborative, representing precisely the kind of multidisciplinary work the chancellor prizes. Desai’s diabetes project is a collaboration between researchers who understand diabetes and engineers who can build the nanotech-based device. And Roy’s artificial kidney project, which marries state-of-the-art bioMEMS with tissue engineering, comprises more than 10 co-investigators: clinicians, bioMEMS experts, biomaterial scientists, mechanical and product development engineers, regulatory consultants, and cell biologists, as well as numerous advisers from industry.

Protecting Insulin Production

Nanotechnology refers to the creation of tiny devices – hundreds, even thousands of times thinner than a strand of hair. Desai’s lab is working on the creation of an implantable nanotech pump that would dramatically improve treatment of type 1 diabetes by delivering the cells that produce insulin to the body and protecting them from being destroyed by the immune system. Patients with type 2 diabetes would also benefit from the steady production of insulin such a device would enable.

Desai’s pump uses nanopore membranes – tiny filters that mimic the properties of natural biomaterials, using precisely etched pores in silicon wafers. The pores match the size of the insulin being released, but do not allow in cells that would destroy those producing the insulin.

“This is an improvement, not just a replacement for the insulin pumps diabetic patients use today,” said Desai, who is a graduate of the UCSF/UC Berkeley joint graduate program in bioengineering. Rather than requiring patients to constantly prick their fingers to check glucose levels and then reprogram the pump accordingly, Desai’s device would maintain a steady insulin flow.

Improving diabetes treatment is a critical need, with a combination of obesity and people living longer making the illness epidemic. Around the world, 250 million people live with diabetes.

“But the technology also has implications for treating a host of other chronic, cell-based diseases such as Parkinson’s, Alzheimer’s, hormone deficiencies – anywhere where the body is unable to produce something it needs naturally,” said Desai.

The Artificial Kidney

Roy is working with nanopore membranes as well – in his case, to better treat end-stage renal disease. More than 500,000 Americans currently suffer from the disease. The ideal treatment is kidney transplant, but because of donor shortages, less than 25 percent of ESRD patients on the waiting list in the United States receive a new kidney each year. Dialysis is the interim therapy, but only about a third of dialysis patients survive more than five years. Not only is dialysis painful and time-consuming, it is also extremely expensive: while only 1 percent of the Medicare population is on dialysis, those patients consume 6 percent of the Medicare budget, or $24 billion per year.

Originally trained as an electrical engineer with a focus on the development of miniature sensors, Roy is a pioneer in translating bioMEMS technology for clinical applications. His laboratory works closely with clinicians, scientists and other engineers to advance novel bioMEMS solutions to cardiovascular, orthopedic and neurological problems. Roy is now principal investigator on research to develop an implantable, artificial kidney that could serve as either a bridge to transplant or a destination therapy for ESRD. Such a device could overcome both the supply limitations of renal transplant and the shortcomings of dialysis.

“It would provide many of the benefits of kidney transplant, including unencumbered patient mobility, freedom from the repeated vascular access associated with dialysis, and improved function, but without the need for immunosuppressive drugs,” Roy said.

Unique Collaborations Yield Rapid Clinical Benefits

The UCSF Department of Bioengineering and Therapeutic Sciences plays an integral role in the California Institute for Quantitative Biosciences (QB3), a consortium of three University of California campuses – UC Berkeley, UC Santa Cruz and UCSF – that fosters collaboration and catalyzes the conversion of discoveries into products and services that address society’s critical needs.

Many of the projects the department works on bring together teams from Northern California that draw on the area’s long-established leadership in biotechnology, medical devices, information technology and electronics.

“In addition to those collaborations, what’s especially exciting about being a bioengineer at UCSF is that we are intimately connected to the patient population, which enables us to develop technologies that address clinical needs,” Desai said.

“Solving problems together, as we do here, is more exciting, faster and more efficient,” Roy said. “And UCSF is a tremendous place for translational science at the interface of medicine and engineering because it’s all about moving it toward the patient. Clinical impact guides everything we do.”

Desai agreed: “Our greatest hope is that these advances will change people’s lives.”

Photos by Elisabeth Fall