Prof. Segura, what is the project ISyPeM 2 (Intelligent Integrated Systems for Personalized Medicine)?
Prof. Jean-Manuel Segura; In the ISyPeM 2 project we develop a new kind of point-of-care device, which makes it possible to measure the concentration of therapeutic drugs in the blood – directly from a single drop of blood. Then, the results will be shown in a reasonable time of about 15 minutes. This device would be offered to general practitioners, specialized clinicians or even directly to the patients. Currently, if therapeutic drugs must be monitored, a blood sample must be taken which would be sent to a central laboratory. And it can take some days to get the results of the sample. Also, there is no real help for the practitioner, no suggestion how to adjust the dose of the drug. Now, in the context of the project, we want to bring the analysis close to the patient and the practitioner.
How does this point-of-care test (POCT) work?
Segura: It is a multicomponent system. The project is not finished yet, but what we envision is a cartridge -reader system. The cartridge which is a disposable component can extract plasma from the blood. After that, it mixes the plasma with the reagents and then brings the solution to the measurement cell. For the read-out, the technology we use is a homogeneous assay based on fluorescence which may be relatively standard but was not very often used for compact devices. Basically, it is "mix and measure", no complicated external sample preparation needs to be done. The blood will be extracted, you mix and measure it.
Why is such a device necessary?
Segura: It's probably not absolutely necessary, but it has two main benefits. First, the time for the diagnosis. It is not life-threatening, but it would be much more efficient when the patient would not have to leave the office, but instead get the diagnosis immediately. So, basically, the measurement will be taken and after 15 minutes the practitioner or the specialist can directly make an adjustment to the drug dosage based on the test results. Also, the individual devices are connected to a remote database. This means that beyond the patient’s measurements, the device provides the physician with information of similar cases, giving a suggestion of dosage adjustment.
The second advantage is the amount of blood needed for the test. Currently, for a test 500 microliters are needed. This is especially difficult for children or neonates. For newborns, there are several therapeutic drugs which need to me monitored. We are working with one particular drug, the antibiotic Tobramycin. That one is typically given to a neonate who got bacterial infection for a couple of days. The concentration of the antibiotic needs to be precisely adjusted. If it is too low, the infection is basically not treated. But if it is too high, then it can be nephrotoxic, but also ototoxic, leading to the child’s hearing loss. For the drug dosage adjustment, regular measurements need to be taken. But taking a blood sample of 500 microliter is for a neonate actually quite critical. With our device, it would be enough to take 20 microliters which is just a small drop of blood. That is the clear advantage. It is less risky for the child.