"New insights into the molecular processes of life enhance our understanding of health and disease. Individualised medicine seeks to put those insights to use for all: for tailored prevention, diagnosis and treatment," goes the Federal Ministry of Health and Research's description of individualised medicine, an approach commonly also known as personalised or personal medicine. Innovative micro- and nanotechnology solutions are helping to enable the development of diagnostic and treatment processes tailored to address the individual patient's disease progress, personal needs and distinctive features. Personalised medicine points the way forward and was the dominant theme of this year's COMPAMED Spring Convention, which was co-hosted by Messe Düsseldorf and IVAM Microtechnology Network on 24 May in Frankfurt am Main. The event, which celebrated its tenth anniversary this year, provides a platform for experts to discuss ideas in the run-up to COMPAMED, the leading international trade fair for medical technology industry suppliers.
"The Spring Convention always gives a preview of the trends at the forefront of technical and business discussion at November's COMPAMED trade fair and accompanying forums. The emphasis is on general trends in medical technology and their relevance for medical technology suppliers, who are key cooperation partners in product development," said Horst Giesen, Global Portfolio Director Healthcare, Messe Düsseldorf, explaining the conceptually coordinated interactive approach.
Medical technology evolution offers opportunities for suppliers
Medical devices are becoming ever smaller, lower-cost and better connected. Accordingly, medical technology companies require suppliers to deliver ever finer, more lightweight yet more powerful components, modules and chips, or dedicated energy and data storage systems. "Medical technology comes to the person, not the person to the technology" could be the credo of the move towards personalised medicine. "At the same time, more and more people are developing chronic diseases," noted COMPAMED Spring Convention speaker Dr Florian Frensch, Philips Head of Strategy & New Business Development for the Germany-Austria-Switzerland ("DACH") region. There are more than 18 million obese people in Germany alone, 20 to 30 million people with high blood pressure, and an estimated eight million will have diabetes by 2030. In return, so to speak, personalisation and digitisation are changing our lives and transforming healthcare delivery: as many as 54 percent of people in Germany think individual treatment methods are very important, and one in 5 of the country's population has a healthcare or medical app on their smartphone. The health apps market is projected to grow ten-fold in the period from 2013 to 2017.
For medical technology manufacturers like Philips, megatrends such as commoditisation, miniaturisation and connected devices are of special interest. Ultrasound is an example of commoditisation: whereas a machine cost about USD 15 000 in 1995 and was larger than an office cabinet, the latest model, "Lumify", is priced at USD 200 (approx. EUR 177) per month. For that price, customers get a mobile, app-based ultrasound solution which offers safe cloud technology and high image quality to a large community of healthcare providers. The ultrasound transducer is connected up to an ordinary commercial tablet PC or smartphone. Miniaturisation is similarly evident: a handy point-of-care device that is easily brought to the patient replaces an entire hospital lab. Digitisation connects it all: "HealthSuite," a powerful cloud-based platform provided by Philips, enables connected, continuous healthcare. The technology collects, compiles and analyses medical and other health data from a wide range of sources. The solution addresses the complexity of cutting-edge healthcare IT and has the capability to combine conventional health data from digital patient files, diagnostic and imaging systems, and clinical monitoring with personal data from smartphones, smartwatches and fitness trackers. Piecemeal collection of diagnostic and treatment data in a largely episodic health care system thus gives way to a continuous health monitoring approach offering proactive and preventive benefits.
Rapid analysis of infectious diseases in just 30 minutes
The Austrian Institute of Technology (AIT) in Vienna develops technologies for point-of-care lab diagnostic systems, including highly sensitive biosensors for molecular diagnostic tests on body fluids such as serum, urine and saliva. Diagoras, a project that has received EUR5.5 million EU funding, sees the Viennese organisation working with eight European partners to develop a mobile device that enables doctors and dentists to diagnose and evaluate infectious diseases in just 30 minutes. Patient samples are entered in a system resembling a CD. The reagents needed for detection are already included. The results are displayed by optical methods (fluorescence and luminescence). The reader is the size of a cassette recorder. "Our main task is to develop nucleic acid-based assays. The DNA and RNA strands are specific to a variety of bacteria and viruses," Dr Giorgio C. Mutinati, AIT project manager said at the COMPAMED Spring Convention. Diagoras has two main goals: to develop a point-of-care diagnostic device based on a microbiology platform intended mainly for use in the diagnosis of oral and respiratory infections.
Efficient methods for complex diagnostic questions
Despite advances in treatment, cancer is still a leading cause of death in Germany. Detection of tumour cells that have dispersed in the body is attracting interest both as a diagnostic tool and as a predictor of prognosis. Research indicates that disseminating cancer cells could play an important role in cancer screening. "Blood will continue to be the main source of in-vitro diagnosis," says Dr Lukas Richter, Siemens Healthcare. The main hindrance to implementing the latest insights in clinical practice is the complexity and cost of currently available detection systems. No high-quality, easy-to-use system suitable for routine practice currently exists that is capable of continuous, real-time detection of isolated tumour cells. The "MRCyte" project funded by the BMBF (German Ministry of Education and Research) and taking place with the participation of Siemens was launched to address this issue. The aim is to measure concentrations of rare cells in patient blood by magnetic detection with a hard drive read. This platform technology based on magnetically labelled cells and matching sensors is called magnetic flow cytometry ("MRCyte"). The new method is much faster and easier to use than the existing technology of optical flow cytometry, especially in the pre-diagnosis stage. "The functions of a living cell would be the ideal biomarker for many clinical decisions. We want to measure non-stable biomarkers in future and reduce pre-diagnosis to a minimum," Richter said. "MRCyte" may help achieve that.
Ever smaller and better point-of-care devices that deliver rapid image data and efficient diagnosis of infectious diseases and cancer: all these things are aspects of personalised medical technology. They call for innovative micro- and nanotechnology solutions on the part of medical technology industry suppliers, such as will be presented and highlighted at COMPAMED 2016 in Düsseldorf (14 – 17 November).
Tiny sapphire implant shells
Implants play an important role in medicine, including individualised medicine. The Centre Suisse d’Electronique et de Microtechnique SA (CSEM) has developed new non-metal miniaturised shells for implants. These special "packaging systems" open up new opportunities for implantation technology because they can be used in hitherto inaccessible parts of the body. "The challenge begins with the inhospitable surroundings implants are exposed to, including an environment that is highly corrosive because of the oxidation processes, pH, temperature, ion composition and protein concentrations in our bodies," Rony Jose James, CSEM, said at the COMPAMED Spring Convention. What's more, implants also have to be biocompatible and biofunctional, which includes being non-toxic and having a long service life. Various materials used in microelectronics were considered, but the chosen solution consists of a tiny sapphire shell that measures just 0.6 by 0.6 by 1.0 millimetres but offers enough space for miniature sensors. "The spectrum of applications is wide-ranging, including implantable microphones in the middle ear, aneurysm detection, neurostimulation implants, and monitoring vital life functions in the heart," James said.
For Micromotion, too, small is all. The company specialises in new solutions based on micropropulsion technology, which is increasingly required in medicine and elsewhere. "Personalisation calls for smarter devices. This means increased automation of the devices coupled with increasingly complex functionalities, which in turn requires more complex control, sensor and actuator technology," Dr Reinhard Degen, general manager of Micromotion, reported at the Spring Convention. This prompted the company to develop robust, exceptionally durable and reliable electromechanical actuators, which present valuable performance benefits in addition to small size. These include biocompatible materials, high precision, zero backlash, high gear ratio, small number of components and low maintenance.
Biological tissue from 3D printers
3D printers are already being used for mass production in many industrial processes, notable examples being lightweight engineering and aviation. 3D printing also holds great promise in medicine. From dental restoration to knee implants to entire organs, the possibilities seem endless. Although a 3D printed heart, liver or kidney may be beyond reach for some time to come, 3D printing in medicine has long begun. "It opens up the possibility of converting digital data directly into objects. Fabrication into individualised forms is very much to be desired in medicine, and plenty of 3D data is already available as a result of high-tech imaging methods," said Dr Kirsten Borchers, Fraunhofer Institute for Interfacial Engineering and Biotechnology (IGB), outlining the excellent starting position. IGB has gone on to develop bioinks for bioprinting, which are produced from gelatine and used to construct chemically crosslinked hydrogels. Gelatine is derived from collagen and closely resembles the natural extracellular matrix. By varying the degree of crosslinking, IGB researchers can produce a matrix of a strength that is compatible with natural tissues such as fat or cartilage. "We modify biomolecules from the extracellular matrix of tissue in a way that enables us to control its gelling behaviour, viscosity and crosslinkability, thus rendering it suitable for use in the bioprinting process," Borchers said, describing the complexity involved.
The 10th COMPAMED Spring Convention again delivered a glimpse of the trends and developments shaping medical technology and medical technology industry suppliers – the ideal warm-up for COMPAMED 2016 (14 – 17 November). The leading platform for medical technology suppliers is once more expected to attract 800 exhibitors from more than 40 nations, filling Düsseldorf Fairground halls 8a and 8b to capacity. More than 18 800 visitors thronged to last year's COMPAMED, the highest attendance ever. 130,000 trade visitors from about 120 nations attended MEDICA and COMPAMED 2015 altogether.
In a globally unique dual combination, the world's largest medical trade fair, MEDICA (approximately 5000 exhibitors) and COMPAMED reflect the entire process chain and present a full range of the medical devices, systems and instruments now available. Both shows together take up the whole Düsseldorf Fairgrounds complex (19 halls).