Innovations in non-communicable disease monitoring

Dr.Deanpen Japrung

National Nanotechnology Center (NANOTEC)

National Science Technology Development Agency (NSTDA)

NAC201812th March 2018

Non-communicable disease

Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behaviours factors

Cardiovascular diseases(17.7 M)

cancers (8.8 M)

Respiratory diseases (3.9 M),

Diabetes (1.6 million).

Updated June 2017

NCD Key facts Updated June 2017

o NCDs kill 40 M people (70% of all deaths globally)o 15 M people die from a NCD (30-69 yrs.) o 80% of these "premature" deaths occur in low- and

middle-income countries

Tobacco use

Physical inactivity

Alcohols

Unhealthy diets

Thailand land of smile

South Korea

Thailand land of smileUpdated June 2017

Cancer!!!

Diabetes!!!

Detection, screening and treatment of NCDs, as well as palliative care, are key components of the response to NCDs

The Most Exciting Medical Technologies of 2017A new era in diabetes care

Artificial pancreases

Dana Lewis

http://medicalfuturist.com/the-most-exciting-medical-technologies-of-2017/

Precision medicine in oncology

Immunotherapy

Liquid Biopsy

The Most Exciting Medical Technologies of 2017

http://medicalfuturist.com/the-most-exciting-medical-technologies-of-2017/

The Most Exciting Medical Technologies of 2017

Narrow artificial intelligence in the clinics

Genomic Sequencing Service to Help Physicians Bring Precision Cancer Treatments to Patients Nationwide

IBM and Quest Diagnostics

Genomics helps advance precision medicine by combining cognitive computing with genomic tumoursequencing.

http://medicalfuturist.com/the-most-exciting-medical-technologies-of-2017/

• Thailand• 6.9% or 4.2 M

with diabetes (2012)• >34% Undiagnosed• Diabetes patients >

8 M in 2020

Diabetes Mellitus

Data from IDF Diabetes atlas /Seventh Edition/2015

Diabetes Mellitus Screening and Monitoring

• Blood sugar• FPG• OGTT

• Glycated Hemoglobin (HbA1c)

Ref: http://www.wikiwand.com/en/Hemoglobin_variants

• 5% Thalassemia/thalassemia carriers around the world

• 40% (24 M)Thalassemia/thalassemia carriers in Thailand

• Glycation of the albumin protein• Albumin is in the blood circulation

outside red blood cell • No limitation in rbc/Hb abnormality • Fasting is not required• 4 weeks half life, can be measured

every 2 weeks

Glycated albumin (GHSA)

New DM biomarker

Human Serum Albumin (HSA) & Glycated Human Serum Albumin (GHSA) aptamer selection

Aptamer bound GHSA

Binding selectivity of the aptamer

Binding selectivity of G8 aptamer. a). Southern blot analysis shows DNA shifted bands after incubation of G8 aptamer with GHSA (0.4 mg and 0.2 mg) or HSA (0.6 mg) in 10 mL PBS at room temperature for 1 h before doing analysis. b). Enzyme linked aptamer assay shows higher OD450 nm from the binding of G8 aptamer with GHSA comparing with the binding of G8 aptamer with HSA.

Biosens Bioelectron. 2016 Apr 7;82:140-145

Truncated aptamers

Biosens Bioelectron. 2016 Apr 7;82:140-145

a) Aptamer preferably binds on the domain IIIB. b) Graph shows the presence of hydrogen bonds between GHSA protein and 5del11and3del15 aptamer as a function of time.

Computer simulation analysis

Panman W , Japrung D*, and Pongprayoon P*. Exploring the interactions of aptamer with human serum albumin: Simulation studies. J BiomolStruct Dyn

[GHSA], mg/mL

Normal 6.31 + 2.39 mg/mLDM 26.28 + 3.39 mg/mL

%GHSA

Normal 14.93 + 6.26 mg/mLDM 64.01 + 6.87 mg/mL

J Biomol Struct Dyn. 2016 Sep 6:1-9.

Biosens Bioelectron. 2016 Aug 15;82:140-5.

Graphene Based Aptasensor

Research HistorySugarAL: DM screening and monitoring for everyone

2012 2013 2014 2015 2016 2017 2018-2019

• Aptamer selection & modification • GHSA detection kit prototype • Field test

Graphene-aptamer based sensor Electrochemical sensor

Portable detectorนาโนพอร์

Phase IIPhase I

The more expert you are, the less innovator you become ??

Innovation definition is stopping us from making innovation???

Time for SIT or Systematic Inventive Thinking?

Subtraction

Unification

Division

Multiplication

Relation

Division + Unification + Multiplication

New monitoring foro Liver functiono Diabeteso Alzhimero Effect of functional

food/drug on liver, diabetes and Alzheimer

Thank you