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Israel’s Medical Innovations
By Lili Eylon
Looking for less invasive heart surgery? Israel has invented a technique. Mobility problems? Israel has an answer. Technology to kill cancer tumors? – it is being developed in Israel.
In fact, Israel is in the forefront in the medical field with many cutting edge projects, whether in the application of methods to mitigate current human suffering or in research of future relief from ills, or even of their partial elimination.
Despite the decline on the general market, the health care and medical devices market is growing, partly because of an aging population, partly because there is always a need for less expensive solutions.
And Israel’s biotech industry is literally soaring. The comparative number of biotech companies per 1 million population: in the US 4.6, in the UK 4.8, in Israel 24.0. What in 1980 were four biotech companies in the country are today 160, with 4,500 top researchers and venture capital of more than $300 million, and a projected $1.8 billion in sales by 2003. One hundred senior academicians in the country’s 7 universities are busy on some 800 projects. What began 10 years ago as an incubator program now has 24 such incubator enterprises. In some 4 years most of them will have “graduated” to become start-up companies.
Much of what goes on in the country’s laboratories today is taking place within the framework of such start-up companies, most of them connected to a university or a major hospital.
Instant bone marrow
Take, for instance, the research into embryonic stem cells. Unlike the belief of many Christian denominations, Jewish law defines the fetus during the first 40 days after conception as “mere water” (according to the laws of impurity. Only after 40 days is an embryo considered an actual human fetus. While Jewish law clearly prohibits the use of embryos that are alive within the body, says Rabbi Yaakov Weiner, head of the Jerusalem Center for Research, it is a Halachic opinion that an embryo outside the body, such as in a test tube has no inherent potential to develop (a very low probability of ever reaching the neonatal stage). This gives researchers in Israel greater freedom to tackle stem cells.
But, says Dr. Avi Treves, founder and president of Gamida-Cell Ltd., his firm uses not embryonic, but rather adult blood. It is taken from the umbilical cord of birthing mothers in the delivery room. Already patented in Europe and in the United States, Stemex, a biopharmaceutical drug developed by Gamida-Cell, is, in effect, instant bone marrow, needed for people suffering from leukemia or lymphoma. Scientist-entrepreneur Treves explains, “ Not always is a family member suitable to donate blood for a relative. And locating a bone marrow donor normally takes 1-3 months, and in some cases this blood is rejected by the body of the sick person. What we do” he continues, “is technologically manipulate cord blood stem cells, enrich them with extracted white corpuscles and freeze them in banks similar to blood banks. In this way the doctors and patients need not wait – they have instant bone marrow, ready for transplants. As part of an overall treatment, together with chemotherapy, bone marrow puts up a two-pronged fight: it attacks cancer cells and fixes injured cells.”
In the fall of 2002, says Dr. Treves, clinical studies of Stemex are being planned in 3 medical centers in the United States- the drug will be tested for safety and efficacy. And, if all goes well, it will be on the market in 3-4 years.
At the moment, the stem cells the 25 people in Gamida-Cell are working on are focused on blood cancer, on leukemia and carcinoma.. It is Dr. Treves’ hope that research will soon be extended to the development of additional products, such as stem cells for the pancreas and for cardiac muscles.
Destroying cancerous tissue
It is called cryotherapy and it is an invention of Galil Medical, a privately owned start-up company in Shaar Yokneam in the north of the country. It is a hypothermic method by which targeted cancerous tissue are destroyed. With patients eager to have less invasive procedures and radiologists increasingly performing image-guided therapy, Galil’s CRYO-HIT system, the owners believe, can be an answer to killing local abnormal cells. The method is a temperature-based therapy for treatment of both benign and malignant tumors by freezing and thus dissolving diseased tissue in the kidney, liver and the prostates. The same technology has also been applied in gynecology to destroy myoma tumors. The tumors are frozen at 186 degrees Celsius. The gases used – helium and argon are used to freeze and thaw the catheter that is inserted to the affected area. Galil Medical ‘s treatments are most effective when the tumors are still in their early stages. According to Uri Amir, the company’s general manager, in cases where the tumor has not spread, one single session is enough to remove it.
In the United States, similar treatments are being offered by Endocare. The American company took Galil Medical to court some years ago, accusing it of violating its patent for a cryotherapy device. A US District Court in California ruled in favor of Galil, with the result that Endocare had to pay Galil $500,000 and was forbidden to use catheters with diameters of less that 2mm for prostate treatments.
Military and Medical Technology
Galil, with 60 employees in theUS and Israel, has a special method for treating prostate cancer called SeedNetT which includes Galil’s unique IceSeedsT technology. A minimally invasive technique specifically designed for use by urologists and based on the familiar brachytherapy procedure, it employs guided ultra-thin needles to enable complete coverage of the prostate at uniform cancer-killing temperatures. The SeedNetT strategy has been approved by the US Food and Drug Administration. With some 1,500 cases of prostate cancer a year in Israel and 200,000 in the US, the technique is certain to have a future.
The technology here is a direct result of technology developed by Rafael (Israel Armament Development Authority)’s method to cool missiles, demonstrating the strangely close relationship between military and medical technology.
Another example of technology as a handmaiden to medicine is a virtual reality device helping victims of Parkinson’s disease. The invention, brainchild of Professor Yoram Baram of the Technion Institute of Technology in Haifa, was originally developed for helicopter pilots. Prof. Baram, holder of a PhD in electrical engineering and computer science from MIT, once designed a mechanism for the US National Aeronautics and Space Administration that helped helicopter pilots navigate around obstacles such as trees and electrical poles.
The device he now developed is based on the idea that optical images of fixed objects help people stabilize themselves, whether they are flying a helicopter or are having difficulty walking. “The device,” says Baram, “ helps the Parkinson’s patient walk without the help of mitigating drugs. It is non-invasive, non-pharmacological and has no side effects.”
The device consists of a wearable computer and glasses that show a “virtual floor.” As the person walks, the virtual floor adjusts according to his/her movements.” When the patient walks, the floor begins moving beneath him, “explains Baram.” And when he turns, the image of the floor also turns. This gives the patient the feeling that he is walking on a steady floor.”
Baram worked with Dr. Judith Aharon Peretz, head of the Department of Cognitive Neurology at Rambam Hospital in Haifa, where the device was tested on some 40 patients, first on Parkinson’s, later on stroke victims. It proved particularly useful in patients who suffer from Stage Four Parkinson’s (Stage Five is the most severe form). In addition to improving coordination, while wearing the device, some patients who had difficulty speaking showed improvement in their ability to talk.
Asked when clinical trial will be completed, Baram replied, “Those will go on forever.” He and his are now at work to bring the device down from its present weight of l kg to 200 grams.
After raising $1-2 million Baram hopes to put the device on the market within a year where it will sell between $2-400.
The mad cow disease that has caused millions of cows to be killed in the last few years is found in humans. The Creutzfeld-Jakob disease is a variation of this neurodegenerative disease in humans where it attacks the brain; both are known as Prions.
A young company in Jerusalem, PrionSense Ltd., founded in 2001 by Hadasit together with Dr. Ruth Gabizon of Hadassah’s Department of Neurology, has developed a technology which detects the disease before it erupts in a way that the cow misbehaves. Until now what was used to diagnose the disease was a biopsy from the cow’s brain, often too late – after the animal began to show symptoms. (There is no cure at a late stage.) But now the method is less cumbersome and allows for early diagnosis before the appearance of clinical symptoms. Priosense has developed a simple in-vitro test during routine checkups, for identifying mad cow disease in urine, using commercially available antibodies. The technology has already been tested on hamsters, humans and cattle. The company is planning to develop a diagnostic kit within 2-3 years, which will be available to veterinarians. With the same proprietary technology the company hopes to develop additional diagnostic tests and innovative target drugs for other neurodegenerative diseases, such as Alzheimer’s.
Blood Clots and Common Diseases
Dissolving blood clots which cause strokes and myocardial infarcts is the business of Thrombotech Ltd. Now in the developing stage just before beginning clinical tests in Israel and after safety checks, it will be available in injection form for emergency treatment in hospitals within five years. What is innovative about this invention is that it distinguishes between old and new blood clots. If an old one is dissolved, it could cause new clots to be formed and bring on eventual death; the Thrombotech drug will dissolve only newly-formed blood clots. The huge market for such an innovative drug includes hospitals and clinics.
Identifying genetic bases for common diseases is the goal for IDGene; the researchers want to gain understanding by finding the genetic components of such illnesses as asthma, Alzheimer’s, manic depression and others. To that end, in a novel strategy, they are looking at a homogenous population, in this case, Israel’s Ashkenazic population to compare the DNA of sick with that of healthy individuals.
With currently some 10,000 such DNA samples, the researchers are now engaged in analyzing them, hoping this will lead them to new insights.
What all these companies have in common is need for more venture capital and, with Israel being removed from major markets, for a widening of the market for its innovative products.
With an increasingly greater focus on health care, and with a plethora of good ideas and researchers in Israel willing and able to explore them, this combination of computer and life sciences is a winning combination.
This article appeared in the Winter 2002 issue of Emunah Magazine