How To Harness The Pain Blocking Effects of Exercise

Athletes have a very complicated relationship with pain. For endurance athletes in particular, pain is an absolutely non-negotiable element of their competitive experience. You fear it, but you also embrace it. And then you try to understand it.

But pain isn’t like heart rate or lactate levels—things you can measure and meaningfully compare from one session to the next. Every painful experience is different, and the factors that contribute to those differences seem to be endless. A recent study in the Journal of Sports Sciences, from researchers in Iraq, Australia, and Britain, adds a new one to the list: viewing images of athletes in pain right before a cycling test led to higher pain ratings and worse performance than viewing images of athletes enjoying themselves.

That finding is reminiscent of a result I wrote about last year, in which subjects who were told that exercise increases pain perception experienced greater pain, while those told that exercise decreases pain perception experienced less pain. In that case, the researchers were studying pain perception after exercise rather than during it, trying to understand a phenomenon called exercise-induced hypoalgesia (which just means that you experience less pain after exercise).

This phenomenon has been studied for more than 40 years: one of the first attempts to unravel it was published in 1979 under the title “The Painlessness of the Long Distance Runner,” in which an Australian researcher named Garry Egger did a series of 15 runs over six months after being injected with either an opioid blocker called naloxone or a placebo. Running did indeed increase his pain threshold, but naloxone didn’t seem to make any difference, suggesting that endorphins—the body’s own opioids—weren’t responsible for the effect. (Subsequent research has been plentiful but not very conclusive, and it’s currently thought that both opioid and other mechanisms are responsible.)

But the very nature of pain—the fact that seeing an image of pain or being told that something will be painful can alter the pain you feel—makes it extremely tricky to study. If you put someone through a painful experiment twice, their experience the first time will inevitably color their perceptions the second time.

As a result, according to the authors of another new study, the only results you can really trust are from randomized trials in which the effects of exercise on pain are compared to the results of the same sequence of tests with no exercise—a standard that excludes much of the existing research.

The new study, published in the Journal of Pain by Michael Wewege and Matthew Jones of the University of New South Wales, is a meta-analysis that sets out to determine whether exercise-induced hypoalgesia is a real thing, and if so, what sorts of exercise induce it, and in whom. While there have been several previous meta-analyses on this topic, this one was restricted to randomized controlled trials, which meant that just 13 studies from the initial pool of 350 were included.

The good news is that, in healthy subjects, aerobic exercise did indeed seem to cause a large increase in pain threshold. Here’s a forest plot, in which dots to the left of the line indicate that an individual study saw increased pain tolerance after aerobic exercise, while dots to the right indicate that pain tolerance worsened. 

The big diamond at the bottom is the overall combination of the data from those studies. It’s interesting to look at a few of the individual studies. The first dot at the top, for example, saw basically no change from a six-minute walk. The second and third dots, with the most positive results, involved 30 minutes of cycling and 40 minutes of treadmill running, respectively. The dosage probably matters, but there’s not enough data to draw definitive conclusions.

After that, things get a little tricker. Dynamic resistance exercise (standard weight-room stuff, for the most part) seems to have a small positive effect, but that’s based on just two studies. Isometric exercises (i.e. pushing or pulling without moving, or holding a static position), based on three studies, have no clear effect.

There are also three studies that look at subjects with chronic pain. This is where researchers are really hoping to see effects, because it’s very challenging to find ways of managing ongoing pain, especially now that the downsides of long-term opioid use are better understood. In this case, the subjects had knee osteoarthritis, plantar fasciitis, or tennis elbow, and neither dynamic nor isometric exercises seemed to help. There were no studies—or at least none that met the criteria for this analysis—that tried aerobic exercise for patients with chronic pain.

The main takeaway, for me, is how little we really know for sure about the relationship between exercise and pain perception. It seems likely that the feeling of dulled pain that follows a good run is real (and thus that you shouldn’t conclude that your minor injury has really been healed just because it feels okay when you finish).

Exactly why this happens, what’s required to trigger it, and who can benefit from it remains unclear. But if you’ve got a race or a big workout coming up, based on the study with pain imagery, I’d suggest not thinking about it too much. Hat tip to Chris Yates for additional research. For more Sweat Science, join me on Twitter and Facebook, sign up for the email newsletter, and check out my book Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance.

By: Alex Hutchinson

Source: How to Harness the Pain-Blocking Effects of Exercise | Outside Online

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Critics:

Exercise-associated muscle cramps (EAMC) are defined as cramping (painful muscle spasms) during or immediately following exercise. Muscle cramps during exercise are very common, even in elite athletes. EAMC are a common condition that occurs during or after exercise, often during endurance events such as a triathlon or marathon.

Although EAMC are extremely common among athletes, the cause is still not fully understood because muscle cramping can occur as a result of many underlying conditions. Elite athletes experience cramping due to paces at higher intensities.The cause of exercise-associated muscle cramps is hypothesized to be due to altered neuromuscular control, dehydration, or electrolyte depletion.

It is widely believed that excessive sweating due to strenuous exercise can lead to muscle cramps. Deficiency of sodium and other electrolytes may lead to contracted interstitial fluid compartments, which may exacerbate the muscle cramping. According to this theory, the increased blood plasma osmolality from sweating sodium losses causes a fluid shift from the interstitial space to the intervascular space, which causes the interstitial fluid compartment to deform and contributes to muscle hyperexcitability and risk of spontaneous muscle activity.

The second hypothesis is altered neuromuscular control. In this hypothesis, it is suggested that cramping is due to altered neuromuscular activity. The proposed underlying cause of the altered neuromuscular control is due to fatigue. There are several disturbances, at various levels of the central and peripheral nervous system, and the skeletal muscle that contribute to cramping.

These disturbances can be described by a series of several key events. First and foremost, repetitive muscle exercise can lead to the development of fatigue due to one or more of the following: inadequate conditioning, hot and or humid environments, increased intensity, increased duration, and decreased supply of energy. Muscle fatigue itself causes increased excitatory afferent activity within the muscle spindles and decreased inhibitory afferent activity within the Golgi tendon.

The coupling of these events leads to altered neuromuscular control from the spinal cord. A cascade of events follow the altered neuromuscular control; this includes increased alpha-motor neuron activity in the spinal cord, which overloads the lower motor neurons, and increased muscle cell membrane activity. Thus, the resultant of this cascade is a muscle cramp.

See also

This Remote Patient Monitoring Startup Just Landed A $70 Million Series C

Health Recovery Solutions in action

hen Covid-19 cases began to soar around Ann Arbor in April, the University of Michigan Hospital reached 100% capacity. Like most hospitals, University of Michigan Hospital was not ready for the pandemic surge, but they did have a leg up.

That same month they’d coincidentally implemented Health Recovery Solutions’ remote patient monitoring, a patented technology system that records patient vitals via Bluetooth and connects them with their clinicians through video or instant messaging. This enabled the resource-strapped hospital to care for over 400 patients remotely throughout 2020.

Today, HRS announced it closed a $70 million series C led by LLR Partners with participation from existing investor Edison Partners, bringing the Hoboken, New Jersey-based startup’s total funding to $86 million. The news comes on the heels of a year of massive growth, which saw their head count balloon 258% to 155 employees and revenue grow by 188% to $23.5 million.

“People are choosing the proven remote-monitoring solution right now,” says Jarrett Bauer, HRS’ Forbes 30 Under 30 cofounder and CEO. “That’s one of the reasons why we’re doing so well—people are looking for the company that’s best.”

Bauer, now 34, was inspired to start by HRS by his grandma. Battling a heart condition, Bauer’s grandma was admitted to the hospital three times, resulting in over $14,000 of medical bills. While pursuing his M.B.A. at Johns Hopkins in 2012, Bauer began constructing an at-home hospital alternative that would eventually become HRS. “We didn’t know where to start,” Bauer told Forbes in 2019 when the company raised its $10 million series B. “We just knew it was a problem, and the best companies solve problems.”

With Covid-19, telehealth doctor appointments have become just doctor appointments, increasing 154% from March to October of 2020, according to the Centers for Disease Control. Rather than cut into HRS’ margins, the telehealth boom has helped HRS soar. The healthcare company has deals with over 220 U.S. healthcare systems—74 of which signed on as clients of HRS during the pandemic—with over 20,000 nurses checking HRS logs every day.

“We consider Health Recovery Solutions the Cadillac model,” says Brandy Knudson, Michigan Medicine’s Telehealth Project Manager. “It fills a huge gap for us because we want to reduce readmissions and reduce unnecessary trips to the hospital.”

The company makes money by billing clinical institutions on subscription to integrate their solutions in treatment, coming at no additional cost to patients. HRS recognizes the varying levels of sickness and technological ability of patients, so the company’s products range from a pulse oximeter for the sickest, while near-recovered patients can manually enter symptoms on HRS’ smartphone app.

All of this patient data is stored in a cloud for clinicians, making it easier to recognize prognosis patterns and health trends. By implementing HRS, major healthcare systems like Penn Medicine have reduced 30-day readmission by over 50% for all heart failure patients, while FirstHealth of the Carolinas says the technology has saved patients more than $1.9 million since its implementation in 2016.

“Patients are looking to stay in their homes longer, get care in their homes longer, and there’s an increasing prevalence of chronic conditions,” says Sasank Aleti, a partner at Philadelphia-based private equity firm LLR Partners. “HRS met our criteria of taking costs out of the system, driving better outcomes and a better patient experience.”

For Bauer, the future of HRS lies in universalizing hospital-from-home treatment. With the $70 million round, the company plans to more than double head count in 2021 to 250 employees with the goal of being able to treat over a million patients by adding new healthcare providers and upping their disease module count (they currently treat 90 diseases). “Why aren’t we like Google? Why aren’t we like Apple?” asks Bauer. “We’re playing to win—to be that.”

I’m the Under 30 Editorial Community Lead at Forbes. Previously, I directed marketing at a mobile app startup. I’ve also worked at The New York Times and New York Observer. I attended the University of Pennsylvania where I studied English and creative writing. Follow me on Instagram and Twitter at @iamsternlicht.

Source: This Remote Patient Monitoring Startup Just Landed A $70 Million Series C

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The coronavirus pandemic has overwhelmed hospitals, physicians and the medical community. That’s pushed telemedicine into the hands of providers and patients as the first response for primary care. Telemedicine isn’t new to the medical community, however it hasn’t been embraced due to insurance coverage, mindset and stigma. Here’s how it works and what it means for the future of health care. » Subscribe to CNBC: https://cnb.cx/SubscribeCNBC » Subscribe to CNBC TV: https://cnb.cx/SubscribeCNBCtelevision » Subscribe to CNBC Classic: https://cnb.cx/SubscribeCNBCclassic
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What’s The Difference Between Covid-19 Coronavirus Vaccines

Coronavirus COVID-19 single dose small vials and multi dose in scientist hands concept. Research for new novel corona virus immunization drug.

The world can’t return to normal without safe and effective vaccines against the SARS-CoV-2 coronavirus along with a coordinated global vaccination programme.

Researchers have been racing to develop potential drugs that could help end the ongoing Covid-19 pandemic. There are currently around 200 vaccine candidates and about a quarter passed preclinical tests and are now undergoing clinical trials.

What’s the difference between the various candidate vaccines?

A pie chart of candidates can be cut several ways. One is to slice it into six uneven pieces according to the technology (or ‘platform’) that’s used to produce the drug. Those six technologies can be grouped into three broader categories: dead or disabled viruses, artificial vectors, and viral components.

Dead or disabled viruses

Traditional vaccines contain a dead or disabled virus, designed to be incapable of causing severe disease while also provoking an immune response that provides protection against the live virus.

1. Live-attenuated viruses

Attenuated means ‘weakened’. Weakening a live virus typically involves reducing its virulence — capacity to cause disease — or ability to replicate through genetic engineering. The virus still infects cells and causes mild symptoms.

For a live-attenuated virus, an obvious safety concern is that the virus might gain genetic changes that enable it to revert back to the more virulent strain. Another worry is that a mistake during manufacturing could produce a defective vaccine and cause a disease outbreak, which once happened with a polio vaccine. MORE FOR YOUJapan Has Opened Hayabusa2’s Capsule, Confirming It Contains Samples From Asteroid RyuguDonald Trump’s Presidency Will End On The Day Of A Comet, A Meteor Shower And A Total Eclipse Of The SunIn A New Epidemiological Study, Daily Doses Of Glucosamine/Chondroitin Are Linked To Lower All-Cause Mortality

But using a live-attenuated virus has one huge benefit: vaccination resembles natural infection, which usually leads to robust immune responses and a memory of the virus’ antigens that can last for many years.

Live-attenuated vaccines based on SARS-CoV-2 are still undergoing preclinical testing, developed by start-up Codagenix and the Serum Institute of India.

2. Inactivated viruses

Inactivated means ‘dead’ (‘inactivated’ is used because some scientists don’t consider viruses to be alive). The virus will be the one you want to create a vaccine against, such as SARS-CoV-2, which is usually killed with chemicals.

Two Chinese firms have developed vaccines that are being tested for safety and effectiveness in large-scale Phase III clinical trials: ‘CoronaVac’ (previously ‘PiCoVacc’) from Sinovac Biotech and ‘New Crown COVID-19’ from Sinopharm. Both drugs contain inactivated virus, didn’t cause serious adverse side-effects and prompted the immune system to produce antibodies against SARS-CoV-2.

Sinopharm’s experimental vaccine has reportedly been administered to hundreds of thousands of people in China, and both drugs are now being trialled in countries across Asia, South America and the Middle East.

COVID-19 vaccine landscape (left) and platforms for SARS-CoV-2 vaccine development (right)
The global COVID-19 vaccine landscape (left) and Vaccine platforms used for SARS-CoV-2 vaccine … [+] Springer

Artificial vectors

Another conventional approach in vaccine design is to artificially create a vehicle or ‘vector’ that can deliver specific parts of a virus to the adaptive immune system, which then learns to target those parts and provides protection.

That immunity is achieved by exposing your body to a molecule that prompts the system to generate antibodies, an antigen, which becomes the target of an immune response. SARS-CoV-2 vaccines aim to target the spike protein on the surface of coronavirus particles — the proteins that allows the virus to invade a cell.

3. Recombinant viruses

A recombinant virus is a vector that combines the target antigen from one virus with the ‘backbone’ from another — unrelated — virus. For SARS-CoV-2, the most common strategy is to put coronavirus spike proteins on an adenovirus backbone.

Recombinant viruses are a double-edged sword: they behave like live-attenuated viruses, so a recombinant vaccine comes with the potential benefits of provoking a robust response from the immune system but also potential costs from causing an artificial infection that might lead to severe symptoms.

A recombinant vaccine might not provoke an adequate immune response in people who have previously been exposed to adenoviruses that infect humans (some cause the common cold), which includes one candidate developed by CanSino Biologics in China and ‘Sputnik V’ from Russia’s Gamaleya National Research Centre — both of which are in Phase III clinical trials and are licensed for use in the military.

To maximize the chance of provoking immune responses, some vaccines are built upon viruses from other species, so humans will have no pre-existing immunity. The most high-profile candidate is ‘AZD1222’, better known as ‘ChAdOx1 nCoV-19’ or simply ‘the Oxford vaccine’ because it was designed by scientists at Oxford University, which will be manufactured by AstraZeneca. AZD1222 is based on a chimpanzee adenovirus and seems to be 70% effective at preventing Covid-19.

Some recombinant viruses can replicate in cells, others cannot — known as being ‘replication-competent’ or ‘replication-incompetent’. One vaccine candidate that contains a replicating virus, developed by pharmaceutical giant Merck, is based on Vesicular Stomatitis Virus (VSV), which infects guinea pigs and other pets.

4. Virus-like particles

A virus-like particle, or VLP, is a structure assembled from viral proteins. It resembles a virus but doesn’t contain the genetic material that would allow the VLP to replicate. For SARS-CoV-2, the VLP obviously includes the spike protein.

One coronavirus-like particle (Co-VLP) vaccine from Medicago has passed Phase I trials to test it’s safe and has entered Phase II to test that it’s effective.

While there are currently few VLPs being developed for Covid-19, the technology is well-established and has been used to produce commercial vaccines against human papillomavirus (HPV) and hepatitis B.

Viral components

All vaccines are ultimately designed to expose the immune system to parts of a virus, not the whole thing, so why not deliver just those parts? That’s the reasoning behind vaccines that only contain spike proteins or spike genes.

5. Proteins

Protein-based vaccines can consist of the full-length spike protein or the key part, the tip of the spike that binds the ACE2 receptor on the surface of a cell — ACE2 is the lock that a coronavirus picks in order to break into the cell.

Manufacturing vaccines containing the protein alone has a practical advantage: researchers don’t have to deal with live coronaviruses, which should be grown inside cells within a biosafety level-3 lab.

A vaccine against only part of the protein — a ‘subunit’ — will be more vulnerable to being rendered useless if random mutations alter the protein, known as ‘antigenic drift‘, but full-length proteins are harder to manufacture. The immune system can recognize either as an antigen.

One candidate vaccine based on protein subunits is ‘NVX-CoV2373’ from Novavax, where the spike subunits are arranged as a rosette structure. It’s similar to a vaccine that’s already been licensed for use, FluBlok, which contains rosettes of protein subunits from the influenza virus.

6. Nucleic acids

Nucleic-acid vaccines contain genetic material, either deoxyribonucleic acid or ribonucleic acid — DNA or RNA. In a coronavirus vaccine, the DNA or RNA carries genetic instructions for producing a spike protein, which is made within cells.

Those spike genes can be carried on rings of DNA called ‘plasmids’, which are easy to manufacture by growing them in bacteria. DNA provokes a relatively weak immune response, however, and can’t simply be injected inside the body — the vaccine must be administered using a special device to force DNA into cells. Four DNA-based candidates are in Phase I or II trials.

The two most famous nucleic-acid vaccines are the drugs being developed by pharmaceutical giant Pfizer, partnered with BioNTech, and Moderna. Pfizer’s ‘BNT162b2’ and Moderna’s ‘mRNA-1273’ both use ‘messenger RNA’ — mRNA — to carry the spike genes and are delivered into cells via a lipid nanoparticle (LNP). The two mRNA vaccines have completed Phase III trials and preliminary results suggests they’re over 90% effective at preventing Covid-19.

As the above examples show, not only there are many potential vaccines but also various approaches. And while some technologies have already provided promising results, it remains to be seen which will actually be able to defeat the virus.

Full coverage and live updates on the CoronavirusFollow me on Twitter or LinkedIn. Check out my website or some of my other work here

JV Chamary

JV Chamary

I’m a science communicator specialising in public engagement and outreach through entertainment, focusing on popular culture. I have a PhD in evolutionary biology and…

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TODAY

Dr. Ashish Jha, dean of Brown University’s School of Public Health, joins the 3rd hour of TODAY to break down the differences between Moderna’s and Pfizer’s coronavirus vaccine candidates. He also comments on speculation of another national shutdown and whether families should still get together over Thanksgiving. » Subscribe to TODAY: http://on.today.com/SubscribeToTODAY » Watch the latest from TODAY: http://bit.ly/LatestTODAY About: TODAY brings you the latest headlines and expert tips on money, health and parenting. We wake up every morning to give you and your family all you need to start your day. If it matters to you, it matters to us. We are in the people business. Subscribe to our channel for exclusive TODAY archival footage & our original web series. Connect with TODAY Online! Visit TODAY’s Website: http://on.today.com/ReadTODAY Find TODAY on Facebook: http://on.today.com/LikeTODAY Follow TODAY on Twitter: http://on.today.com/FollowTODAY Follow TODAY on Instagram: http://on.today.com/InstaTODAY Follow TODAY on Pinterest: http://on.today.com/PinTODAY#COVID19Vaccines#AshishJha#TodayShow

FDA Approves Remdesivir For Covid-19 Treatment

The Food and Drug Administration on Thursday approved remdesivir as a treatment for hospitalized coronavirus patients, Gilead Sciences said, making it the first FDA-approved drug for Covid-19.

Key Facts

The drug was previously granted an emergency use authorization in May, which allowed healthcare providers to administer the treatment even though it wasn’t formally approved by the FDA.

Remdesivir, which is sold under the brand name Veklury, “should only be administered in a hospital or in a healthcare setting capable of providing acute care comparable to inpatient hospital care,” Gilead said.

The drug is approved for adults and children 12 and older weighing at least 88 lbs. for coronavirus treatment requiring hospitalization.

Clinical trial data has been mixed: A randomized trial from the National Institute of Allergy and Infectious Diseases found remdesivir improved recovery time, but a study from the World Health Organization, which has not yet been peer reviewed, found last week the drug did not increase the chances of survival or result in faster recovery.

Gilead shares jumped 3.8% in after hours trading following the announcement. 

Crucial Quote

“It is incredible to be in the position today, less than one year since the earliest case reports of the disease now known as COVID-19, of having an FDA-approved treatment in the U.S. that is available for all appropriate patients in need,” said Gilead CEO Daniel O’Day in a statement.

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Key Background

President Donald Trump took remdesivir when being treated for the coronavirus earlier this month. Follow me on Twitter. Send me a secure tipRachel SandlerI’m a San Francisco-based reporter covering breaking news at Forbes. I’ve previously reported for USA Today, Business Insider, The San Francisco Business Times and San Jose Inside. I studied journalism at Syracuse University’s S.I. Newhouse School of Public Communications and was an editor at The Daily Orange, the university’s independent student newspaper. Follow me on Twitter @rachsandl or shoot me an email rsandler@forbes.com.

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Remdesivir is a prodrug of an adenosine triphosphate (ATP) analog, with potential antiviral activity against a variety of RNA viruses. Upon administration, remdesivir, being a prodrug, is metabolized into its active form GS-441524. As an ATP analog, GS-441524 competes with ATP for incorporation into RNA and inhibits the action of viral RNA-dependent RNA polymerase. This results in the termination of RNA transcription and decreases viral RNA production.

Remdesivir has an FDA Emergency Use Authorization for use in adults and children with suspected or confirmed COVID-19 in hospital with an SpO2 ≤94%.[L13239] This is not the same as an FDA approval.[L12609] The FDA Emergency Use Authorization suggests a loading dose of 200mg once daily in patients ≥ 40 kg or 5 mg/kg once daily in patients 3.5 kg to less than 40 kg, followed by a maintenance dose of 100mg once daily in patients ≥ 40 kg or 2.5 mg/kg once daily in patients 3.5 kg to less than 40 kg.[L13239] Patients not needing invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO) should be treated for 5 days (including the loading dose on day 1), up to 10 days if they do not show improvement.[L13239] Patients requiring invasive mechanical ventilation or ECMO should be treated for 10 days.[L13239]

Clinical trials used a regimen of 200mg once daily on the first day, followed by 100mg once daily for another 9 days.[A191931,L12174,L12177] Early data suggests that some patients may benefit from only 5 days of treatment.[A198810] Remdesivir was originally investigated as a treatment for Ebola virus, but has potential to treat a variety of RNA viruses.[A191379] Its activity against the coronavirus (CoV) family of viruses, such as SARS-CoV and MERS-CoV, was described in 2017,[A191382] and it is also being investigated as a potential treatment for SARS-CoV-2 infections.[A191427,A193254]

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CNBC Television 1M subscribers The FDA has approved Gilead’s Remdesivir as a Covid-19 treatment. Previously, the drug was approved only for emergency authorization. Gilead stock was up 4 percent after the news. Meg Tirrell joins ‘Closing Bell’ to discuss. For access to live and exclusive video from CNBC subscribe to CNBC PRO: https://cnb.cx/2NGeIvi » Subscribe to CNBC TV: https://cnb.cx/SubscribeCNBCtelevision » Subscribe to CNBC: https://cnb.cx/SubscribeCNBC » Subscribe to CNBC Classic: https://cnb.cx/SubscribeCNBCclassic Turn to CNBC TV for the latest stock market news and analysis. From market futures to live price updates CNBC is the leader in business news worldwide. The News with Shepard Smith is CNBC’s daily news podcast providing deep, non-partisan coverage and perspective on the day’s most important stories. Available to listen by 8:30pm ET / 5:30pm PT daily beginning September 30: https://www.cnbc.com/2020/09/29/the-n… Connect with CNBC News Online Get the latest news: http://www.cnbc.com/ Follow CNBC on LinkedIn: https://cnb.cx/LinkedInCNBC Follow CNBC News on Facebook: https://cnb.cx/LikeCNBC Follow CNBC News on Twitter: https://cnb.cx/FollowCNBC Follow CNBC News on Instagram: https://cnb.cx/InstagramCNBChttps://www.cnbc.com/select/best-cred…#CNBC

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This Japan Startup Is Using Deep Learning To Detect Early-Stage Cancer In Blood Samples

Imagine going for a routine blood test during an annual health checkup and being able to select a screening option that could tell you whether you have early-stage cancer. A Japanese startup is using deep learning technology to realize this dramatic advance in the fight against cancer, one of the top causes of death around the world.

A technician prepares samples at PFDeNA’s lab in Tokyo
A technician prepares samples at PFDeNA’s lab in Tokyo, where researchers are developing a screening system for early detection of cancer from blood samples. Japan BrandVoice

Unique skillsets

PFDeNA Inc. was established in 2016 as a joint venture between DeNA, a Japanese internet giant, and Preferred Networks, Japan’s leading artificial intelligence startup, to solve complex problems. One such problem is cancer detection.

PFDeNA’s cancer research can be traced back to the vision of one of Japan’s pioneering entrepreneurs. In 1999, Namba Tomoko founded DeNA, a mobile and online services company that had extraordinary success in e-commerce and gaming. Namba stepped down from her role as CEO in 2011 to care for her cancer-stricken husband, but her commitment to fighting the disease inspired DeNA to launch a healthcare business with its own bioscience lab in 2014. Meanwhile, Preferred Networks had been conducting research on cancer screening with National Cancer Center Japan since 2015, but needed a partner with expertise in lab operations and business. The two companies decided to use PFDeNA as a platform for collaboration, which began in 2018.

DeNA founder Namba Tomoko
DeNA founder Namba Tomoko’s commitment to fighting cancer inspired DeNA’s healthcare business. Japan BrandVoice

Led by board members including DeNA President and CEO Moriyasu Isao and Preferred Networks CEO Nishikawa Toru, PFDeNA is harnessing the power of deep learning, an artificial intelligence technique modeled on the brain, as a way to detect cancer as early as possible. To do that, the venture is building computer tools as well as a state-of-the art lab that will be able to find almost undetectable signs of cancer in routine blood samples. This “liquid biopsy” approach contrasts greatly with current methods such as radiographic imagining and tissue biopsies.

“We want to transform healthcare from a sick-care model, in which patients are cared for when they become ill, to one based on preventive medicine,” says Yoneyama Hiroshi, executive officer at DeNA and vice president of PFDeNA. With a background in business development and healthcare, Yoneyama is keenly aware of the challenges faced by the medical care system in Japan.

“There’s a dire need for early-cancer detection, not only in Japan but overseas as well,” Yoneyama says. “There are hurdles in the liquid biopsy field but we believe we can overcome them based on the strengths of our two founding companies.”

Each partner brings a unique skillset to the challenge. Preferred Networks’ specialty is developing cutting-edge AI solutions. DeNA is able to quickly make decisions on large-scale investments based on its long experience in mobile services. It’s also a player in the healthcare business, and has accumulated significant experience in negotiating with medical centers as well as lab operations. In 2014, DeNA began a direct-to-consumer genetic testing service called MYCODE, which can detect predisposition to a variety of illnesses. About 90% of MYCODE users have made lifestyle modifications to protect their health.   

Looking for molecular changes

PFDeNA aims to screen for 14 types of cancer, including lung and pancreatic cancer, and estimates the domestic market for such services could be worth about 400 billion yen ($3.8 billion). The startup is working to develop a system that can rapidly detect telltale signs of the 14 cancers with just one blood test. These can include changes in the number of molecules that can indicate the likelihood or presence of cancer.

Prostate-specific antigen (PSA), for instance, is a protein produced by the prostate gland that is used to screen for prostate cancer. Genetic mutations can also suggest whether a patient may be more likely to develop certain kinds of cancer. PFDeNA is examining the expression patterns of extracellular ribonucleic acid (exRNA) including microRNA (miRNA) as a potential screening tool for multiple types of cancer. Many cancer researchers expect that certain changes in these miRNA biomarkers can indicate the presence of cancer in various organs.

PFDeNA Vice President Yoneyama Hiroshi
Healthcare must be transformed from a sick-care model to one based on preventive medicine, says PFDeNA Vice President Yoneyama Hiroshi. Japan BrandVoice

“In addition to massive computational resources, high-quality data is indispensable for the high-precision deep learning computations needed to create an accurate screening system,” says Abe Motoki, a bioinformatics engineer at Preferred Networks. Abe is in charge of developing a predictive model using deep learning. He also has access to Preferred Networks’ computational resources including the MN-3 supercomputer, recently ranked as the world’s most energy efficient on the Green500 list.

“With a disease like prostate cancer, we only need to look at the levels of just one biomarker, PSA,” Abe says. “But with we are trying to detect multiple types of cancer by analyzing over a thousand exRNA expression levels, which is way more than humans can possibly handle. That’s why we need technology like deep learning.”

A powerful collaboration

Japan provides an ideal location for medical startups such as PFDeNA, in part because of readily available medical checkups covered by employers and municipalities, as well as a wealth of high-quality medical data. At its lab in Tokyo, PFDeNA is analyzing thousands of blood samples provided, with patient consent, by medical institutions such as National Cancer Center Japan. The company is working with more than 10 medical centers as it works toward its goal of building a rapid-screening system that could be part of annual medical checkups in the future. These partnerships, along with collaborations with industry and academia, form a solid foundation that’s giving PFDeNA the best chance of succeeding in its quest.

Abe Motoki, a bioinformatics engineer at Preferred Networks
An accurate cancer-screening system requires high-quality data, says Abe Motoki, a bioinformatics engineer at Preferred Networks. Japan BrandVoice

The Japanese government has also pivoted to support such efforts. With their universal healthcare system, Japanese tend to focus on treating problems, paying less attention to prevention. This tendency, along with the aging population, has increased demand for medical care. While grappling with these issues, the Japanese government is trying to transform the national healthcare system into one that focuses more on prevention. The state is also backing R&D projects in the field of early disease prediction and intervention through programs such as the Cabinet Office’s Moonshot R&D program.

“The Japanese government is very keen to come up with measures for cancer detection and prevention, so we fit into the context of what it’s doing,” says Yoneyama. “We were able to receive cooperation from more than 10 medical institutions because they’re working on this issue, and it’s now a trend. So Japan, as a government and as a whole, is very much backing this movement and taking leadership in this area.”

While PFDeNA works toward publishing the results of its research in academic journals, it’s consulting with the Pharmaceuticals and Medical Devices Agency, the authority responsible for certifying drugs and medical devices in Japan, in order to streamline approval of its services when they’re ready for the market. 

PFDeNA’s lab
PFDeNA’s lab has already processed thousands of samples in its quest to build an early cancer detection service. Japan BrandVoice

“Japan is an aging society, and early cancer detection is one way in which the burden of healthcare costs can be reduced,” says Ishikura Kiyo, associate director of PFDeNA’s healthcare business. “Liquid biopsies are a hot international topic right now. This service would be the first of its kind in the world and it’s a complex challenge to overcome. It’s a long-term journey but we have already begun.”

Note: All Japanese names in this article are given in the traditional Japanese order, with surname first.

To learn more about PFDeNA, click here (Japanese).  

To learn more about DeNA, click here.

To learn more about Preferred Networks, click here.

Japan

Japan

Japan is changing. The country is at the forefront of demographic change that is expected to affect countries around the world. Japan regards this not as an onus but as a bonus for growth. To overcome this challenge, industry, academia and government have been moving forward to produce powerful and innovative solutions. The ongoing economic policy program known as Abenomics is helping give rise to new ecosystems for startups, in addition to open innovation and business partnerships. The Japan Voice series explores this new landscape of challenge and opportunity through interviews with Japanese and expatriate innovators who are powering a revitalized economy. For more information on the Japanese Government innovations and technologies, please visit https://www.japan.go.jp/technology/.

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