There was money behind this vision: the British pharmaceutical giant GlaxoSmithKline announced a $1 million research prize, a $50 million venture fund, and an ambitious program to fund 40 researchers who would identify neural pathways that could control specific diseases. And the company had an aggressive timeline in mind. As one GlaxoSmithKline executive put it, the goal was to have “the first medicine that speaks the electrical language of our body ready for approval by the end of this decade.”
In the 10 years or so since, around a billion dollars has accreted around the effort by way of direct and indirect funding. Some implants developed in that electroceutical push have trickled into clinical trials, and two companies affiliated with GlaxoSmithKline and Tracey are ramping up for splashy announcements later this year. We don’t know much yet about how successful the trials now underway have been. But widespread regulatory approval of the sorts of devices envisioned in 2013—devices that could be applied to a broad range of chronic diseases—is not imminent. Electroceuticals are a long way from fomenting a revolution in medical care.
At the same time, a new area of science has begun to cohere around another way of using electricity to intervene in the body. Instead of focusing only on the nervous system—the highway that carries electrical messages between the brain and the body—a growing number of researchers are finding clever ways to electrically manipulate cells elsewhere in the body, such as skin and kidney cells, more directly than ever before. Their work suggests that this approach could match the early promise of electroceuticals, yielding fast-healing bioelectric bandages, novel approaches to treating autoimmune disorders, new ways of repairing nerve damage, and even better treatments for cancer. However, such ventures have not benefited from investment largesse. Investors tend to understand the relationship between biology and electricity only in the context of the nervous system. “These assumptions come from biases and blind spots that were baked in during 100 years of neuroscience,” says Michael Levin, a bioelectricity researcher at Tufts University.
Electrical implants have already had success in targeting specific problems like epilepsy, sleep apnea, and catastrophic bowel dysfunction. But the broader vision of replacing drugs with nerve-zapping devices, especially ones that alter the immune system, has been slower to materialize. In some cases, perhaps the nervous system is not the best way in. Looking beyond this singular locus of control might open the way for a wider suite of electromedical interventions—especially if the nervous system proves less amenable to hacking than originally advertised.
How it started
GSK’s ambitious electroceutical venture was a response to an increasingly onerous problem: 90% of drugs fall down during the obstacle race through clinical trials. A new drug that does squeak by can cost $2 billion or $3 billion and take 10 to 15 years to bring to market, a galling return on investment. The flaw is in the delivery system. The way we administer healing chemicals hasn’t had much of a conceptual overhaul since the Renaissance physician Paracelsus: ingest or inject. Both approaches have built-in inefficiencies: it takes a long time for the drugs to build up in your system, and they can disperse widely before arriving in diluted form at their target, which may make them useless where they are needed and toxic elsewhere. Tracey and Kristoffer Famm, a coauthor on the Nature article who was then a VP at GlaxoSmithKline, explained on the publicity circuit that electroceuticals would solve these problems—acting more quickly and working only in the precise spot where the intervention was needed. After 500 years, finally, here was a new idea.
Well … new-ish. Electrically stimulating the nervous system had racked up promising successes since the mid-20th century. For example, the symptoms of Parkinson’s disease had been treated via deep brain stimulation, and intractable pain via spinal stimulation. However, these interventions could not be undertaken lightly; the implants needed to be placed in the spine or the brain, a daunting prospect to entertain. In other words, this idea would never be a money spinner.
The vagus nerve runs from the brain through the body WELLCOME COLLECTION
What got GSK excited was recent evidence that health could be more broadly controlled, and by nerves that were easier to access. By the dawn of the 21st century it had become clear you could tap the nervous system in a way that carried fewer risks and more rewards. That was because of findings suggesting that the peripheral nervous system—essentially, everything but the brain and spine—had much wider influence than previously believed.
The prevailing wisdom had long been that the peripheral nervous system had only one job: sensory awareness of the outside world. This information is ferried to the brain along many little neural tributaries that emerge from the extremities and organs, most of which converge into a single main avenue at the torso: the vagus nerve.