The Edge of Medicine
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|Rob Norman MD||December 17th 2015|
Cutting Edge contributor
â€œI call heaven and earth to record this day against you, that I have set before you life and death, blessing and cursing: therefore choose life, that both thou and thy seed may liveâ€
On my many trips to Israel as the national chairman of the Jewish National Fundâ€™s Doctors for Israel, I have observed the amazing life-saving and life-enhancing advances of Israeli medicine and discussed the future of medicine and science with many leading scientists.
I visited the makers of Rewalk robotic exoskeleton (featured on the hit TV show â€œGleeâ€) that enables paraplegic runners in London and Tel Aviv to complete marathons and spent time at Given Imagingâ€™s PillCam capsule endoscopy company. Among other Israeli medical leaders are Itamar Medicalâ€™s fingertip monitors for sleep disorders and cardiac issues, IceCure Medicalâ€™s IceSense3 and Surpass Medicalâ€™s NeuroEndoGraft.
The list of amazing technologies provided by a country of only 8 million people keeps growing. Among the numerous people on the cutting edge of Israeli medicine and science is Eran Perry, managing director at Israel Health Care Ventures (IHCV), one of the largest venture capital funds in the country. â€œItâ€™s almost a clichÃ© to say Israel is an excellent place for medical innovation,â€ she said. â€œBut if you look at global statistics, itâ€™s evident â€” from total expenditure on civilian R&D, where we are ranked first; to human infrastructure and entrepreneurship, where we rank in the top five. You can see the results in patents. We are first in the world for medical device patents per capita, and second in Europe for bio-pharma.â€
I believe this is one of the most important times in the history of medicine and science and that Israel plays a key role. According to the newest data, more than 1,000 Israeli companies are in healthcare or life-science products, including 700 in medical devices, and approximately half are already generating revenue. I will provide compelling ideas on why Israel is a world center in innovation and highlight a number of accomplishments by Israeli medicine and science companies.
The Medical and Science Entrepreneurial Spirit in the Start-up Nation--Why Israel and the Jews?
My belief is the medical and science entrepreneurial spirit resides not just in Israel, but in Jews, and promotes an innovative culture. Not always satisfied with what the world currently offers (we like to kvetch), there is a drive to improve life and perform Tikkun Olam (repairing the world) whenever the opportunity arises and is reflected in the numbers of Jews in medicine and the helping professions. At least 181 Jews and people of half- or three-quarters-Jewish ancestry have been awarded the Nobel Prize, and 22% of all individual recipients worldwide between 1901 and 2010 and 36% of all US recipients during the same period were Jewish. Of all organizations awarded the Nobel Peace Prize, 25% were founded principally by Jews or by people of half-Jewish descent. Not bad, considering Jews currently make up approximately 0.2% of the world's population. Of course, many Jews in national and local environments have also done their share.
As Jews, we have an enormous precedent in making history in medicine and science. Reverend Eric Strachen recently wrote an essay about the Jews where he pointed out Jewish achievements in the whole field of medicine. He writes, â€œIt was Richard Lewisohn, a Jew, who developed the technique by which blood could be stored by using an anticoagulant. Another Jew, Richard Weil, devised how it could be refrigerated, thus permitting the creation of the first blood banks. It was Lewisohn again, in partnership with another Jewish researcher, Karl Landsteiner, who is credited with inventing the modern blood transfusion. Their discoveries have saved billions of lives. It would be fair to say that if you've ever received a blood transfusion you've a Jew to thank for it.â€
Strachen continues, â€œTuberculosis was once a deadly disease but Selman Waksman and Albert Schatz created streptomycin, the first effective antibiotic to combat TB. It was Paul Zoll who invented the cardiac defibrillator, the external pacemaker, and the cardiac monitor. Henry Heimlich invented â€œThe Heimlich Maneuverâ€ which when employed has prevented many from choking to death. In the 20th century Abel Wolman determined a means by which water worldwide could be chlorinated, and deaths due to cholera, dysentery and typhoid could be eradicated. Charles Kelman developed the technique for cataract removal and eye lens implantation. Three Jewish men in research partnership invented cancer chemotherapy. Jewish research and ingenuity by Barnett Rosenburg have now made testicular cancer in men 90 per cent curable.â€
As Strachen highlights, the Jews helped develop the hepatitis-B vaccine, the Wasserman test for syphilis. The vaccines by Salk and Sabin have virtually eliminated polio and are estimated to have prevented half-a-million new cases of lifelong paralysis each year. â€œThe contribution made by Jews in the whole field of medicine and science is nothing short of astounding. For sure without the impact and inventiveness of the Jewish people in the field of medicine, countless billions would be dead,â€ Strachen writes. â€œMaybe you're alive today because of a Jew.â€
The new contributions made by the Israelis and Jews were founded on the springboard of the hard work and dedication of past Jews everywhere. Strachen points out that Leslie Flynn, in her book What the Church Owes the Jew, wrote, "If an anti-Semite decided to boycott all the tests and cures discovered by the Jews, he (or she) would certainly open themselves to a host of serious diseases."
Why have the Jews succeeded when so many others have failed? For an answer, we can open the Torah and read the words of God to Abraham. God said, "I will make you into a great nation and I will bless you; I will make your name great, and you will be a blessing. I will bless those who bless you, and whoever curses you I will curse, and all peoples on earth will be blessed through you." (Genesis 12:2-3). As the good reverend Strachen writes, â€œThousands of years later He is still using them to bless humanity.â€
Amazing Innovations in Medicine and Science
Israel is filled with superstar medical and science companies. The ReWalk Rehabilitation model currently is used by patients in rehab centers all over the world; the ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with spinal cord injury. Sensors in the device detect subtle shifts in the userâ€™s center of gravity and upper-body movements and automatically translate these shifts into movement of its motorized leg joints. The ReWalk device allows the user to stand upright, walk, turn, and climb and descend stairs and is the only FDA cleared exoskeleton for rehabilitation and personal use in the United States. The new modelâ€”the Personal 6.0--is worn outside the clothing and is attached to the user via leg braces and a harness and provides a more precise custom-fit system. / http://rewalk.com/rewalk-personal-3
Using the technology provided in Given Imagingâ€™s PillCam capsule endoscopy a physician has a way to see inside a patientâ€™s GI tract by having them simply swallow a pill-sized camera. More than 1.5 million patients have experienced the benefits from PillCam capsule endoscopy to visualize the small bowel, esophagus with a small, disposable capsule used to monitor and diagnose disorders of the gastrointestinal tract without sedation or invasive endoscopic procedures. The PillCam to view the colon has been developed and waiting final approval.
The mission statement of Itamar Medical reads: Itamar Medical is dedicated to the research, development and commercialization of a wide range of medical products based on the PAT (Peripheral Arterial Tone) Technology in order to improve the quality of healthcare. The PAT signal is described as a non-invasive "window" to the cardiovascular system and the autonomic nervous system and Itamar Medicalâ€™s fingertip monitors are used for sleep disorders and cardiac issues. New diagnostics are currently in development to help pharmaceutical companies preselect those patients most likely to benefit from and exclude those likely to be harmed by a new drug. http://www.itamar-medical.com/EndoPAT%E2%84%A2/PAT_Technology
IceCure Medicalâ€™s IceSense3 has been used by US doctors since 2011 to remove benign breast lumps in a 10-minute ultrasound-guided procedure that penetrates the tumor and engulfs it with ice and is being clinically tested against small malignant breast tumors as well. Surpass Medicalâ€™s NeuroEndoGraft flow diverters redirect blood flow from a brain aneurysm (a bulge in a weak artery wall), so that a stable clot can form and the potentially fatal aneurysm no longer is in danger of rupturing.
Whatâ€™s in the Future?
Money is funneling into many Israeli start-ups, including several under the umbrella of Trendlines. The Trendlines Groupâ€™s tagline states the group â€œcreates and develops companies to improve the human conditionâ€ and â€œinvents, discovers, invests in, and incubates innovation-based medical and agricultural technologies.â€
Gordian Surgical, a portfolio company of Trendlines Medical, recently announced the completion of a raise nearing $1 million, including an investment from Virtus Inspire Ventures, a Chinese venture capital firm. Gordian has developed an innovative trocar that offers surgeons a simple, economical solution for opening and suturing (closing) internal incisions made during laparoscopic surgery. Despite the more than 10 million laparoscopic surgeries performed worldwide, the challenge of closing the abdominal incisions remains time-consuming, requires expertise, and poses risks of post-operation complications such as hernias.
ApiFix, another Treadlines company, was Awarded Best Start-Up 2012 by Israelâ€™s Office of the Chief Scientist of the Ministry of Economy for a less invasive, less painful, and less costly option for spine curvature correction. Apifix is developing a truly breakthrough minimally invasive deformity correction system for patients with Adolescent Idiopathic Scoliosis (AIS).
Todayâ€™s gold standard for correcting spinal deformities involves fusing an average of 10 motion levels using a large number of screws in a surgical procedure that lasts an average of six hours and costs upward of $100,000. As opposed to the current procedure, ApiFix uses only two screws to support its ratchet-based, small expandable rod inserted through a small incision in the patientâ€™s back. In addition to the smaller incision, a shortened surgery time (1 hour vs. 4-6 hours) and reduced hospitalization stay.
Gamida Cell, headquartered in Jerusalem, Israel, has developed many exciting new products. A leader in immuno-oncology, the company develops alternative treatment to bone marrow transplantation for patients with high risk leukemia and lymphoma treatments using stem cells and Gamidaâ€™s NK cell product. Gamida has another product being tested as a potential cure for sickle cell disease (SCD) and thalassemia.
Gamida Cell signed an investment and option agreement with Novartis who invested $50 million. Gamida Cell president and CEO, Yael Margolin, Ph.D. commented, â€œWe are very pleased to receive continued support from Novartis. This support is testament to the potential of Gamida Cellâ€™s immune therapy platform and its potential to improve outcomes for patients with diseases like leukemia and lymphoma who need a bone marrow transplant but who do not have a matched related donor.â€ Gamida Cell is also supported by a group of investors including Israel Healthcare Venture and
Teva Pharmaceutical Industries.
How will more and more needy people get access to these amazing technologies? Through the work of innovative service providers such as Hadassah Hospital and Rambam Medical Center, the fruits of rigorous medical research will pay off in lives changed and saved. Groups such as the Jewish National Fund are improving access to care, often in
more remote places such as Halutza and the Central Arava, by building new medical centers to
serve groups of Israelis.
During this time of unique importance in the world of medicine and science, Israel is a shining star in following the basic principle set forth in Deuteronomy: Choose Life. As it has with other innovations in this Start-up Nation, Israel will help save the world.
Dr. Normanâ€™s upcoming book is Choose Life: How Israeli Medicine and Biotechnology Will Help Save The World. Dr. Rob Norman can be found at email@example.com.