Team:KU Leuven/HP/Gold Integrated

Human practices

In HEKcite we create an oscillating HEK-cell, but for what purpose? Therapeutic drug monitoring is our answer. In the treatment of multiple severe diseases, a stable concentration of drugs is crucial. Steady blood levels determine therapeutic outcomes and increase survival rates. Currently, the most common therapeutic drug monitoring technique is blood sampling. For patients who need lifelong observation, the numerous hospital visits and frequent blood samplings can have a negative effect on the quality of life. Therefore, we develop a system that allows patients to determine the level of drugs at home. Furthermore, the ease of these measurements allows for daily or even continuous analysis.

Using this dynamic data collection instead of the static measurements performed in hospitals today, we might increase both therapeutic outcomes and quality of life of patients. In order to investigate the different views on our projects we talked to specialists in several fields where therapeutic drug monitoring is of great importance: transplantations, epileptics and psychotics. Three specialists have provided insights in how they expect our project will influence the lives of their patients and future treatments. We used this information to further shape our project.

professor Diethard Monbaliu

Professor Monbaliu is a reputable abdominal transplant surgeon, at the department of microbiology and immunology at UZ Leuven, Belgium. He also part-time teaches the medicine students ‘topographical and radiological anatomy’ and supervises thesis students.

Professor Monbaliu confirmed that there is a need for a more dynamic measurement and a better evaluation of patients’ compliance which could result in less transplant rejection. He brought our attention to Tacrolimus, which is now the most used immunosuppressant. Furthermore, he mentioned the problem of patient variability and how our device should take this into account.

Before our meeting with professor Monbaliu, we were doing research on the immunosuppressant cyclosporine, which we thought was used most after transplantations to reduce the chance of rejection. However, professor Monbaliu clarified that it is not cyclosporine that is mostly used nowadays, but tacrolimus is. Both drugs have the same mode of action but tacrolimus has less side effects. We were interested in using tacrolimus for our research however the drug is too expensive for us to use. Therefore, considering the information professor Monbaliu gave us and our financial possibilities, we chose to use cyclosporine. Next to this, professor Monbaliu confirmed that there is a need for a more dynamic measurement and a better evaluation of patients’ compliance which could result in less transplant rejection.

Furthermore, the reduction of blood sampling is, according to the professor, a great advantage. However, a problem he brought to our attention was the fact that every patient is different which means that finding the optimal concentration of cyclosporine/tacrolimus is a challenge. Our device should thereby be calibrated individually for every patient. Bringing this information into account we considered that these differences and the problems that go with them could be assessed during clinical studies. Where different patients and their different values can be assembled, which can lead to procedures needed to determine the optimal drug concentration and calibrate our device.

professor Wim Van Paesschen

Prof. dokter Wim Van Paesschen is a neurosurgeon specialized in epilepsy. He also is head of the epilepsy research laboratory, part-time teaches at the faculty of medicine and supervises thesis students.

Professor Van Paesschen confirmed that therapeutic drug monitoring is necessary for anti-epileptics and mentioned the importance of verifying patient compliance. He also showed us that our project has more potential than even we imagined by giving some more examples of possible applications.

In light of our group focusing on drug monitoring as our target for human practices, anti-epileptic drugs seemed to be a quite interesting to research. Given that, we set a meeting with Doctor/Neurologist Wim Van Paesschen, a specialist in epilepsy. Prior to the meeting, our main interest was figuring out if drug monitoring was in fact needed for patients being treated from epilepsy, and it case it was, how could the concept of HEKcite come in handy for said patients. During the meeting, Prof. Van Paesschen showed a great deal of excitement and enthusiasm about the concept of HEKcite, assuring us that drug monitoring of anti-epileptics is indeed necessary, especially for patients suffering severe forms of epilepsy. There have been already various attempts to implement drug monitoring in epilepsy patients but none were quite successful. Since the concept of HEKcite mainly relies on different ion channels, his advice wasn’t to necessarily work with the most used anti-epileptics, but instead focus on those directly linked to the ion channels we are working with. Some of those include: Retigabine which opens potassium channels or ethosuximide which influences T-type calcium channels. Furthermore, some epileptics bind partially to albumin which hinders their activity. Nowadays laboratory tests can only measure the total concentration of anti-epileptics in the blood and not only the free, active concentration. Our system would be able to distinguish between the free, active versus the bound, non-active drug compounds. Another crucial point that was discussed during the meeting was what the patients would think/react to idea of an inserted monitoring device. He proceeded to say that field of “biosensors” is now a very interesting, growing field, and due to its simplicity and accuracy, it would be most welcome by patients. Prof. Van Paesschen was also so helpful, shedding light on a very important matter related to drug monitoring, that is, checking patients’ compliance. He mentioned how that is such a big problem especially with epilepsy patients, and that HEKcite could also be used to solve that problem. Last but not least, he gave a few suggestions for other useful applications that HEKcite could be used for. First of all he gave the idea of using our system as a form of personalized medicine. By using ion channels who contain the exact mutation of the patient, we could use our system to verify which drug is most effective specifically for the mutated channel of the patient. Next to this, he mentioned that epilepsy is often the result of multiple mutations in multiple channels. Our system could study the interactions between different ion channels and their mutation to further understand the mechanisms that can lead to epilepsy. These examples of the professor show again the diversity of our project and the great range of possible applications. All in all, the meeting was extremely helpful to us. We were able to leave the meeting with an answer to our original inquiry, that is, if the concept of HEKcite could be useful with patients with cases of epilepsy. We were also able to realize the full potential of the project and its various applications, giving us extra motivation and drive to move forward with our human practices.

professor Iemand anders

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Professor Victor Top

Always angry and disappointed with others. Mainly known as Victator.

Victator spotted in his natural habitat. His phone has our numbers. Will he or will he not call one of his slaves again? xoxo Gossip Girl

Before our meeting with professor Monbaliu, we were doing research on the immunosuppressant cyclosporine, which we thought was used most after transplantations to reduce the chance of rejection. However, professor Monbaliu clarified that it is not cyclosporine that is mostly used nowadays, but tacrolimus is. Both drugs have the same mode of action but tacrolimus has less side effects. We were interested in using tacrolimus for our research however the drug is too expensive for us to use. Therefore, considering the information professor Monbaliu gave us and our financial possibilities, we chose to use cyclosporine. Next to this, professor Monbaliu confirmed that there is a need for a more dynamic measurement and a better evaluation of patients’ compliance which could result in less transplant rejection.

Furthermore, the reduction of blood sampling is, according to the professor, a great advantage. However, a problem he brought to our attention was the fact that every patient is different which means that finding the optimal concentration of cyclosporine/tacrolimus is a challenge. Our device should thereby be calibrated individually for every patient. Bringing this information into account we considered that these differences and the problems that go with them could be assessed during clinical studies. Where different patients and their different values can be assembled, which can lead to procedures needed to determine the optimal drug concentration and calibrate our device.