Injecting optimism into healthcare’s future

Throughout history, great scientists have struggled for years to develop vaccines to cure plagues and pandemics. Not this time. Amid the pain and loss of Covid-19, the speed of the creation, testing and roll out of the anti-viral inoculations has highlighted spectacular advances in scientific discovery.

It took just four days to sequence the genomic code and design a vaccine for Covid-19. That success has immediate implications for dealing with the pandemic, but it’s also good news for the search for cures for other diseases, according to Julia Angeles.

In her view, the pace of the global response was thanks to the pre-existing technology of genome sequencing, which could ‘read’ the virus’s genomic signature.

“[Researchers] have been experimenting with this tool for more than a decade, and continuously reducing the cost and increasing the precision of the technology. And, because of these advances, we could read and analyse the genome of the virus in such a short time.”

Vaccine technologies can now use entirely new approaches, relying on innovations such as the use of messenger RNA (mRNA), the genetic instruction that the body ‘translates’ into proteins. The approach could help companies such as vaccine pioneers Moderna lead the world in treatment of the four big killers: autoimmune disease, cardiovascular disease, cancer, and infectious disease.

In the case of the highly infectious Covid-19, mRNA vaccines artificially introduce into the body the now-notorious ‘spike’ protein, that causes the virus to attach itself to cells. Preventing attachment means preventing infection. Injecting this alien virus protein instructs the cells to create antibodies, causing it to be excreted from the cell.

According to Angeles, recent developments in medicine resemble digital technologies rather than the products of life science industries. The ability to manipulate genetic data has been transformative for vaccine production and was also a factor in the fight against Covid-19. That technology offers a broad, and growing, range of therapies.

“What most people understand from how mRNA works in vaccines, the next big application is actually to apply the same concept to oncology. So, companies such as Moderna, BioNTech, and CureVac are leading in mRNA, and all of them are working on personal vaccines for cancer.” Angeles talks with enthusiasm about how the mRNA vaccines could “leverage the immune system” to recognise cancerous cells, and then kill them. “It’s a genuine paradigm shift” she says.  

Such discoveries could benefit Baillie Gifford’s Health Innovation Fund, which seeks to invest in ground-breaking companies using technology to accelerate the pace of medical evolution. At the moment, that evolutionary path leads to the intersection of healthcare and technology.

Angeles offers the example of a portable ultrasound machine, saying, “Currently, ultrasound is performed in hospitals, in a dark room with a massive machine operated by a highly-trained person. It takes skill to acquire the image and to make an interpretation. And it’s also quite an expensive diagnostic tool. For this reason, two-thirds of the world doesn’t have access to ultrasound technology.”

There are early steps towards remedying this through the work of companies such as Butterfly Network, which has invented  a portable device. It also addresses cost, being a hundred times cheaper than a traditional machine.

It’s little wonder that Angeles and her colleagues are excited by the developments they’re seeing. She herself has a long-standing fascination for “how the human body works”, which combines well with her studies in economics and her experience as a fund manager.

“When you see what’s happening with the proliferation of all the tools that really help us to understand, actually, how we function as very complex human entities, that is probably the most exciting thing.”

Julia Angeles, investment manager.

Her fascination extends to other emerging technologies, including imaging of the brain, and the use of stem cells to conduct research into Alzheimer’s disease. This, in turn, can direct work that aims to find treatments for brain diseases, another field of special interest to Angeles, as are ways of cracking the problem of the body’s ‘blood-brain barrier’ which makes drug therapies hard to apply.  

“Only recently, we’ve started making some big steps towards finding solutions on how we can bypass that challenge. Companies like Denali are making a lot of progress in getting round the blood-brain barrier, and actually, they have already demonstrated, through their technologies, that they could get through that challenge.”

The benefits are potentially massive: “On one hand, we start understanding better what drives brain diseases, but on the other hand, we also have tools to get access to the brain. So, this will be transformational for the brain biology in the long term. ”

After all the pain and adversity caused by the pandemic, Angeles’ injection of optimism about the future of healthcare has, it seems, a solid basis in science.

Words by Colin Renton

If you’d like to learn more about how messenger RNA vaccines are disrupting drug discovery, listen to our podcast, Short Briefings on Long Term Thinking. You can find the podcast at bailliegifford.com/podcasts