MANHASSET, NY — Zucker School of Medicine professor of medicine and Feinstein Institute for Medical Research investigator, Larry Miller, MD, has received a one-year, $1.4 million grant from the National Institutes of Health (NIH) to develop and test a non-invasive method that accesses nerves in the chest and abdomen. Gaining non-invasive access to these nerves has the potential to drive development of bioelectronic medicine devices for treatment of conditions like obesity, heart failure and pulmonary hypertension.
The Feinstein Institute is the scientific home of the emerging field of bioelectronic medicine, which combines neuroscience, molecular biology and bioengineering to tap into the nervous system to treat disease and injury without the use of pharmaceuticals. Two primary discoveries made in this field are that inflammation plays a role in virtually all diseases and that inflammation can be modulated through a nerve in the neck called the vagus nerve. Researchers have shown that devices can be implanted directly on the vagus nerve in the neck. Dr. Miller aims to access branches of the vagus nerve that are closer to organs in the chest and abdomen so that he can stimulate at the site where the issue is taking place.
“Many of the conditions bioelectronic medicine targets, like Crohn’s disease and diabetes, are caused by malfunctions of organs in the abdomen,” said Dr. Miller who is also chief of division in the Gastroenterology department at North Shore University Hospital and Long Island Jewish Medical Center. “With the support of the NIH, my team will explore how we can access branches of the vagus nerve near these organs using endoscopy technology and develop stimulation devices that are implanted using this non-invasive technique.”
The obstacle to stimulating nerves in the chest and abdomen has been that it requires invasive surgery to gain access to the nerves. Dr. Miller believes an endoscopy technique called transmural endoscopy could provide a solution. Transmural endoscopy uses Z-track technology to tunnel through the stomach or esophagus to access nerves close to the organs. Dr. Miller will develop a method to implant the device on a nerve which controls these organs. The vagus nerve runs along the esophagus and stomach. It then branches out to innervate the lungs, heart, liver, pancreas, small intestine, colon, stomach and esophagus, which could all be potential stimulation targets for bioelectronic medicine.
“Advances in bioelectronic medicines using surgical implants for Crohn’s disease and other gastrointestinal syndromes are occurring at a rapid pace,” said Kevin J. Tracey, MD, president and CEO of the Feinstein Institute. “Dr. Miller’s proposed solutions to miniaturize devices and insert them through endoscopy onto vagus nerve branches represents an extraordinary opportunity to accelerate development of future cures for patients.”
Feinstein Institute for Medical Research