The Beginning of Better Care
Singaporean invention has potential to raise quality of healthcare for liver patients globally.
BY SOL E. SOLOMON
PHOTOS HISTOINDEX, IE SINGAPORE
n 2010, Dr Gideon Ho and Dr Dean Tai created the world’s first fully automated stain-free imaging system for diagnosing liver diseases. Called Genesis®100, it gave a more accurate diagnosis of liver fibrosis, or the accumulation of tough, fibrous scar tissue in the liver caused by ongoing inflammation, compared to other methods available.
“There was no tool in the healthcare market that could accurately assess liver fibrosis at the time,” says Dr Ho. “Dr Tai and I discovered a new technology during our days in A*STAR (Agency for Science, Technology and Research Singapore) that could provide a more objective and accurate diagnosis of liver fibrosis, and pave the way for improved patient outcomes.”
“ Dr Tai and I discovered a new technology...that could provide a more objective and accurate diagnosis...and pave the way for improved patient outcomes. ”
Dr Gideon Ho, co-founder and CEO of HistoIndex
Dr Ho and Dr Tai left A*STAR, started HistoIndex, and set to work getting their smart digital pathology system into the global healthcare market. Their computer-assisted tissue diagnostic system broke new ground and set a new standard with its quantitative, stain-free, and high-resolution scanning. HistoIndex and Genesis®100 went on to win several awards, including National Instruments’ 2012 Best Innovation in Biomedical & Pharmaceutical Applications award, and A*STAR’s 2013 Scientist-Entrepreneur Award, as well as funding from SPRING Singapore’s 2010 Technology Enterprise Commercialisation Scheme. In 2014, the Genesis®200, which has the ability to detect fibrosis in other organs apart from the liver, and cancers as well, was launched. Manufactured in Singapore, it is now being used in animal and human studies of over 30 diseases in 18 organs, worldwide. Dr Ho says that US-based pharmaceutical companies are also using it as a clinical trial tool to assess the efficacy of their drugs in the final stages of obtaining U.S. Food and Drug Administration (FDA) approval.
The early days of getting their idea off the ground, however, were not easy. It took three years and a lot of perseverance. Dr Ho, CEO of HistoIndex, knew that the key to more effective treatment was greater accuracy in detection. But he and Dr Tai, HistoIndex’s chief scientific officer, found it difficult to convince researchers and clinicians to use the tool. Both had to convince them that the new tool could simplify their work, enhance their research process, and aid in diagnosing patients.
To overcome this, HistoIndex engaged researchers and clinicians throughout every stage of the Genesis® system’s development process. Prototypes were also put through proof-of-concept animal and clinical studies, as well as multi-centre trials. To convince the experts of the system’s strengths, clinical data from all studies conducted with key opinion leaders in their fields were also published in peer-reviewed medical journals, or presented at medical conferences.
Another initial challenge was finding a suitable contract manufacturer to build the Genesis®100 prototype. This was difficult because their brainchild was something that no one had ever seen, let alone built, before, says Dr Ho. A manufacturer with laser, optic, electrical, electronic, and mechanical capabilities, which could all operate as one precision engineering unit, was needed. They finally found one in Ireland, and once they were satisfied with the product, they moved production back to Singapore and kick started work on Genesis®200.
“We were greatly helped by grants from SPRING Singapore, and funding by our investors, in bringing our innovation to reality,” says Dr Ho.
DOORS TO NEW OPPORTUNITIES
Genesis®100 was discontinued in 2014 when HistoIndex started selling the Genesis®200 for research use. Dr Ho shares that clinical research has shown that patients benefit from at least a 30 per cent reduction in misdiagnoses with use of the Genesis® imaging system, and HistoIndex achieved more than S$2 million of income from this business segment during its last financial year.
As news of the Genesis®200 spread, more collaborations transpired with medical communities around the world. Today, HistoIndex works with about 100 institutions and 250 research groups worldwide, and they either use an in-house system they’d purchased, or send tissue samples to one of HistoIndex’s global partners (comprising hospitals, research institutes, universities, and contract organisations) for scanning. Scanned images are analysed by HistoIndex’s Singapore team.
Peking University People’s Hospital in China has been a Genesis® user and HistoIndex collaborator since 2013. The hospital and HistoIndex have jointly published in many international medical journals and presented at conferences; this has raised both their profiles in the public eye and opened doors for more partnerships and collaborations for both organisations.
Last year, HistoIndex facilitated a partnership between the Chinese hospital and Singapore’s Institute of Molecular and Cell Biology, A*STAR, for the Singapore-China Joint Research Programme. This resulted in a jointly funded project on liver fibrosis.
Professor Stephen Harrison, medical director, Pinnacle Clinical Research, and chairman of HistoIndex’s Scientific Advisory Board, addresses the global race towards a cure for Nonalcoholic Steatohepatitis (NASH). “The current gold standard has its limitations; we need a diagnostic tool that can power both clinicians to efficiently diagnose it, and pharmaceutical companies to effectively develop treatments based on a more quantitative assessment of NASH and fibrosis.”
Genesis®200’s recent winning of the 2017 Asia-Pacific Nonalcoholic Steatohepatitis (NASH) Diagnostics New Product Innovation Award is a glimpse into a future in drug development, something Dr Ho is confident will cement Singapore’s place on the world map as a premier medtech powerhouse.
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