Precision nutrition and precision medicine--individualized nutritional interventions and treatments--have the potential to dramatically improve human health, happiness and productivity, but what happens if it is only accessible to those with the financial resources to afford regular, costly lab tests?
A diagnostic platform being developed by researchers in the Institute for Nutritional Sciences, Global Health and Technologies (INSiGHT), housed in the College of Human Ecology (CHE), uses a mobile phone app and 3-D printers to provide a user-friendly, non-invasive and inexpensive test for disease, nutrition status and inflammation in as little as fifteen minutes.
The team, led by Dr. Saurabh Mehta, associate professor of global health, epidemiology and nutrition in the Division of Nutritional Sciences (DNS) and the Department of Global Development in the College of Agriculture and Life Sciences, has been awarded a $100,000 National Institutes of Health Technology Accelerator Challenge prize for their concept for a point-of-care, saliva-based test for malaria, iron deficiency and inflammation.
“Malaria kills nearly half a million people every year and affects many more people around the world. Iron deficiency is the most common micronutrient deficiency and leading cause of anemia, affecting over a billion people worldwide. Together, these conditions are major threats to human health and development,” Mehta said.
In 2018, there were 228 million malaria cases reported worldwide and 405,000 deaths. Treatment based on symptom presentation risks over-treatment and increased resistance to first-line drugs, as well as missing the underlying cause(s) of those symptoms.
“Iron deficiency is also common in these parts of the world,” Mehta said, “and iron supplementation without appropriate measures for malaria treatment and prevention in place can cause harm. Further, the assessment of iron status is often limited by the inflammatory response to disease as it affects the concentrations of the relevant biomarkers.”
In other words, iron status is partly assessed by detecting ferritin, the blood protein that stores iron, releasing it when needed by the body. In many disease processes, including infection, ferritin concentrations are often elevated but do not necessarily indicate excess iron in the body. A person could have both malaria and iron deficiency, but the body’s inflammatory response to malaria can result in inaccurate iron assessment. Simultaneous assessment of inflammation status can aid in determining underlying iron status accurately.
“Availability of accessible diagnostics for iron deficiency, inflammation and malaria are critically needed to enable comprehensive care, particularly for children in these settings. If we can develop a device that can empower community health workers or individuals to be able to concurrently assess malaria and anemia and provide individualized treatment, we would change the course of these diseases and the impact they have on people’s livelihoods and lives.”
The project builds on the FeverPhone and NutriPhone platforms developed by the INSiGHT team to use smartphones and blood samples to identify several infectious diseases and micronutrient concentrations respectively. Developing a saliva-based test would make the technology more accessible, easier to use and more suited to precision nutrition, which can require repeated testing to evaluate the effectiveness of interventions.
For all three platforms, the user acquires the sample and applies it to a test strip that is inserted into a 3-D printed cartridge adapter, or “reader,” that attaches to a phone and utilizes the camera for sample analysis. An app walks the user through the process with a step-by-step guide.
“We set out with the goal of developing a common platform for a whole portfolio of tests rather than a separate instrument for each test. Now, we are trying to figure out what body tissues are compatible with these analyses and how to make this approach non-invasive and more user-friendly,” Mehta said.
The prize-winning INSiGHT team includes David Erickson, the SC Thomas Sze Director and Sibley College Professor in Cornell’s Sibley School of Mechanical and Aerospace Engineering; Julia L. Finkelstein, associate professor of epidemiology and nutrition in DNS and in Global Development; and research associate Balaji Srinivasan and postdoctoral associate Bryan Gannon in DNS.
The myriad opportunities for this kind of multidisciplinary research was what drew Mehta to CHE. “This collaboration brings together different disciplines including nutrition, medicine, epidemiology and technology to target global health problems,” he said of working with Erickson. “We have been able to learn from each other and contribute to each other’s research programs, to be more than the sum of our parts. That’s the foundation that enables us to tackle some of these urgent public health problems.”
Learn more about the work of the Mehta Research Group.