The human body holds the secrets of disease, from compounds in our breath to microplastics and protein pattern fingerprints hiding within our blood, foretelling potential illness long before symptoms may appear. Dr. Stephen Williams, Chief Medical Officer of Standard BioTools, Dr. Max Allsworth, Chief Science Officer of Owlstone Medical, and Dr. Kari Nadeau, Chair of the Department of Environmental Health at Harvard Chan School of Public Health, shared their work — and technologies — that are uncovering these once-hidden biomarkers during the “Blood (Proteomics), Breath and Microplastics” session at DOC 2025, moderated by Parneet Pal, founder of Systematically Well Advisory.
Dr. Allsworth’s at-home breath test is undergoing clinical trials and has detected lung cancer with a nearly 70% sensitivity, even at the earliest stages. Dr. Nadeau’s lab is developing a “fingerprint” of microplastic exposure from just two drops of blood, pinpointing the source, whether that’s polyethylene from face scrubs to rubber particles from cooking equipment. Dr. Williams’ proteomics platform decodes our body’s proteins, uncovering cardiovascular concerns, metabolic dysfunction, and cancer risk. All three also featured prominently at this year’s Living Room Lab, where the DOC community had the opportunity to engage with these next-gen technologies.
The importance of this work is clear: early detection can catch diseases and other ailments while they’re still treatable. Or as Dr. Nadeau notes, “We can measure, we can monitor, and then we can manage.”
You can hear from this panel in the video of the session, or read our lightly edited transcript below.
TRANSCRIPT:
Parneet Pal
Back in the 19th century, there was a statistician in Britain by the name of George Yule, and he famously said that in our last full measurement, we often measure that which we can, rather than what we wish to measure and forget that there is a difference. This is a challenge that all of our remarkable panelists today will be tackling, because they are sort of at the forefront of figuring out the next generation of biomarkers.
Welcome. Max Allsworth, Kari Nadeau and Stephen Williams. But before we get into all of this, I wanted to spend just a quick minute with all of us reflecting both on the utter beauty, but also the unfathomable complexity of the human body that all three of our panelists are dealing with. So if you would please, humor me for just a minute. I’d love for you to bring your attention to your body. I want you to see if you can imagine the 30 trillion cells with 14 quadrillion mitochondria, while also connected to the 30 trillion bacteria, viruses and fungi that make up your microbiome and all of these cells. Even in this minute, they are listening to the rhythm of your life.
How you eat, how you move, how you sleep, how you manage your stress, who you connected with last night at the party, how much time you spend in nature, as well as all the chemicals that you are exposed to, including the 8.3 billion metric tons of plastic that you and I have consumed that’s in our landfills, but also seeping into the air that we breathe, the water that we drink, and the soil that our food is grown in.
All of this constitutes our exposome, right? All of our exposures from the moment of conception to the day that we die, and as our cells try to make sense of this exposome in order to keep us healthy, they engage more than 19,000 of your genes that express more than 30,000 proteins that make everything possible. Your growth, your repair, the cell communication, the more than 1 billion metabolic reactions that happen every single second in your body.
Then all of this blood goes through your lungs in about, you know, every minute and you breathing when you breathe. Right now, for example, we breathe 22,000 breaths in a day and we exhale 11,000, liters of air that contains not just carbon dioxide, but up to a thousand organic volatile compounds. So our body is truly a wonderland, and health is not something static. It’s a dynamic conversation between our inner and outer ecologies. As we dive into this panel today, what our, brilliant experts are going to shine a light on is how do we make sense of this complexity? How do we come up with biomarkers that are not just sensitive but also accurate, that are dynamic, that are cost effective? So that, clinicians and researchers have a more nuanced view of health? The way this is going to work is we are going to do a lightning round of talks. Then we’re going to talk to each other for just a little bit. But then we mostly want to hear from you. Please keep your questions and your comments ready to go, so that we can end on time.
First off, it’s my great pleasure to introduce Dr. Max Ellsworth. He is the chief science officer at Owlstone Medical, and he is going to take us on a journey of breaths and volatile signatures. Max, please.
Max Ellsworth
I’m going to talk today about his breath analysis, and how it can be used and how it can be used in the home by everyone.The first thing is why have you got so many chemicals on your breath? They represent pretty much everything you’re exposed to in your in your lives. They’re the food you eat, the things you drink, the chemicals in the environment. But they’re also representative of what your body’s doing that endogenous compounds that are generated as you process sugars, as your muscles operate, these these mixtures of chemicals, represent that that everything that’s happening in your body and the exposure and the risks that you’re involved with.
thing that Owlstone has been doing is building up an atlas of all these chemicals. With the support of one of our investors the Gates Foundation., we also built an interactive, sample biobank that links all those different chemicals in breath to the patient data that’s there, where we can play models to understand what’s happening. There’s all these compounds on breath. But what can you do with them? I’m going to tell you quickly three examples of tests under development agreement. Some are already available. This one’s a the device is FDA-approved, others, so in late stage clinical trials, so this first one is talking about hydrogen and methane on breath. Now this comes from your microbiome. When you eat any carbohydrates, they need to be broken down by the bacteria in your gut. Now, if some of these bacteria aren’t in the right place or they’re too many certain types of bacteria, that fermentation produces gases, hydrogen and methane. They drive some of this cold comfort, bloating and all the side effects of IBS.
Being able to measure those all the time, gives you great capabilities in diagnosing problems. This device is a pure point of care device, something you can take home with you, links to your phone, the app that it’s connected to tracks symptoms, your food, and the hydrogen methane and provides the information to a doctor to be able to make clinical decisions.
A quick example of that, this is a case report of something you could never do with regular with standard testing at the moment, because you wouldn’t have a number of data points. Each one of these blue dots is a measurement of, of methane, one of the two gases this device is measuring. Every day they were taking multiple measurements of the methane as they ate different foods. These methane levels for this patient was particularly high. It was causing all sorts of G.I symptoms. The doctor was consulted, they identified, message ionic, overgrowth. So too much of a certain type of bacteria, and they’re given an antibiotics regime that’s just a standard of care. But as you can see, after that, at first, antibiotic dose, it didn’t it knocked it down a bit, but it didn’t solve the problem.
Normally in this case, they would have gone on to something else. But the doctor quick look and say it did do something. It was just it wasn’t an option of treatment. So a second treatment knocked it down. This is where this sort of, continuous information, the amount of data you can get from a breath sample, which is available all the time, you can always breathe.
We’ve got other problems. Let’s a patient take many samples and really delve deeply into the data that can be generated. But that’s not the only application. So we’ve been exploring, another big problem in the world is, liver disease. Especially advanced liver disease. And the kicking into cirrhosis and decompensated cirrhosis. The problem is definitely real because it’s most often diagnosed in emergency rooms. So 50% up to 75% of people get find out their life is decompensated, and it’s too late to do anything about it in an emergency room. So there’s definitely something we’re not doing right today. Here we were looking at this thinking like, how can we use a breath test to help us? You test your liver every day when you eat food, drink, drink, particularly alcohol. Your liver is there to take the chemicals out of your bloodstream, metabolize them away so they’re safe. So every time you eat, you are challenging your liver. If your liver is not very well working very well, and you drink a glass of orange juice instead of those, compounds in there being sucked out of the bloodstream and processed away. They go straight into your circulatory system, and they’re being continuously breathed out. So you can make a test with orange juice and a breath test. We went slightly more controlled than how much pulp is an orange juice to how much compound you receive, and build a small test where you receive a compound, a cocktail of compounds, those three compounds that you drink, a few minutes later, you take a breath test.
What this is doing is looking at how those compounds are extracted from the liver and how they were metabolized. So a simple core function or test of the liver, now, you might think there are lots of really simple liver function tests out there already. There are things that called liver function blood tests. But in fact, these really look at how much damage the damage markers in the liver. They’re not telling you how much function the liver has, and its imaging techniques, as you say, ultrasound and, things to measure the fibrotic state of the liver. But again, they’re looking at the damage, not how well your liver is working.
Having these sort of tools that let you really screen what the liver is functionally doing, lets you, well, test only what’s happening to liver, but also these tests, like, can post them out to someone. They bring screening to everyone. You can try and reach these patients that otherwise wouldn’t be found. So they hit the emergency room and if you get them early, you don’t have the treatment can be lifestyle. There are a couple of drugs now. It’s much simpler treatment if they’re caught late. Treatment is very difficult. So the final one is lung cancer the biggest cancer killer in the US. And this is what our stone was founded on, after the medical was founded on it was trying to find a way to get lung cancer tests to, the individual in the home.
There are tests out there at the moment. They have limitations. They either can’t detect cancers at the earliest stage when, a, treatment is most effective or they require hospital visits. People are resistant to it, and their compliance is really poor, like, low dose CT, is no co-pay free in the US. Only 4% of people comply with it, and state to state that’s in some states it’s incredibly low. So people just don’t want to do the test. So if we can bring a test to a patient, we can hopefully increase the compliance rate as long as we can get not good enough sensitivity. Early stage, and I talked about using a probe, taking something and testing your liver.
We’ve taken exactly the same approach with lung cancer. So here we’ve looked at an inhaled probe and inhaled compounds that you breathe in. And then this reacts with, certain enzymes in the tumor microenvironment and you breathe it out again. So this is a test that again can be done at home. There is no limitations, on who can do it as long as you can, so easily suck in a dry powder from an inhaler, like many children do for asthma. Wait a few minutes and breathe out into a collector. This gives you a at home, hopefully highly compliant test. We started this test without in, without using an inhaler form. We injected the probe into patients. We formed a stage two trial last year. Last year, and even at the earliest stage from cancers, we were already getting, close to 70 or 68.5% sensitivity.
So you can detect cancers this early using these sort of approaches. And we’re aiming to, well, we’re running a stage one this week, on our inhaled probe where we hope to make this test usable for everyone. Okay. And I’ll just close up. I’ve given a whistle stop, the different applications you can use for breath. You can see this is a thread through them. It’s about getting these diagnostic tests into the home. Maximizing compliance, finding diseases as early as possible, where they’re easily treatable. And I think it fits with what other speakers have been talking about. Prevention. These are all hitting the diseases when they’re asymptomatic early enough that you can make a difference, maximizing health, for as long as possible for everyone.Thank you very much. Fantastic.
Pal
Thank you so much. Stuff that always was. Next up we have Dr. Kari Nadeau, who is going to talk to us about the ramifications of the plastic both outside and inside us. She is a John Rock Professor of Climate and Population Studies and the Chair of Environmental Health at Harvard Chan School of Public Health. Please take it away.
Kari Nadeau
Thank you. It’s great to be here. I’m excited to talk to you about something that’s on many people’s minds today. But importantly, it’s also in your mind and I’ll talk about that. So we are in an era called the Pleistocene era. This is taken from Texas, where one of their floods deposited a lot of plastic in one particular layer. This is not just in Texas. This is in many parts of the US as well as the world. That plastic will probably last for thousands of years. You see this embedded in the Earth. Unfortunately, plastics are also embedded in our body. With that in mind, how do they get into our body? Well, microplastics versus nanoparticles are important because size matters.
Anything less than about a millimeter is called a microplastic. Anything that’s less than about a micrometer is called a nano plastic. Why is that important to you? Because these can be absorbed through the skin. They can be absorbed through the gut, they can be inhaled as well. That’s a problem in terms of overload of plastics in our bodies. This is just what we breathe in. For example, how many of you heard that you eat about a credit card’s worth of plastic a week? In Indonesia, it’s about a day, but that’s just eating. That’s just through our gut. This is inhaling. I’ll talk about this as well. But we have about over a year. The height of two giraffes over a lifetime, potentially the height of the Eiffel Tower. In places like Indonesia, the height of a mountain. When we think about what we’re doing and how we’re getting exposed to microplastics in nano plastics, it’s through bottled water. Water that’s in bottles that are plastic. It’s through beer. It’s through air. You notice I didn’t put wine on this list. We don’t know that data yet. Tap water, seafood, sugar, salt and honey.
Importantly, per year, the average person is consuming between 70,000 to over 200,000 particles of plastic. Why is that important? We know a lot about how in marine life, how they break down these plastics, and there’s about 14,000 different chemicals in a typical plastic mixture. Of that 14,000 chemicals, about 4000 are known to be toxins, toxins to the planet, toxins to marine life, toxic to humans. What happens is they break down and they break down into these components. Phthalates and BPA. You’ve all heard those things we worry about in terms of being estrogen mimics and causing hormonal problems. You’ve heard of polycyclic aromatic hydrocarbons and styrene. They can be associated with cancer. Importantly you see nickel and lead on this. Those are two heavy metals that can also be associated with inflammation and increase health disease.
Why do we worry about plastics? Well, unfortunately they exist from head to toe in our bodies. Now thanks to a lot of studies that have occurred throughout medicine, we’re seeing that microplastics are not only in our brain or our hearts, but they’re also in umbilical cord blood. They’re also in placenta. They’re in semen there and over there in follicular fluid. These are associated with diseases. Many papers have been published now over the past five years showing the association of microplastics and disease, like John had mentioned, the sea and that we worry about cardiovascular disease, neoplasia and neurodevelopment disorders are all unfortunately associated with microplastic burden now in our body. For example, a recent paper in Nature Medicine came out this past year showing that the number of microplastics in someone’s brain is associated with dementia. There’s also data out that came out of the New England Journal of Medicine showing that if people have high amounts of microplastics in their carotid arteries compared to those that do not, you have a two-fold increase in your rate of stroke and heart attacks. That’s similar to smoking about seven cigarets a day for a lifetime. So microplastics are problem, and we need to think about how we can work to manage this.
This is a video that was done through I by my colleague in Australia, Peter Smith, and this shows you in the typical adult brain there’s about a teaspoons worth of plastic. Now it’s not this size, but this is for an image sake. Important to show that this plastic is added to the load of plastic that’s also in our bodies throughout our bodies, not just in our minds. With that in mind, how are we going to measure this? We’re using at Harvard, in my laboratory, a laser directed infrared system to be able to measure microplastics. The reason this is important is because we could take two drops of blood. And this is, for example, a microscope in ten acts. And that shows you the plastics that were in a typical healthy person’s blood at about ten acts.
What we can do with this by our machine is look at the different types of plastics in that person’s blood. Why is this important? Because you can go back and look at the fingerprint, I’m going to call it of someone’s plastics, what they were exposed to. For example polyethylene is from soft plastic. It’s also from micro abrasion and scrubs that people use for their face. We were able to tell this person to use less of that. We’re also able to say that the number of rubber particles that was equivalent to silicone was associated with the cooking equipment that they were using in the kitchen, and were able to, over a period of three months, show that this plastic was able was reduced in their plasma by 80%.
The reason why I want to mention this is because we can measure, we can monitor, and then we can manage. And about every three months we can look at someone’s plasma and see how well they’re doing to reduce plastic use. Importantly, we can also talk to policymakers. There’s bills in California right now to reduce plastic use across our state, talk to businesses and look at safer alternative products.
One can use home filters, for example, to reduce your tap water exposure to plastics. There are ceramic filters as well as life straws that you can use to reduce plastics in the water supply. But importantly, there’s plastic alternatives now being used not just in regular household products, but also in the medical field, especially in hospitals. So I just want to talk about the fact that this is these are new businesses that are coming out, bio matter, organisms and tissues, as well as monomers and polymers that could potentially be used as alternatives and hopefully be much healthier.
In conclusion, human exposure to micro nano plastics is increasing. These are found in most organs of the human body. It’s associated with pathology, pathology and disease. These unfortunately are harbingers for microorganisms. This is also another place where antibiotic resistance will increase with the load of microplastics in the human body. Methods for detection and characterization need further standardization. We’re doing that under research now in my laboratory at Harvard, and the environmental policies are urgently needed to reduce plastic exposure. So in my lab called the Allergy Extreme Weather and Exposomics lab, we’re doing research not just on microplastics, but I have some of the kits that are in the living lab to show you we can take two drops of blood and not only look at microplastics, but also other toxins in the body.
This concept of exposomics is very important because it’s what you’re exposed to, both good and bad, at any one point in time and over someone’s lifetime. So now we can actually look at what you might have been exposed to when you were two years old, based on what lies in your DNA. So this is a very important concept. We’re doing more and more in terms of research on this, and there needs to be more research, not just in my own lab, but around the world, to be able to understand exposed omics and how it can improve the health span. Thank you.
Pal
Last but not least, we have Dr. Stephen Williams, who is the chief medical officer at SomeLogic. He’s going to talk to us about our blood proteomics symphony.
Stephen Williams
Thank you. Good to be here. We are all in the information business. We care about us, ourselves living longer and our patients living longer. So we want to predict future risks. We want to work out, can we predict what interventions would be good for someone? We want to be able to detect whether an intervention actually worked, and we want to be able to discriminate between snake oil and things that really work. We’re all in the information business. The question is where is it? Where does this miracle of information about the whole person and about all these different systems reside? The bet that we’ve taken is that it’s in proteins.
If you measure enough proteins, you can get a map like this. There are 7000 spots on this map, each one of which is a protein, and it’s an information landscape. The spots are distributed mathematically over that over there, over the picture here, ones that are more alike close together and ones that are less alike a further apart. They’re color-coded on the left. You can see those blue spots are the ones that are predominantly influenced by genetics. You can see that Francis Collins was half right when he said that genetics is going to explain everything about every disease known to humans, but only half because the other half of the proteins are mostly influenced by something else in the environment.
But the nice thing is that proteins catch that both of those kinds of information, the environment and genetics. And we’re going to start looking at what use that might be. This is a volcano plot. You may not be familiar with volcano plots, but like real volcanoes, the bits you care about are the bits of lava that fly the highest and move the furthest. Those are the protein spots at the top. And of these, of these graphs, the key point here is if you don’t measure it, you can’t find it, and not all of these proteins are things that you would predict from what we already know from human physiology. Our thesis is if you measure enough proteins, you can find effects that are completely unexpected. They don’t work on their own. In medicine we do use individual proteins. But proteins have evolved in networks to transmit information in patterns. So if you measure thousands of proteins, you can find the patterns. But the serious point here is you can develop a technology that’s precise and sensitive and useful, but if nobody trusts it, then it won’t get used and it won’t be useful. We have a lot of publications, many of which have got hundreds of citations.
Now we move on to what is the point of all of this? What we’ve done over the past decade or so is to measure thousands of proteins in about 250,000 people with about a million participant years worth the follow up data. And what we’ve done with that is to try and find the protein network patterns that relate to outcomes and that relate to current health state and the ones that change when you intervene in a good way, and the ones that change when you intervene in a way that might be harmful. Today we’ve developed this group of Soma signal tests, each of which is a mathematical model, a subset of proteins within the assay itself. The assay has two versions today one measures 7000 proteins at once. The other measures 11,000 proteins at once, these models between them. Today, they only use about 600 proteins with very little overlap.I’ll talk a bit more about that in the future.
We hope that people like yourselves will become equivalent to genetic counselors, but we proteomic counselors because even though the soma signal tests are useful, they don’t cover every impact of every intervention and every lifestyle change. We think that as we learn more about human physiology, will actually be able to interpret individual proteins as well. But that’s for the future. These are the tests that have been validated so far. And in those publications that we talked about. When we saw earlier about, about the whole person, it’s not simply, you know, a urologist or a single system. What we’re saying here is that you can measure any one of these or all of them from the same blood test at the same time. You can measure changes over time. So you can see they do cover cardio, metabolic health. That was all that was our focus, and cancer. We may have a chance to talk about that later, but the likelihood of developing cancer is very dependent on environmental exposure and immune surveillance. We think proteins are really good at following those things. But those tests are in the process of being validated.
So how does this work in practice? How does this help you work out whether a particular change in lifestyle or pharmacology actually did something useful? Well, this is the results of a of a test of, of actual of a dietary intervention. It was a pretty severe caloric restriction study. Each of the rows is a proteomic test. Wach of the spots says, well, what happened to that test during the year in this study? You can see that dietary intervention in people who lost more than ten kilos, the purple spots improved a lot of body composition. The glucose tolerance test is a it. The proteins mimic the result of a glucose tolerance test without fasting and without glucose. You can see that there was a huge improvement in those tests, as well as cardiovascular events and body composition.
As you might have expected, some of these changes weren’t slow. That even though that was a year study, as a component of one of the studies, there was that you could measure these things over time and you can see changes quickly. And the tests have also been used by far more. We’ve heard some this some information this morning about cheap ones. Novo has published on using the Soma scan assay, and they used it in both ways that I talked about at the beginning. They measured the changes in individual proteins. You see one of those volcano plots where they found 495 proteins that change many of those in pathways that impact the some of the benefits and some of the this benefits like loss, muscle mass loss.
On the right they also measured the cardiovascular event prediction test. Now you might say, why on earth do you care? Because they did this big outcome study and the event rate was less. So why do they need to show the protein effect? Well, the key point here is that their cardiovascular events study was 57,000 participant years worth of data. It took them seven years to run the benefits. Those cardiovascular benefits to those patients were all delayed while they ran a seven year study. We were interested in measuring those things today in individuals, and that’s what they did on the right, the the bars crossing the dashed line of zero change in the placebo groups and the ones that went fell below that other proteomic predictor of cardiovascular event rates falling over time in much smaller studies.
Talking of much smaller studies, this is a randomized control study of providing this information. So this was run by Rosalind Gale, who’s sitting there at the back. People told us that behavioral change. Now maybe I don’t think this audience believes it, but behavioral change is a lost cause that even if you provided people with an individualized, accurate assessment of their likelihood of dying, developing heart failure, or having a stroke, they wouldn’t change anything.
What we did was to take a group of 400 people, and we randomly assigned them to be informed or not informed, and we measured prescribing rates of enhanced cardio-protective drugs. That’s the plot on the left. The blue section is the people who were informed, and these were all people who should have been on an SGLT2 inhibitor or GLP-1 or more intensive statins, but weren’t. You can see the prescribing rates went up to between 30 and 40%. And on the gray side, you can see that the uninformed group there was a clinical trial effect from extra attention, but they only went up to about 10%. So providing people with individualized information changed behavior. If you want to visit the learning lab, you can see whether it changes your behavior, because you can get this done yourselves. Thanks.
Pal
What we’re going to do now is please get ready with your comments and your questions. We’ll take them in a little bit. But before that, I just want to, make some observations with the group here and see what came up for you as you were listening to each other in terms of both, some of the challenges that you might be noticing that are similar across the board. But maybe also some opportunities for collaboration, especially when you think about exposomics and, where that needs to go. So maybe Kair, I can direct this to you is, you know, one of the themes of this summit today is, women’s health. The thing that I discovered when Jordan and I wrote a white paper that we collaborated with your team on, by the way, one of the things I was really surprised by was that when we get exposed to microplastics, it’s not just a microplastic particle. You get three for one, you get the plastic associated chemical, like the phthalates and the PFA and so on, and then the environmental toxins and there’s very strong evidence for them being endocrine disrupting chemicals.
Could you speak to that a little bit in terms of women’s health.
Nadeau
I think this is really important as we think about all the opportunities that we’re talking about at this gathering. There’s a lot of great things that we’ve discovered over the many years in terms of including our health spend an increasing years since the early 1900s. But one thing that we have not done well is to assess the state of microplastics and nano plastics and how that’s affecting the human body.I think the break down into hormone mimics, like the phthalates and how that might affect women’s health is critical. We’re doing a study now is how it’s affecting infertility, because infertility is increasing in our country as well as throughout the world, not just for microplastics, but microplastics are also associated with pollution now.
So I think when we think about connecting to Owlstone, connecting to SomaLogic, what would be great to see is breath test that we could perhaps be able to infer issues with estrogenic changes, with hormonal changes, men and women, because this is affecting both. And then in addition, for SomaLogic to be able to perhaps link together and collaborate with looking at a proteome profile that could be associated with microplastic burden and looking at to what extent that proteomic profile might be associated with inflammable disease, hormonal diseases, and then also cancer. I think these are the things that we can look at putting an ensemble of data sources together with machine learning algorithms to really think about a composite end point that one could then detect disease, and also management of that disease with these excuse me, with these tools.
Pal
Wonderful. Max, any thoughts on that? And did you have a question for Steven and yes.
Allsworth
The interaction between small chemicals and plastics is very significant as well. But chemicals permeate into microplastics and live in there. So they act as a source inside the body of those chemicals would otherwise be cleared very quickly. They end up being stuck in those microplastics so that then you get the combined effect of prolonged exposure to chemicals you wouldn’t normally be exposed to, as well as the direct effect of the microplastic. Those are the sort of things we do a lot of work measuring. I can definitely see a correlation there and a way we could explore, on the question side or the challenge of microplastics always seems it’s how do you do anything about it? And I did wonder if there was like one thing you could change. You had a magic wand or a presidential order or something that you could just say, do this, get rid of this. But where do you think the biggest, sources. Because I think a lot of it’s at work in business rather than just in your home, that you can fix these problems.
Nadeau
For what we know right now the biggest bang for your buck, as it were, the biggest bang for your change would probably be in soft plastics. Avoid them. Do not microwave anything that’s plastic. Do not use plastic bottles any longer and try to avoid saran wrap. Those are the most researched with polyethylene and polyethylene up to now has been the most highly associated chemical from plastics associated with neurodegenerative disease, as well as cardiovascular disease. So I hope that’s an answer that is helpful. We can manage that. We can change that in our living styles. Not everyone can. But that’s just the tip of the iceberg we’re learning. So there might be some if you ask me. Next year might be different.
Allsworth
Soft plastics are the ones that would absorb the most chemical as well. It’s the biggest source for exposure to the rest of the body. Steven, yes, super interested in your talk actually. But hon the sort of trying to get through the plastic side, how, the changes that you get, how do you pick out those differences from normal phenotype changes over someone’s lifetime? I think about that because back in the day when I still worked in the lab, I had to monitor a certain enzyme level because I was working with something quite toxic.
Mine stayed stable. The colleague I was working with, they had a big jump in a certain enzyme in their body so that they had a feeling of lifestyle, phenotype change. That must be happening quite extensively in the data you chain. So how have you pulled that out? How would you separate that from exposure related things? A change that’s happened being driven by what you’ve been exposed to.
Williams
There are proteins that relate beautifully to aging. You can make a lovely age clock model that predicts your chronological age and follows and uses proteins that just track with age. But when we’re trying to predict health outcomes, we let machine learning choose the subset of proteins that most closely relate to that phenotype or that risk. If you include, in the training population, if you include all of the confounding variables, people of different ages on different drugs, different sexes and different ethnic groups, then you enable the machine learning to pull out the proteins that are most direct that survive those confounding, confounding variables and potentially to include correction proteins for other things like age.
So often, for example, FSH or PSA will get included in models that are nothing to do with those hormones, but the machine learning is using them to correct that, you know, you know, older women or older men and, it can incorporate them in the model.I think that it’s kind of the opposite of a clean physiology experiment is a beautifully matched set of cases and controlled with no other variables. A beautiful machine learning experiment is a really dirty experiment where you, you enable it to find the robust ones and correct.
Pal
Were there any questions from the audience? Any comments? Questions? Raise your hand. Or go to go to the mic. Yes, please.
Audience Member
Thank you. It’s Gabriela Valero from Camino Partners. The science is undeniable. The question that comes up for me is, what are your observations in terms of the individual’s willingness to pay for this, for this knowledge, for this journey? Like an example, in the human health side, low Fodmap has existed for many years. How does the cost of a device would compare for, you know, just trial and error in low Fodmap and so forth. Similarly, on the blood testing side, it’s undeniable, observing how much you can get with just a simple small blood drawn. But at the same time, as we try to bring health to a broader set of audience, how what are the green shoots that you’re observing in terms of people’s willingness to learn and to then take this step and, and participate in what you’re doing?
Allsworth
I can start with that on the IBS, applications. I think that the patients are often very driven to solve the problem. The number of days of work missed due to, digestive disease problems is huge in the States that there is a driver for that, for paying for these tests. You can get, reimbursement as well. There is a repair. I think it’s much harder in liver disease, as I said, it’s silent, asymptomatic, and no one worries about the little until it’s a problem. So getting that paid for is much more difficult. That does push a need for a very low price point. Even then, it’s like getting people to take the test is difficult. I don’t know if, anyone else wants to drive it.
Williams
I like the question, but what it really is, it’s a manifestation of market failure. When you look at we want to measure things which are pre-symptomatic, you know, pre disease, they’re viewed as not medically necessary by insurance companies or by Medicaid and Medicare. Screening tests require an act of Congress to approve. What we’re saying is that in the face of a complete market failure in terms of traditional diagnostics, now we’re in the cash pay business. I think that it’s, it’s a perception of value for money for us. It’s, if you added up ways of getting all of that same information from treadmills or glucose tolerance or, you know, coronary, and you add it all up and it’s thousands of dollars and we’re less and it’s easier.
I think the value proposition can be there. The challenge to us is to keep on lowering the cost and making it more and more accessible. But the fundamental problem is there’s a failure of the traditional market for diagnostics, for things which are pre-symptomatic. Early warning not medically necessary. Thank you. Thank you for that question.
Audience Member
I have a question with regards to the microplastics. So many of us in the health space, I’m a physician, we see consumer based, medicine where patients are coming forward and asking for vitamin IVs and all sorts of other things. We think, gosh, if it does no harm, why not? But is there an inherent harm in vitamin IVs and doing IVs, if they’re maybe the risk maybe outweighs the benefit. And what’s being explored in terms of alternative mechanisms for, for non-plastic tubing and other things in the health care industry, because we want to do no harm.
Nadeau
Absolutely. Let’s follow up Hippocrates as much as possible. I think to that end the national health care system in the UK is going as ecologically friendly as possible in their health care supply chain.That’s about 30,000 companies that not only have to agree to net zero in terms of renewable energy sources for the national services, but it also means ecologically friendly plastic alternatives. Now, I say that it’ll be very difficult to become pre 1940s and be completely a plastic free society, and medical care is one in which plastics have potentially improved some outcomes. But when you look at IV tubing, when you look at some of the bags that we use and some of the plastics that we use and some of the wrapping that we use, we are potentially doing harm. With that in mind, there all there are alternatives. Baxter, for example, is making a fiber type IV, a tubing that is just as flexible.
I showed some of the other alternatives on my slide. I think as we get smarter about plastic alternatives, we get smarter about looking to nature, to what alternatives there are for, waterproof type bendable, equipment that can be used in the health care system. I think we are going to get there. It’s going to take resources. It’s going to be expensive. But I think what I say to answer the previous persons question is there’s a drive, there’s a personal drive on behalf of the public to know what they’re exposed to, what they don’t know could hurt them. I think we can multiply the message that we need to do better testing and read to better products. We need to reduce plastic pollution.
Audience Member
I have a quick question around removal of microplastics. So there are some, technologies that exist in the aphaeresis space that are removing the, lipoproteins, obviously very medically-indicated. Now, those are will remove all your plastics from your body space. So I’d love to have your comment on the validity of this.
Nadeau
Absolutely. And I’m not Orlando Bloom, but apparently he was one of the first people to have one of these plasmapheresis systems. We’re trying to now do a research from this group because we were very interested in before and after, are you actually reducing your plastics? We contacted the company that Orlando Bloom used, and we have yet to hear back from them. But I would, say to all of you, if you have patients, if you yourself are thinking about this, please be careful because the very same things that are being used for it, if aphaeresis or plasmapheresis actually do contain plastics. The filter has plastics in and of itself. Let’s do the research to be able to answer that question appropriately. But right now I don’t have the full answer. I don’t know if that’s the way that someone would want to approach this problem.
Pal
Any other questions or comments? One of the things, Kari I remember when we were writing the paper was that with every liter of I.V. fluid, there’s 58,200 microplastic particles, and that get injected. It’s also the DHP that is the plasticizer that’s used in the with the PVC bags and, and tubing. And one of the things that, you know, what I love about all your work is that it’s really highlighting the importance of tracking, our environmental exposures to what’s happening. But with the multinomics technology that we have.
I was really sad, a couple of months ago when we came very close to signing of, the International Plastics Treaty. It fell through because nations couldn’t agree on, on reducing the production of plastics. Maybe in the, in the, in the last three minutes that we have here, just a final reflection from each of you on, what is the one wish if you could, put out into the world, in your field, what would that be? What is that one big wish, that you would love to make happen so much?
Allsworth
I think it would be to,Steven mentioned the change, how diagnostics and early disease are treated, or valued for investment purposes as well. The device I was showing that treatment plan. Our objective was to get people well, so they didn’t need to have the device anymore. That was the endpoint. Three months, and they’re better, and, they may not need the voice again for years, rather than a therapeutic where they might be on something for the rest of their life. The value to society of finding disease early and dealing with it when it’s, when you can make a difference and change the life for good. Some way to change the core economics of diagnostics and early and early detection.
Pal
Hopefully some of the folks in this audience can kind of support you, as you do that. Congratulations. Owlstone Medical just got a $49 million award.
Allsworth
I talked about using probes for lung cancer detection. That technology with. Well, that’s in human at the moment. But the next level back, we’ve been developing suites of probes that could be used for over 30 solid cancers. And we’ve, we’re working with M.I.T., Georgia Tech and Boston University to develop, and test these probes out. That’s what the grant that we receive two weeks ago, just in time to develop that over the next five years. So it’s a very exciting project. It’s a screen, a multi cancer screening application where everything could be done in the home. It’s a complete home test.
Pal
That’s such a fantastic vision to be able to do that at home. Thank you Kari.
Nadeau
We’ve only been able to talk about microplastics today, but there are many other exposures that affect our bodies, in a way that’s deleterious and can increase our health risk. But there are also behaviors and exposures that improve our health.To me, to be able to understand this concept of exposome makes everything all at once, at any one point in time, as well as over someone’s lifetime. To be able to get better at measuring, I’ve seen just in my lifetime of being a physician, how much the tools here that we’ve had spoken about have improved our ability to predict potential diseases, as well as try to prevent the onset of diseases.
I’m excited about this tool and being able to spread that knowledge to help others for the social good.
Pal
Fantastic. Thank you. Kari. Stephen.
Williams
I think I want to say the commitment to preventative health scale beyond the committed people in this room and that probably takes markets like the Middle East. We heard from Nicole and maybe like Japan where they care about long-term preventative health. They recognize that, that they have, problems that can be tackled with some existing interventions and where they’re creating a way of actually, you know, solving their market failures. I’m hoping that those places will show the rest of the world the health economics of preventative health can be good, and that they’ll lead to a change in the commitment and the financing of preventative actions top scale
Pal
May that wish come true. Please join me in thanking Max, Kari and Stephen.