GOALIE: a mobile treatment of depression
Just like everything else, psychiatry moves on. Since the 1960s the overall treatment of depression is psychotherapy, sometimes supplemented with medication. All therapy is directed to changing the behaviour of patients, so they will become and feel better. In this way, psychotherapy is like taking piano lessons: once a week you visit a therapist who teaches you how to deal with life (‘the game’) as well as possible. Sitting behind a desk, the therapist tries to enhance healthy behaviour (beautiful piano music) and root out unhealthy behaviour (‘false notes’). The game will be even better if you encounter correct thoughts (cognitive therapy). Like a piano teacher, the therapist will give you homework. This is called cognitive behaviour therapy (in Dutch: CGT), and appears to be one of the most successful ways of getting people out of their depression.
Mobile application for behaviour therapy
The direct effect of the CGT therapist is not limited to the therapy appointments. Nowadays, you do not visit your therapist once a week, but close contact and continuous advice are also possible via smartphones. We have developed an app that takes over the behaviour therapy of CGT. Research has demonstrated that this behaviour activation is the most effective part of the total CGT treatment, and easily applicable. This app is called Goalie and enables patients to set and achieve their daily goals. The app uses all of the sensors on the smartphone to see whether a patient has already achieved his/her goals. Did you find a rhythm for sleeping, eating, drinking, social contacts or intake of medicines? Goalie tells you when you have achieved your goal and celebrates the success. Goalie is ‘context sensitive’ and makes ‘direct ratification’ possible, so that ‘stimulus contingency’ increases. In this way, Goalie provides 24/7 medical care that cannot be supplied by a human therapist.
Researchers think that CGT with mobile behaviour activation (Goalie) enables a desired change in behaviour to take place more quickly than with normal CGT that involves a once a week behaviour activation session. With the support of a PPP allowance and the involvement of Top Sector LSH and MIND Foundation of Psychic Health, we can investigate whether this hypothesis is correct. A consortium of the LUMC, MUMC, SENSE Labs Rotterdam, PsyQ and Parnassia Group The Hague will perform a study that includes 150 patients with a depression. The consortium seeks to realise innovations in healthcare that provide not just better but also more cost-effective treatments.
For more examples on public-private partnerships visit the project page on the Health~Holland website. Read already two new projects of this webpage below.
Development of next-generation Vero cells to improve vaccine production
Deciphering cellular proteins and pathways involved in virus replication and in suspension growth of Vero cells
Despite the critical role for vaccines in public health, there are issues with costs and manufacturing that prevent a significant portion of the world’s population from accessing vaccines.
The aim of this project is to make the production of viral vaccines less expensive. To achieve this, Intravacc aims at the identification of cellular pathways that are important in virus replication and suspension growth in Vero cells. By permanent modification of the identified host factors, Vero cell lines can be constructed that are better suited for the production of viral vaccines. The industrial partner, Applikon, is aiming at developing disposable, single use bioreactors, which offer flexibility and require less investment in infrastructure compared to conventional bioreactors. Combining these strategies in this partnership will ultimately result in the development of vaccines in less time at lower costs.
This innovative project will lead to more fundamental knowledge on proteins and intracellular pathways important for viral replication by doing siRNA screens. This knowledge will be used to develop new Vero cell lines with modulated host genes using CRISPR-CAS9 that can significantly enhance virus production at reduced costs, thereby promoting global introduction of affordable vaccines. Also, we aim to use the knowledge obtained from the screens to design Vero cells that are capable of growing in suspension, which is a great advantage for easier scale-up and less expensive production of vaccines. The last aim is to develop single-use, disposable bioreactors, that will eliminate the costs in the vaccine production process associated with disassembly, cleaning and reassembly of conventional bioreactors. This offers flexibility in vaccine development, and in change-over from one vaccine manufacturing process to another. In the last phase of this project, the modified Vero cells will be cultured at lab-scale in the disposable bioreactors developed by Applikon.
'Sticky' peptides to fight antimicrobial resistance
PharmAMPs: Pharmaceutical development of antimicrobial peptides for the prevention and treatment of infections against (multi)-drug resistant bacteria.
Antimicrobial peptides (AMPs) are inspired by naturally occurring antimicrobial proteins and peptides, that are produced by all living organisms and can combat bacterial infections, including resistant infections. AMPs are typically small, cationic peptides (“sticky peptides”) that exhibit a broad range of antimicrobial activities, and often also possess immunomodulatory properties. Moreover, intrinsically, they are also more robust towards resistance development than traditional antibiotics. In the recent O’Niell report on solutions to fight AMR, AMPs and their derivatives are ranked amongst the most promising alternatives to traditional antibiotics.
The concept of using AMPs for therapeutic purposes has been around for some time. Unfortunately, the 1st generation AMPs had limitations that prevented further development, especially with regard to their (limited) potency and high cost of goods, resulting in poor commercial perspectives. Several peptides have been tested in clinical studies against a range of topical infections, but their development was halted for these reasons.
A new public private partnership was formed between the Leiden University Medical Centre (LUMC) and Madam Therapeutics with the intent to work on 2nd generation peptides with improved characteristics. Madam Therapeutics, is a near clinical stage biotech company that is developing a new generation of AMPs specifically to combat resistant bacterial infections and to prevent and treat infections that are currently left untreated due to the risk of resistance development with current antibiotics. The new peptides are based on technology from LUMC with whom Madam Therapeutics has been working closely over the recent years to develop the most optimal peptides, which we are now converting into powerful antibacterial products.
Within this PPP, we have established that the lead peptide (SAAP-148) indeed has significant advantages over traditional antibiotics. SAAP-148 was found to be a very effective, broad-spectrum anti-microbial peptide which possesses very rapid bactericidal activity. SAAP-148 has shown in this project to be very effective against bacteria residing in biofilms whereas traditional antibiotics are not. SAAP-148 is also very effective in the killing of (multi-) resistant bacteria and is very robust against resistance formation itself. Finally, we established that SAAP-148 has also shown significantly more potency than 1st generation AMPs in in-vitro comparison studies; in fact we demonstrated that SAAP-148 is one of the first in its class to be active at a sub-micromolar range.
As a follow-up to this project, Madam Therapeutics and LUMC are now preparing the first clinical proof of concept studies with the lead product SAAP-148 formulated as a gel for topical treatment of bacterial infections in chronic wounds, burns and in a nose gel to treat nasal MRSA carriers. In addition, we are also investing possible novel PPPs for collaborative (academic) research efforts and continuous pre-clinical development of other AMP-based products for other indications and other formulations.