Medicine comes in all shapes and sizes — from mundane pills to less-pleasant intravenous infusions. But one form of drug delivery that doesn’t get its proper due is gel. We’re talking about the kind of gooey, semi-solid, and viscous material that can get smeared onto our skin or injected into our bodies. To remedy this injustice, here are seven recent medical innovations in gel technology, which are either close to fruition or available now.
Male Birth Control
Male contraception outside condoms or surgery has been a long-sought goal in medicine, and it’s likely that it will first show up as a topical gel. The first larger-scale clinical trials of a product called NES/T have been underway in the U.S. and elsewhere since 2018. The gel is a combination of testosterone and the drug Nestorone, which is a progestin hormone, and it’s rubbed onto a person’s arm and shoulder daily.
Studies have suggested that Nestorone can reliably induce temporary infertility in men, but at the cost of lowering natural levels of testosterone, which leads to many unwanted side effects like a lower sex drive. The hope is that by supplementing testosterone back in, you can counteract these side effects while still keeping men sterile. The findings from this research are expected to be out early next year, but early indications are that it’s working just as well as intended. It will take larger trials and probably at least a few more years before we can expect NES/T to reach the public, though.
Back Pain
Back pain remains one of the most common and difficult to manage ailments of life. But new research out this week provides hope that a gel-based treatment might help people with a particular cause of back pain. The early phase study injected an experimental hydrogel into the backs of 22 patients with degenerative disc disease (DDD), a condition where the cushy discs between our spinal cord begin to wear away. Treated patients experienced a significant improvement in pain, dropping an average 5 points on a 1 to 10 pain scale (from 7.1 to 2), that lasted at least six months later.
Injectable gels are an existing option for chronic pain, but appear to provide modest benefits at best. ReGelTec, the developers of this second-generation gel, known as Hydrafil, are optimistic that it can offer more substantial and reliable relief for people with DDD. But it will take larger studies to confirm the gel’s potential.
Autoimmune Diseases
Since the 1950s, an injectable gel treatment has been helping people with certain autoimmune disorders such as lupus. The gel contains corticotropin, a hormone naturally found in our bodies that helps reduce inflammation. This year, the gel was additionally approved for treating flare-ups of multiple sclerosis and rheumatoid arthritis, along with excessive urination caused by nephrotic syndrome.
Heart Disease
While the heart is a sturdy organ, it normally only has a limited ability to heal itself after serious injuries like a heart attack. Past attempts to inject stem cells directly into the heart to boost its healing have proven tricky, with most not able to survive the process. But this week, a team of scientists in the UK have reported that using gel as a delivery method might be able to work around this limitation. In experiments with mice, they’ve found that their gel-based injection can act as a scaffold for these cells, allowing them to successfully graft onto the heart and regenerate it.
Human trials will be the next important step, but this could end up becoming a major advance in heart disease treatment.
Making Medicine Easier to Swallow
Speaking of drug delivery, a spoonful of gel may just help some medicines go down smoother. This past May, scientists at MIT and Brigham and Women’s Hospital published research suggesting that their novel types of gel might help people swallow certain drugs much more easily.
The plant-based gels, or osegels, that they developed can be produced cheaply and combined with edible materials like beeswax to create different textures and viscosity, ranging from something like a protein shake to yogurt. So far, they’ve shown that it can be used to deliver an effective dose of antimicrobial drugs commonly given to children around the world, such as the antibiotic azithromycin, but many drugs could theoretically be formulated to be given via their gels.
The scientists are now planning to run a Phase I clinical trial in the next few months.
Parkinson’s Disease
Scientists are trying to harness the sticky power of gel to better help those with Parkinson’s disease. Last year, researchers in Australia published a study in mice suggesting that stem cells can be safely and effectively delivered into the brain using an injectable hydrogel. Once there, the gel allows the cells to better survive and begin regenerating neurons lost to the degenerative condition. In animal studies, the gel-based treatment appeared to restore the movement of animals with symptoms similar to Parkinson’s.
Elsewhere, other scientists are working to develop a gel-based nasal spray that can deliver the drug levodopa directly into the brain. Levadopa is a common Parkinson’s treatment, but it tends to wane in effectiveness over time, in part because the body breaks it down before it reaches the brain.
Gene Therapy
People with a rare but devastating genetic skin condition known as butterfly disease may one day be helped by a topical gel loaded with DNA-altering viruses.
Patients with the painful disease, formally known as epidermolysis bullosa, are unable to produce proteins that help repair skin. Without these proteins, their skin easily tears open and leaves behind wounds that often never fully heal.
But in a small study published this past March, patients given a gel-based gene therapy were able to heal their wounds better than those given a placebo. The gel contains a neutered version of the herpes simplex virus, one that’s been modified to insert a healthy version of a gene that’s defective in the skin cells of these patients. The gene then helps them produce a form of collagen that they otherwise couldn’t. Larger preliminary studies of the gel have shown similarly promising results, and the gel’s developers expect to file for approval later this year.