Delivering Diagnostics

Life-threatening viruses need to be diagnosed in all corners of the world. Lee Gehrke may have an answer.

Since 2010, Gehrke’s team has collaborated with a wide range of experts, including engineers, app developers, molecular virologists, and materials scientists, to create handheld diagnostic tests able to differentiate diseases in austere environments.

“A patient comes to a clinic with a fever, but what pathogen is causing that fever?” says Gehrke, the Hermann von Helmholtz Professor in the Institute for Medical Engineering and Science (IMES) at MIT, and Professor of Microbiology and Immunobiology at Harvard Medical School. “Our rapid diagnostic is very simple, very inexpensive, and can be used without power, a cold chain, special chemicals or special training to distinguish among the many different pathogens that cause disease.”

Simple tests are crucial to clinicians making triage decisions under challenging conditions. Viruses such as Ebola, Marburg, dengue fever, Zika disease, yellow fever, and chikungunya all present with fever, but “fever is a nondescript symptom.” Fast diagnosis allows for appropriate patient support and public safety.

“We’re not just trying to box up a diagnostic and send it off to places in the world without any feedback loop,” Gehrke says. “We work with scientists, engineers, users, and health care professionals in the affected countries to learn from them. To make it possible for them to make their own devices and to improve the ones that we have, so everybody wins.”

Working democratically and collaboratively is what Gehrke calls the “MIT way.”

“MIT likes projects where the playing field is leveled, where everybody has the chance to improve, build, express innovation, and contribute to the development of a product that’s going to help a lot of people. It’s sort of a hacking mentality…rather than creating a ‘black box’ only one person in the world knows how to repair.”

Gehrke and his colleagues work hands-on with 3D-printers, laser cutters, their own reagents, and antibody nanoparticle sensors to make the devices.

Central to this effort are: Dr. Kimberly Hamad-Schifferli, a physical chemist and associate professor at UMass Boston, who focuses on nanoparticle surface chemistry; Dr. Irene Bosch, a molecular virologist, who has studied mosquito-borne viruses for a decade; and Jose Gomez-Marquez, an engineer specializing in hardware for signal detection and data communication.

In the E25 lab, the group conducts tests, such as subjecting the rapid diagnostics to a cell culture incubator environment at 37 degrees centigrade and 90 percent humidity, to mimic the West African climate. Now the MIT Technology Licensing Office will help them “figure out how to keep our day jobs while making these tests available where they might be helpful.”

The team also collaborates with the Wildlife Conservation Society to determine if Ebola is killing gorillas in the Congo, and if the animals act as sentinels for the disease’s circulation.

Further, Gehrke remains deeply involved in viral pathogenesis—how viruses infect people and make them sick. With a background in biochemistry, structural biology, developmental genetics, and human anatomy (teaching anatomy to medical students for 33 years), Gehrke’s focus naturally progressed from plant viruses to human outbreaks and emerging threats like Ebola, Marburg, Zika, and chikungunya. Gehrke’s team studies how viral molecules succeed and why our own human RNAs don’t activate innate immune response.

“Human RNAs contain chemical modifications—a methyl group here or a bond shift there—that somehow hide the RNAs from innate immune sensing,” says Gehrke. “This has significance for biotech applications in designing therapeutic RNAs that will not activate an immune response.”

In addition, Gehrke collaborates on the IMES/HST MakerLab course with colleagues Jose Gomez-Marquez and Anna Young, lecturers at MIT, inviting undergraduates to build medically related devices. The course debuted in spring 2015, sponsored in part by an award from the MIT Alumni Fund, including a mix of students from Biology, Chemical Engineering, AeroAstro, and Mechanical Engineering.

“The students have access to laser cutters, soldering guns, arduinos, and 3D printers, to design prototypes and build devices,” Gehrke says. “This is truly a hands-on course. Our goal is to extend the course for students into the summer so that promising prototypes might be further developed. We’d also like to partner in real clinical studies at the MIT/IMES Clinical Research Center, so students could have that human interaction. That would be the whole package.”

Ultimately, Gehrke is dedicated to helping students expand science to solve medical problems, as he did.

“The students are just fantastic. And I am very much committed to the HST idea of bringing medicine, engineering, and science together to solve problems in human health . . . IMES fills an important niche as a locus of medically related research at MIT with a combination of faculty who are basic scientists and practicing physicians. I think that makes it a natural fit.”