ARPA-H Project Awardees

DAIRS: Disease-Agnostic Immune therapies using RNA Structure

The project will develop novel and tunable RNA-based therapeutic modalities that target retinoic acid-inducible gene I (RIG-I) in order to activate the innate immune system and stimulate the production of interferons (IFNs). The project will achieve this objective through several steps, including refining the lead molecule dsRNA-1, which selectively activates RIG-I. The project will also leverage this platform to discover additional tunable agonists and antagonists to this key immune system modulator.  

Existing IFN treatments are predominantly protein-based, which necessitates the systemic administration of recombinant IFNs. This approach has several drawbacks, such as an increased potential for side effects and a lack of modulation. On the other hand, the new approach the project team is exploring selectively activates RIG-I, inducing type I/III IFNs. As a result, superior efficacy and safety profiles have been demonstrated when these molecules were administered intravenously, compared to IFN biologics or agents that stimulate the IFN pathway. In addition, the development of RNA therapeutics needs to overcome challenges that are inherent to RNAs, such as rapid degradation, non-specific immunogenicity, and delivery across various cell membranes. The project includes de-risking strategies for these challenges.  

AB-MRI: Affordable Breast MRI

Breast cancer is the second most common cancer affecting women, with over 200,000 new cases and 40,000 deaths in the United States every year. Early detection improves outcomes, reducing mortality rates by 15-40% with current mammography technology. Although mammography is the standard of care for screening, it does not have particularly high sensitivity. MRI is approximately twice as sensitive, but MRI is an expensive technology and not commonly available outside large radiology centers. 

The project aims to develop a low-cost MRI device for breast cancer screening. A small magnet generates the magnetic field, and an innovative field cycling concept bypasses the constraint of a high, homogeneous magnetic field, enabling the smaller, cheaper magnet. The small footprint system, including the gradients, coils, and console, will all be designed specifically for breast cancer screening. The intent is to create a device that costs 10x less than the current standard and can be used in community settings. 

SARRTS: Supervised Autonomous Robotic Renal Tumor Surgery

Surgery is essential to cancer treatment, but skilled surgeons are unevenly geographically distributed. Autonomous robotic surgery has the potential to increase access to skilled surgery, improve consistency of some types of procedures compared to unaided human surgeons, and unlock new types of procedures that human surgeons cannot do due to difficulties in anatomy and visibility. SARRTS aims to demonstrate a supervised autonomous kidney resection, propelling us towards a future state where a general surgeon could supervise a resection robot in a rural hospital, and patients would no longer have to travel to major oncology centers for the best outcomes. Using a CT scan of the area registered to the 3D point cloud generated by the robot’s RGB-Depth camera, the robot plans and executes the incision and resection. While the robot generates the surgical plan, the surgeon approves the surgical plan and can stop, adjust, and replan the surgery at any time. The surgery will be tested and demonstrated in realistic kidney phantoms created for the project. The intent is to demonstrate the feasibility of a supervised autonomous tumor resection and to develop enabling technologies that facilitate the advancement and generalization of this autonomous tumor resection system and other autonomous robotic surgery capabilities. 

CT-NEURO: Cell Therapies for Neuroinflammation and Neurodegeneration

The overarching goal of the CT-NEURO program is to develop strategies for targeting therapeutic immune cells to the central nervous system using biological logic gates. Three specific objectives include 1) development of an immune cell-based, disease-agnostic platform that targets therapeutic payload to the brain, 2) demonstrating that this platform can be expanded to generate engineered cells to selectively target other organs and tissue types, and 3) employing this platform to deliver therapeutic payloads to treat diverse neurological conditions such as brain tumors, neuroinflammatory diseases, demyelination, and neurodegeneration. 

MATRIX: ML/AI-Aided Therapeutic Repurposing In eXtended uses

Millions of individuals worldwide suffer from diseases for which there are no available treatments. While the Food & Drug Administration (FDA) has approved roughly 3,000 drugs to address a corresponding number of diseases, there remain an additional 9,000 diseases without a single approved therapy. Given that numerous diseases share common underlying mechanisms of action, and individual drugs can target multiple mechanisms, the existing pool of 3,000 FDA-approved drugs holds the promise of addressing the 9,000 diseases that currently lack therapeutic options. 

MATRIX (Machine Learning/Artificial Intelligence-Enabled Therapeutic Repurposing in eXtended uses) aims to develop computational methodologies for identifying the FDA-approved drugs most likely to treat diseases with inadequate treatment options, and to identify and validate top candidates for drug repurposing using these methodologies. 

This program aims to develop the first comprehensive scoring system that queries the world’s biomedical knowledge of “all drugs vs all diseases” to predict the efficacy for every drug to treat every human disease. The resulting information on the pharmaco-phenome will be made available open-source, allowing researchers to view the probability of efficacy across the entire landscape of FDA-approved drugs and human diseases.  

PIC-OCT: Enabling Technologies for Photonic Chips-based Optical Coherence Tomography

As the US population ages, and with the increasing prevalence of obesity and related chronic health problems that affect the eye, debilitating eye disease poses a substantial medical and cost concern. With early diagnosis and appropriate management, > 90% of severe vision loss may be prevented. Imaging modalities that excel at screening, early diagnosis, staging, and tracking treatment response, and can do so safely, quickly, and inexpensively are highly valued by ophthalmologists. Optical Coherence Tomography (OCT)-based technologies have revolutionized eye disease diagnosis, along with demonstrating clinical potential across a myriad of other areas – including cardiology, urology, dentistry, and more. However, high cost and complex assembly of current systems limit their widespread adoption and hamper their broad implementation. This project will develop next-generation OCT systems based on photonic integrated circuits (PICs) and custom-designed electronic integrated circuits (ICs). By leveraging the latest advances in the nanofabrication of photonic and electronic ICs, acquisition speeds 50 times faster than the current standard will be achieved alongside immense decreases in the OCT system footprint (i.e., readily employable at walk-in clinics) and unprecedented reductions in manufacturing cost that will facilitate community-wide accessibility. Pediatric patients will especially benefit from the shorter scan times. Altogether, by enhancing patient treatment and adherence to repetitive testing, PIC-OCT will substantially reduce vision loss and its medical and societal costs. 

REO: REvolutionizing the Oral route: delivery of electroceuticals and mRNA therapeutics for transforming health

Metabolic diseases are on the rise, with roughly 40% of Americans being obese and 10% diabetic. Treating these chronic diseases currently requires daily injections, surgery, or expensive drugs. Recent innovations, such as continuous glucose monitoring and insulin pumps, have greatly lowered the burden on patients but can still be painful to use and can limit activity.  

The MIT team aims to revolutionize these treatments by developing two orally delivered pill-sized devices. The first device will sense its location in the gastrointestinal tract and then inject mRNA into the tract lining that provides long term treatment for diabetes or obesity. The second device will temporarily reside in the GI tract, electrically stimulating it to release hormones associated with hunger and satiety. The devices will be remotely controlled and wirelessly powered for enhanced efficacy and safety.  

Although the proof-of-concept effort focuses on metabolic diseases, the designs could be applied to deliver therapies for many clinical conditions. Critically, this innovative delivery of therapies could provide treatment access to socioeconomically disadvantaged classes, who are most affected by metabolic diseases. The self-administration of capsule-sized devices could also reduce healthcare worker involvement, the need for hospitalizations, and healthcare costs associated with the need to store, stabilize, and medications. 

DARTS: Defeating Antibiotic Resistance through Transformative Solutions

Bacterial infections remain a leading cause of death worldwide and will likely become an even greater health care challenge. The number of antibiotic-resistant pathogens grows daily while the discovery of new antibiotics lags dangerously. When a patient arrives at a hospital with a bloodstream infection, every minute matters but choosing the correct antibiotic is also crucial to success. Current methods of bacterial identification and antibiotic susceptibility are not up to the challenge. Testing can take hours, if not days, resulting in longer hospital stays, major complications, and higher mortality rates. Defeating Antibiotic Resistance through Transformative Solutions (DARTS) aims to address these challenges by advancing an ultra-high throughput imaging and culturing platform that can continuously track and test billions of bacteria one by one. If successful, the system will serve as a rapid platform for the discovery and development of new antibiotics. It will also be adapted for patient use as a microbial diagnostic that can rapidly identify the pathogen and the appropriate antibiotic to prescribe, enhancing the stewardship of antibiotics that remain effective. Such a rapid microbial diagnostic would enhance health outcomes, not just for the tested patient, but for everyone, as the diagnostic would greatly reduce the misuse of the antibiotics that remain effective.

CDTR: Stem Cell-Derived Thymus Rejuvenation

Thymmune Therapeutics’ Stem Cell-Derived Thymus Rejuvenation (CDTR) project aims to restore immune and endocrine function in patients lacking a functional thymus by using engineered stem cell-derived treatment. The thymus is an organ responsible for supporting normal immune cell development. The project is divided into two phases. The goal of the first phase is to use a combination of chemical and genetic factors to make best-in-class human induced pluripotent stem thymic epithelial cells (iPS-TECs) with capacity for supporting T lymphocytes (white blood cells) development in vivo. In the second phase, Thymmune plans to develop protocols for transplantation and long-term engraftment of iPS-TEC in animal models to achieve effective immune function, demonstrating a path towards using iPS-TEC to ultimately treat patients lacking functional thymus. Overall, Thymmune’s disease-agnostic approach to combat thymus dysfunction by bolstering immune responses against pathogens, cancer, and vaccines presents a potentially revolutionary means to reboot immunity. Thymmune has the potential to both rescue patients lacking a functional thymus from morbidity and mortality and addresses a crucial unmet need to rejuvenate immunity in the aging population.

HEART: Health Enabling Advancements through Regenerative Tissue Printing

Over 3 million patients in the United States need tissue transplants, with more than 100,000 patients on the national transplant waiting list. Unfortunately, many of these people die while waiting for a donated organ. The Health Enabling Advancements through Regenerative Tissue Printing (HEART) project proposes to advance multiple technologies, including the optimization of purity and scalability of human cells, improved 3D printing technology and speed, advances in computational modeling, and novel approaches to organ maturation and implantation. The end result is the 3D printing of a human heart in one hour. This ambitious project has the potential to revolutionize the fields of human tissue and organ printing through large advances across multiple technologies. HEART could create a world where a doctor could 3D print an organ for their patient instead of waiting for a donor, effectively ending waitlists for transplants. This advance would improve the lifespan and quality of life for many Americans and provide broader patient access across all communities.