Around seven million individuals globally struggle with inflammatory bowel diseases (IBDs) such as colitis and Crohn’s disease. One of the significant challenges in managing IBDs is predicting clinical flares, which often occur in these patients and influence their treatment strategies. Current methods to identify conditions inside the gut might be invasive, like colonoscopies, and often fail to recognize crucial, short-lived molecular biomarkers of the disease in real time. The absence of robust biomarkers to predict inflammatory flares leads to patients experiencing severe symptoms that require hospitalization for proper management.

Researchers at MIT (Cambridge, MA, USA) and Boston University (Boston, MA, USA) have developed a groundbreaking innovation: a smart pill, about the size of a blueberry, that could revolutionize the way IBDs are diagnosed and treated. This pioneering device is the first ingestible technology that can automatically identify and relay real-time data about critical biological indicators of potential complications. The latest work significantly advances earlier research with the current pill being more than six times smaller than the earlier prototype, conforming to safe, ingestible dosage forms available in the market. Moreover, the smart pill is designed to detect essential biological compounds, like nitric oxide and byproducts of hydrogen sulfide, both of which are significant indicators of the inflammation seen in IBDs.

This innovative pill, which has already shown promising results in pig trials, combines specially engineered living bacteria with compact electronics and a miniature battery. Upon detecting a target molecule, the bacteria emit light. The pill's electronics then convert this light into a wireless signal, which is sent to an external device like a smartphone or computer, offering real-time updates as the pill navigates the gut. The research highlighted the pill's capability to identify nitric oxide, a short-lived molecule linked to numerous IBDs. Notably, the sensors can detect varying nitric oxide concentrations, enabling medical professionals to distinguish between a normal situation and disease. This feature is crucial as biomarker levels can greatly differ among patients. The team envisions further adapting the pill to identify other essential biomarkers. Additionally, this synergy of microbes and electronics holds potential for applications in monitoring health apart from gastrointestinal issues.

“The inner workings of the human gut are still one of the final frontiers of science. Our new pill could unlock a wealth of information about the body’s function, its relationship with the environment, and the impact of disease and therapeutic interventions,” says Timothy Lu, an MIT associate professor of biological engineering and of electrical engineering and computer science. 

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