Slide 1: Non-invasive sampling from the deepest of our lungs
Non-invasive sampling from the deepest of our lungs - a novel opportunity for Precision Respiratory Medicine ays rw Ai all The Sm PExA founded by among others Prof. Anna-Carin Olin, Gothenburg University, Sweden PExA is a Swedish early-phase company that develop a unique technology that enables Non-
Slide 2: COPD, asthma, lung cancer & COVID-19 among most common causes of severe illness
COPD (KOL), asthma, lung cancer & COVID-19 are among the most common causes of severe illness and premature deaths worldwide 2 2
Slide 3: Lung disease develops slowly and is often not noticed until late stage
Lung disease develop slowly and is often not noticed until in a late stage Biological material can be collected for accurate diagnosis - but highly invasive and costly - safety concerns Examination at late stage - indirect and inaccurate methods. - spirometry and symptom scoring Disease manifestatio
Slide 4: Early detection, treatment before disease becomes too complex, improved outcome
Early detection ➔ Treatment before disease become too complex ➔ Improved outcome Biological material can be collected for accurate diagnosis - but highly invasive and costly - safety concerns Examination at late stage - indirect and inaccurate methods. - spirometry and symptom scoring PEx sampling h
Slide 5: Pathological process often takes place unnoticed in the small airways
Pathological process often take place unnoticed in the small airways COVID-19 NRP1 ACE2 s w ay >70 m2 ir ll A ma The S Slow progression + difficult to sample -> Difficult to study and detect 5 so.., the main reason for why PExA have been developed is based on the notion that many lung disease initia
Slide 6: Lack of non-invasive methods for assessment of small airways pathology
Lack of non-invasive methods for assessment of Small Airways pathology is often considered being a bottle neck for improved healthcare Other techniques to assess small airways are more invasive and typically only used for research purposes, for example, sputum induction after inhalation of hypertoni
Slide 7: PEx originates specifically from the region where lung disease develops
PEx originate specifically from the region where lung disease develops Exhaled Breath Condensate Volatile Organic Compounds Particles in Exhaled Air - C° .. . . . . .. . . .. ... .. . . . . . . . .. . .. . . . . .. . .. . . . .. . . . . . . .. . . . . . . ... . . . . . . . . . . . . .. . . .. . . .
Slide 8: The PExA breathing manoeuvre
The PExA breathing manoeuvre 1. Full exhalation 2. Full inhalation 3. Exhalation airways reopen Side view aerosol formation airways close Airway wall is covered with surfactant fluid keep breath for 5 sec Sectional view Open airway Closed airway Surfactant film stretch until it burst (like a soap bu
Slide 9: PEx sample collection in short
PEx sample collection in short Exhaled particles are collected by impaction Newton's first law, inertia Particle data Sample For research only. Patented. • Apply a series of PExA breathing manoeuvres • Particles are collected on a removable substrate by impaction (no VOCs) • Amount of collected drop
Slide 10: Particle data
Particle data 10
Slide 11: Particle data is automatically stored after each sampling session
Particle data is automatically stored after each sampling session Sampled mass [ng] 35 Bin µm Particle data 30 1 0.31 and airflow is 2 0.38 25 displayed 3 0.45 20 4 0.56 in real time 15 5 0.7 6 0.94 10 7 1.15 5 8 1.28 9 1.38 0 10 1.47 Bin 1 Bin 2 Bin 3 Bin 4 Bin 5 Bin 6 Bin 7 Bin 8 Bin 9 Bin 10 Bin
Slide 12: Particle flow and size varies with lung pathophysiology
Particle flow and size varies with lung pathophysiology COVID-19 infection, groups Symptom, COV-NEG: neg PCR tests (n=16) Symptom, COV-POS: PCR-verified (n=20) HCO: healthy controls (n=12) Particle size (µm) Hirdman, G. et al. Proteomic characteristics and diagnostic potential of exhaled breath part
Slide 13: PExA in ICU, mechanical ventilation
PExA in ICU, mechanical ventilation Exp Clin Transplant, 2019 Dec;17(6):803-812 Patients with PGD showed a stepwise increase in particle count from day 0 until extubation. No adverse events related to the PExA device was observed https://pubmed.ncbi.nlm.nih.gov/31615381/ 13 There are also several st
Slide 14: Biochemical analysis
Biochemical analysis … some examples 14 Here follows examples of data that illustrate what proteins can be detected and measured in PEx samples
Slide 15: The molecular content of PEx
The molecular content of PEx PEx sample contain large proportion of phospholipids but also proteins Weight % SpA (11.6%) Surfactant protein A SpB (0.6%) SpC (0.2%) CC16 (3.5%) Albumin (25%) low Transferrin (3.8%) abundant Alpha-1-antitrypsin (1.8%) proteins Immunglobulins (29%) Others (24.5%) Pilot
Slide 16: Complement system and its neighbors are well represented in PEx
Complement system AND its neighbors are well represented in PEx ACQ: Complement C3, C3a Healthy Well Poorly controlled controlled asthma asthma Matching the 207 proteins with Pathway Studio database Östling et al, ERS 2017 Spela Kokelj et al, Respiration 2023;102:621–631 16 Interestingly, when the 2
Slide 17: Gene ontology enrichment
Gene ontology enrichment Cellular Component ="Localisation" Target set: 226 PEx/SomaScan proteins Background set: Blood Extracellular microparticle organelle SomaScan panel (1300 proteins) Vesicle P-value colour scale Extracellular Vesicles Extracellular Exosome Platelet alpha Platelet dense granule
Slide 18: Take home messages
Take home messages • PExA is a technology that have been developed to enhance identification and development of actionable biomarkers in the field of precision respiratory medicine. • PEx is not the same as EBC or VOC. • PExA is a non-invasive method for collection of biological material from the di
Slide 19: Please feel free to contact us
www.pexa.se Biotechcenter • Gothenburg • Sweden • info@pexa.se Winner Co-funded by WINNER European Union Horizon 2020 Quickfire Challenge 19 Please feel free to contact us at info@pexa.se