Elixirgen Builds Rare Disease Pipeline Around Telomere Biology Disorders and DMD

During the 2026 BIO International convention in San Diego, GEN sat down with Aki Ko, CEO of Elixirgen Therapeutics, to discuss the company’s multi-platform technology development efforts. The company, which was founded in 2017, is developing what it believes are breakthrough technologies that target telomere biology disorders (TBD) and aging as well as mRNA-based therapies.

Its therapy for addressing telomere biology disorders, based on its proprietary ZSCAN4 approach, is the furthest to the clinic. The biotech company will also target other aging-related diseases with the technology. Meanwhile, its efforts in the mRNA space are currently focused on Duchenne Muscular Dystrophy (DMD), although there are plans to pursue other targets there as well. 

Ko founded the company with CSO Minoru Ko, MD, PhD, in 2017. Elixirgen’s 15 employees are based in Baltimore in its office space in the Johns Hopkins Medical campus, although there is no affiliation with the university. This location offers some advantages to the company, according to Ko. Specifically, “we have a wet lab and an animal lab” that has “helped us go from in vivo to in vitro very quickly to test concepts or optimize formulations and things like that.” 

Recently, Elixirgen announced an option agreement with Japan’s Nippon Shinyaku focused on DMD. Under the terms of the agreement, Elixirgen will be responsible for the development of an asset dubbed EXG-7001, a locally administered, full-length dystrophin mRNA therapeutic that is currently in preclinical development for the treatment of DMD.

As part of the deal, Nippon Shinyaku will provide funding for the developmental costs of the therapy. Meanwhile, Elixirgen will receive an upfront payment and is eligible to receive additional development and sales-based milestone payments if the option were to be exercised. Also, Nippon Shinyaku may obtain exclusive worldwide rights to commercialize EXG-7001.

“Current approaches for treating DMD focus on delivering or restoring an incomplete dystrophin protein, and there still remains a significant unmet need for a therapy that can successfully deliver a full-length dystrophin protein,” Ko said in comments about the announcement. “By design, EXG-7001 has the potential to deliver the full-length, complete dystrophin protein that is missing in DMD patients, regardless of their genetic mutation.”

EXG-7001 leverages one of Elixirgen’s core technologies. The company has developed a platform for delivering mRNA-based therapies that it claims addresses the major delivery limitations of current methods. “The key features are that it is a lipid nanoparticle-free, localized mRNA therapeutics platform,” Ko explained to GEN. With this approach, “we’re avoiding some of the complications of gene therapies and delivering genes systemically by going local” and avoiding liver accumulation, which remains “a big issue” for mRNA therapeutics. 

The system has two components. The first component, called RNA tether, is designed to ensure that the RNA stays in the tissue that is injected without migrating to the liver. The second component is the mRNA cargo itself, which the company calls Bobcat® mRNA. Though the lead indication for this technology is DMD, there are other diseases involving large genes that the company could target. 

“We’re able to express the full length protein as mRNA as a single strand” and “it stays where you administer it, which is kind of unusual,” Ko said. Combining RNA tether and Bobcat makes it possible to express large genes and localize them to target tissues even without accumulation in the liver. Preclinical data has demonstrated its effectiveness in mice with no safety concerns associated with administration or treatment. “A full length dystrophin being given to kind of key muscles could potentially change quality of life,” particularly for the non-ambulatory population, Ko said. 

Beyond EXG-7001, Elixigen has other candidates in its pipeline that are much closer to the clinic. Its lead candidate is currently in Phase I/II testing at Cincinnati Children’s Hospital Medical Center. This is an ex vivo cell therapy based on the company’s ZSCAN4 technology, which is designed to extend the telomeres of stem cells in “a controlled way” using a telomerase-independent mechanism. EXG-34217 is comprised of autologous CD34+ hematopoietic stem cells that have been treated ex vivo with EXG-001, a non-integrating, non-transmissible, temperature-sensitive Sendai virus vector encoding human ZSCAN4.

The features of that technology were identified by the company’s CSO and his team while he worked at the National Institutes of Health’s National Institute on Aging. In 2024, the U.S. Food and Drug Administration granted Rare Pediatric Disease Designation to the treatment, dubbed EXG-34217, for the treatment of patients with dyskeratosis congenita and related telomere biology disorders. 

“Telomeres obviously have a relationship with aging, and there are in fact genetic diseases associated with short telomeres and telomerase mutations,” CEO Ko told GEN at BIO. People with TBDs are “born with shorter telomeres typically, but also have a mutation in their telomerase so they are not necessarily maintaining them either.” The result is a type of premature aging, so conditions like bone marrow failure and cytopenia happen earlier in the life of the patient. In fact, “bone marrow failure is one of the largest issues” affecting both adults and young children, CEO Ko said. 

One treatment option in these cases is allogeneic hematopoietic stem cell transplantation (HSCT), he continued. However, people with short telomeres have more fragile genomes that are less resistant to chemotherapy and radiotherapy and are at greater risk of cancer even after HSCT treatment. In an ideal scenario, it would be possible to postpone or avoid HSCT for these patients, and the company’s ZSCAN4-based therapy could make it possible to do that. 

The treatment is currently being tested in adult and pediatric patients in Cincinnati. “We started in adults because this is first-in-human,” but the disease is also very severe in children, Ko said. “Our target ultimately is to make sure as many people with TBDs can get this if they need it.” Early clinical results published in 2025 in a paper in NEJM Evidence show durable telomere extension overall with no treatment-related safety concerns observed over a 24-month and 5-month period after infusion. The trial has been going on for some time, and “we have a lot of longer-term data now” and are “looking toward potential accelerated approval.”

But targeting TBDs is just one indication. “Short telomeres manifest in many different ways,” Ko said. Other potential targets for the company’s technology are aging-related diseases, including things like idiopathic pulmonary fibrosis. 

To date, Elixirgen has raised roughly $34 million from existing investors.

The post Elixirgen Builds Rare Disease Pipeline Around Telomere Biology Disorders and DMD appeared first on GEN – Genetic Engineering and Biotechnology News.

<![CDATA[Expert explores fast-acting depression treatments, psilocybin trial pitfalls, and why stigma still limits buprenorphine access for opioid use disorder.]]>

Merck and Insilico Make Deals, Claude Science’s Debut, Vaccines for Neglected Diseases

More big biotech deals on the docket this week. First, Merck KGaA is buying Bio-Techne for $11.3 billion to expand its presence in high-growth life science markets. We dive into the details of this deal and then turn our attention to a $2.5 million collaboration to use artificial intelligence to find drug candidates for neuroimmune disorders. That deal involves Insilico Medicine and SK Biopharmaceuticals. Still on the theme of AI, we discuss Anthropic’s Claude Science, the latest entrant to the growing ecosystem of tech platforms specialized for biology, and a set of models for antibiotic design and vaccine target prediction. Lastly, we dig into two recent publications that discuss vaccines for Nipah virus and one of its relatives, and for treating schistosomiasis.

Listed below are links to the GEN stories referenced in this episode of Touching Base:

Merck KGaA to Acquire Bio-Techne for $11.3B, Expanding Life Science Tools Presence

By Alex Philippidis, GEN Edge, June 25, 2026

Insilico, SK Launch Up-to-$2.5B Neuroimmune AI Drug Collaboration

By Alex Philippidis, GEN Edge, June 28, 2026

Claude Science Is Here, Antibiotics Designed by Text Prompt Among Applications

By Fay Lin, PhD, GEN Edge, June 30, 2026

Schistosomiasis Vaccine Shows Strong Immune Memory in Early Clinical Trials

GEN, June 29, 2026

Nipah and Hendra Viruses: Antibody Cocktail Provides Complete Protection in Hamster Model

GEN, June 26, 2026

Touching Base Podcast

Hosted by Corinna Singleman, PhD

Behind the Breakthroughs

Hosted by Jonathan D. Grinstein, PhD

The post Merck and Insilico Make Deals, Claude Science’s Debut, Vaccines for Neglected Diseases appeared first on GEN – Genetic Engineering and Biotechnology News.

ASMS 2026: Solving Proteomics’ Next Bottleneck

At the 74th American Society for Mass Spectrometry (ASMS) Conference in San Diego, the obvious story was hardware. Vendors showcased faster acquisition, higher sensitivity, alternative fragmentation, spatial workflows, and software ecosystems. New or highlighted platforms and workflows came from Waters, Thermo Fisher Scientific, Sciex, Bruker, Biognosys, and Evosep.

But after several days of talks, posters, hallway conversations, and interviews with senior figures in mass spectrometry (MS)-based proteomics, the deeper story was not simply that instruments are getting better. The field is beginning to look past the instrument. The mass spectrometer is still central, but the question is shifting: what has to happen around it for proteomics to become clinically useful, scalable, trusted, and routine?

Beyond the instrument

Jennifer Van Eyk, PhD, professor of cardiology, biomedical sciences, pathology, and laboratory medicine, and director of the Advanced Clinical Biosystems Research Institute at Cedars-Sinai Health Science University, put it most directly: “I think mass spec is no longer the limitation. We have the sensitivity, the throughput, and the accuracy at discovery and targeted levels.”

Jennifer Van Eyk, PhD [Gustav Ceder]

That is a remarkable statement in a field long defined by instrument performance. Van Eyk was not saying that MS innovation is finished. She pointed to continuing gains in quantitation, protein structure, conformational analysis, post-translational modifications (PTMs), top-down proteomics, and protein dynamics. But for clinical impact, she argued, the next bottlenecks are increasingly sample preparation, data analysis, standardization, harmonization, and quality control.

Joshua Coon, PhD, professor of biomolecular chemistry at the University of Wisconsin-Madison and the Pyle Chair at the Morgridge Institute for Research, saw instrument speed as the force opening new applications. Faster scanning mass analyzers are allowing deeper proteome coverage, more post-translational modification (PTM) measurements, and shorter runs. Ryan Kelly, PhD, professor of chemistry and biochemistry at Brigham Young University, framed the same shift as a throughput problem. “Now the mass spec is so fast that we need to figure out how to feed it faster,” he said. In plasma proteomics, Coon said, faster instruments, nanoparticle-based enrichment, and improved chromatography are moving the field from hundreds

Joshua Coon, PhD [Gustav Ceder]

toward thousands of detectable proteins in blood.

John R. Yates III, PhD, the John Lytton Young Endowed Chair in the department of integrative structural and computational biology at Scripps Research, highlighted electron activation dissociation methods and the possibility that high-throughput workflows could push MS deeper into plasma and population-level studies. He described targeted affinity platforms as powerful for “known knowns” because they measure targets defined in advance. “But with mass spectrometry,” he added, “you can look for unknown unknowns, which is where the gold lies.”

John R. Yates III, PhD [Gustav Ceder]

The point cuts to the heart of where the field now stands, and a recurring ASMS tension. The future of proteomics is not a choice between platforms. It is a division of labor. Targeted affinity technologies have become central to large-scale plasma proteomics and population studies. MS remains uniquely powerful for unbiased discovery, tissue proteomics, complex sample matrices, protein modifications, structural diversity, and biology that is not yet named.

From depth to trust

If the first era of modern proteomics was about seeing more, the next may be about measuring better. Devin Schweppe, PhD, assistant professor in the Department of Genome Sciences at the University of Washington, described the current moment as a “duality.” Instruments can now deliver deep coverage, and computational tools are making interpretation faster. Together, he said, they are creating “a comfort level with trusting the data.”

Devin Schweppe, PhD [Gustav Ceder]

Trust came up repeatedly. For discovery biology, a strong signal can be enough to generate a hypothesis. For clinical practice, it is not. Van Eyk said clinical-grade assays are “way harder than people think they are.” A research study can iterate. A clinical assay has to deliver the same measurement today, in five weeks, in six months, and years later. Once a test is locked, “you can’t go, ‘Oh no, we should have had this extra protein in there,’” she said. “It’s done.”

This distinction matters across assay types. Targeted MS methods such as multiple reaction monitoring (MRM) and parallel reaction monitoring (PRM) can provide absolute quantification, but only for preselected proteins. Data-independent acquisition (DIA), meanwhile, has moved discovery proteomics closer to translation by improving reproducibility and scalability. DIA is still often used for relative quantification, but its ability to capture patterns across tens or hundreds of proteins may become important as clinical decision-making moves beyond single biomarkers and reference intervals.

The field is responding to these demands. David Kotol, PhD, R&D manager at ProteomEdge, discussed an independently validated nine-protein plasma panel designed to improve emergency department triage and imaging decisions for patients with suspected venous thromboembolism, compared with D-dimer alone.

David Kotol, PhD [Gustac Ceder]

Kotol described a shift “from relative protein measurements toward robust, multiplexed absolute quantification.” He emphasized stable isotope-labeled protein standards added early in sample preparation to monitor digestion efficiency, downstream analytical variation, and multi-peptide quantification. These standards cannot remove variation introduced during sample collection, handling, or storage. But they can make the analytical workflow more transparent and transferable.

The clinical gap

Mathieu Lavallée-Adam, PhD, associate professor in the department of biochemistry, microbiology and immunology and director of the specialization in bioinformatics at the University of Ottawa, gave the least glamorous answer to what still blocks clinical translation. “My answer is going to be boring,” he said. “It’s going to be education.”

Mathieu Lavallée-Adam, PhD [Gustav Ceder]

Lavallée-Adam argued that many clinicians and biomedical researchers still do not fully understand what modern MS can do. Too often, the outside view is still: give me a list of differentially expressed proteins. But MS-based proteomics has moved beyond lists, into proteoforms, structural information, PTMs, protein dynamics, and flexible acquisition. “We’re past that now,” he said. “The main barrier is our inability to communicate the possibilities that we offer.”

Sasha Singh, PhD, assistant professor of medicine at Harvard Medical School, associate scientist at Brigham and Women’s Hospital, and director of proteomics research at the Center for Interdisciplinary Cardiovascular Sciences (CICS), described this translation role from inside a hospital environment. “That’s actually my role at the hospital,” Singh said. “I am a liaison between the technology and the application scientist.”

Sasha Singh, PhD [Gustav Ceder]

The translation is becoming harder because proteomics is diversifying. End users often need to distinguish among discovery MS, which can provide broad relative quantification; targeted MS, which can provide absolute concentrations for selected proteins; and targeted affinity proteomics, which can scale well for plasma cohorts but is limited by predefined assays and available binding reagents. Singh added that different technologies may produce profiles that do not fully overlap. Rather than treating that as a failure, she suggested it reveals something real: the circulation contains many subproteomes, and different technologies enrich different views.

AI with guardrails

No 2026 conference escapes artificial intelligence (AI), and ASMS was no exception. But the mood among the researchers was cautious rather than breathless.

Lavallée-Adam said agent-based AI was dominating conversations in his part of the field. The dream is seductive: put a sample on an instrument, ask an AI agent to maximize protein identifications or optimize a method, and let it select the best protocol. But he drew a clear line between potential and reality. “Are such agents really driving change? It’s unclear at this point,” he said. “I think it’s unproven.”

Still, AI-assisted acquisition strategies are entering workflows. Lavallée-Adam’s group works on real-time MS data acquisition, where software analyzes data as it is acquired and adapts the run to the biological question. Instead of measuring the same abundant proteins repeatedly, the system can decide it has seen enough and move on to new targets. In that sense, AI becomes less a magical oracle than an instrument assistant.

Faster instruments are generating more data, and faster analysis is needed to keep up. Schweppe also argued that open-source tools remain essential because they let laboratories build on one another’s work rather than rebuild it.

More than abundance

Much of the clinical proteomics effort is focused on plasma because it is minimally invasive and suitable for screening, longitudinal sampling, and routine monitoring. But even in blood, researchers are learning that plasma is only part of the story.

Roman Fischer, PhD, associate professor and head of the Discovery Proteomics Facility at the Target Discovery Institute, University of Oxford, pushed the conversation back toward biology. Plasma alone does not capture the full circulating system, he noted. Peripheral blood mononuclear cells, extracellular vesicles, microvesicles, and other compartments may contain disease-relevant information that conventional workflows miss. “We have to be more sophisticated in addressing the compartments of the blood,” Fischer said.

Roman Fischer, PhD [Gustav Ceder]

He also pointed to the proteoform problem. A single gene can give rise to many transcripts, isoforms, modified proteins, and glycosylated forms. These differences may affect activity, localization, disease pathways, and therapy response. Capturing that diversity is not possible with targeted affinity assays alone. It requires deeper characterization of the proteome, not only quantification.

Yates offered a clinical example. His group has been developing protein-footprinting approaches that can detect conformational changes in proteins in blood. In one transthyretin amyloid cardiomyopathy project, he said, abundance alone was not the answer. The important signal was how the protein folded or misfolded. That kind of assay moves proteomics beyond proteins going up or down, into structural disease biology.

Van Eyk’s work on remote sampling devices pointed to another future: patient-collected blood samples that make longitudinal cardiovascular studies easier, more inclusive, and better matched to real clinical questions.

In the background was a broader translational arc: discovery, verification, clinical validation, health economics, and access. Plasma proteomics highlights included Lekha Sleno, PhD, professor at Université du Québec à Montréal, who is combining nanoparticle enrichment with isotope-enabled targeted proteomics, and a CinderBio breakfast seminar featuring Fredrik Edfors, PhD, assistant professor at KTH Royal Institute of Technology and SciLifeLab, and Simion Kreimer, PhD, senior research project advisor in the Proteomics and Metabolomics Core at Cedars-Sinai Health Science University.

The seminar focused on accelerated plasma proteomics, rapid digestion workflows, stable isotope standards, Human Protein Atlas resources, and faster enzyme workflows that can reduce lead times. The common message was that sample preparation, quantification, and validation may become as decisive as instrument resolution.

The next bottleneck

ASMS 2026 was not short on technical spectacle. High-resolution instruments, electron-based fragmentation, narrow-window DIA, rapid acquisition, MS imaging, top-down workflows, and AI-enabled software all had their moment. But the most interesting conversations were less about spectacle than maturity.

Proteomics is no longer trying only to prove that it can see more. It is trying to prove that it can measure consistently, explain biology more deeply, support drug development, fit into clinical laboratories, and eventually improve patient decisions.

That means the next bottleneck is distributed across the ecosystem: sample preparation, standards, software, education, reimbursement, clinical menus, regulatory validation, open tools, and the ability to translate technical power into something a clinician can use.

Longer term, integrated proteomics, other omics, imaging, clinical data, and AI may support not only single biomarkers, but interpretable molecular patterns, longitudinal trajectories, and digital-twin-like models of patient biology.

The field spent decades making proteins visible. The next challenge is making proteomic measurements dependable enough to act on.

The post ASMS 2026: Solving Proteomics’ Next Bottleneck appeared first on GEN – Genetic Engineering and Biotechnology News.

Automated Optic Disc Tilt Classification in Fundus Photographs Using Segmentation and the Elliptical Ratio: External Clinical Validation Study

Background: Optic disc tilt is a morphological change in myopic eyes that complicates clinical interpretation and artificial intelligence (AI)–based analysis of fundus images. Accurate detection of optic disc tilt is necessary to avoid misinterpretation of disc morphology and enhance diagnostic reliability across different disease types. Objective: This study developed and externally validated an end-to-end AI-based pipeline for optic disc segmentation and quantitative tilt classification in color fundus photographs (CFPs), offering an objective alternative to manual segmentation and subjective clinical assessments. Methods: We trained a nnU-Net–based optic disc segmentation model on the Standardized Multi-Channel Dataset for Glaucoma (SMDG; n=3103 CFPs) and externally validated it on the Samsung Medical Center (SMC) dataset (n=2448 CFPs from n=1370 patients). Model generalizability was assessed using both a fixed 80:20 random split and 5-fold cross-validation. Tilt was classified using the ratio of the long-axis diameter to the short-axis diameter, with a ratio of ≥1.3 indicating tilt. Segmentation performance was evaluated using the Dice similarity coefficient, intersection over union, and pixel accuracy on the SMDG dataset and using the clinical acceptance rate determined by 2 independent ophthalmologists on the external SMC dataset. Results: Using the SMDG dataset, nnU-Net achieved consistently high performance, with mean Dice similarity coefficients of 0.956 (SD 0.042) across 5-fold cross-validation and 0.961 (SD 0.055) for the best-performing single-fold model across 8 datasets. On the SMC dataset, 2 independent expert reviews yielded mean clinical acceptance rates of 98.61% and 98.86% across disease types, with acceptance rates ranging from 81.63% and 93.88% for edema to 99.59% and 99.17% for pallor, respectively. Tilt was detected in 7.5% (186/2448) of images, with rates of 9.7% (118/1215) for normal images, 3.9% (35/894) for glaucoma, 7.8% (19/241) for pallor, and 14.2% (14/98) for edema. Segmentation errors were observed in 1.39% (34/2448) and 1.14% (28/2448) of cases by the 2 reviewers, mainly due to edema-related swelling, peripapillary atrophy, and vessel confusion. Conclusions: Our pipeline provides objective and reproducible detection of optic disc tilt in CFPs, with strong generalizability to clinical images. By replacing manual segmentation and subjective assessments, the pipeline supports tilt-aware AI diagnostics and scalable screening for myopia-related conditions, with future refinements needed to address edema-related challenges.
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Effects of Virtual Reality on Postoperative Pain Management Following Minimally Invasive Gynecologic Surgery: Randomized Controlled Trial

<strong>Background:</strong> Postoperative pain and anxiety remain common concerns after minimally invasive gynecologic surgery despite advances in surgical techniques and analgesic strategies. Virtual reality (VR) has been investigated as a potential nonpharmacological intervention for pain management; however, evidence in gynecologic postoperative settings is limited. <strong>Objective:</strong> This study aims to evaluate the efficacy and safety of VR technology compared with standard postoperative analgesia for pain and anxiety management in patients undergoing minimally invasive gynecologic surgery. <strong>Methods:</strong> This randomized controlled trial was conducted at Sun Yat-sen Memorial Hospital of Sun Yat-sen University in China. A total of 131 patients undergoing laparoscopy or combined hysteroscopy for benign gynecologic diseases were randomly assigned in a 1:1 ratio to either a VR group (n=68) or a control group (n=63). All patients received a standardized general anesthesia protocol intraoperatively. The control group received conventional analgesic therapy after surgery, and the VR group received a 20-minute VR intervention 6 hours postoperatively. The pain and anxiety levels were evaluated using a visual analog scale at 6 and 7 hours postoperatively. The primary outcome was the change in pain scores between 6 and 7 hours. Secondary outcomes included maximum pain score, anxiety score changes, length of hospital stay, hospitalization costs, and occurrence of adverse events. Analyses were performed according to the intention-to-treat principle. <strong>Results:</strong> There was no statistically significant difference in the primary outcome between the VR and control groups (mean difference 0.169, 95% CI −0.271 to 0.608; <i>P</i>=.45). Similarly, no significant differences were observed in the maximum pain score (mean difference 0.839, 95% CI −0.101 to 1.779; <i>P</i>=.08), and no improvement was observed in the anxiety score (mean difference 0.042, 95% CI −0.365 to 0.449; <i>P</i>=.84). No significant differences were found in length of hospital stay, hospitalization costs, or incidence of adverse events, including dizziness, nausea, and vomiting (all <i>P</i>&gt;.05). <strong>Conclusions:</strong> A single 20-minute VR intervention did not provide additional analgesic or anxiolytic benefit compared with standard postoperative care after minimally invasive gynecologic surgery. VR was well tolerated, and its role in postoperative recovery requires further investigation. <strong>Trial Registration:</strong> Chinese Clinical Trial Registry ChiCTR2400091244; https://tinyurl.com/4b92a9td

From Alliance to Nexus: Rethinking Digital Therapeutic Relationships

In traditional human psychotherapy, the therapeutic alliance (TA) is regarded as a fundamental factor that describes the client-therapist relationship, mainly due to strong evidence demonstrating its impact on treatment outcomes regardless of theoretical orientation. More recently, advances in artificial intelligence (AI) and other technologies have led to the emergence of the concept of digital TA, used to characterize the relationship between clients and AI-based therapeutic systems. This approach replicates human dynamics but overlooks key differences between human therapists and digital agents. Prematurely translating the concept of TA into the digital context fails to address issues such as the sycophantic tendencies of current systems and the inherent limitations of algorithmic interaction. We propose the digital therapeutic nexus, a framework that recognizes these differences and provides a set of structured criteria for categorizing digital interactions into 3 progressive levels. This Viewpoint argues that only at the highest level can parallels be drawn to the human TA and stratifies the main risks associated with each nexus level. Transitioning from the concept of alliance to that of a nexus offers a more precise conceptual basis for describing and evaluating digital therapeutic relationships, with implications for research, design, and the ethical development of AI-based mental health interventions.
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<![CDATA[As America nears 250 years, a psychiatrist argues independence is core to mental health, urging clinicians to fight stigma and restore autonomy.]]>

Blood circRNAs Can Predict Alzheimer’s Years Prior to Symptoms Onset

A set of blood-based circular RNAs (circRNAs) could change how we diagnose and monitor Alzheimer’s disease, providing a simple, noninvasive test that can detect the disease with remarkable accuracy and predict its progression years before symptoms appear.

Washington University School of Medicine researchers analyzed blood samples from 1,221 individuals, including people with Alzheimer’s disease and cognitively healthy participants, making it one of the largest investigations of blood circRNAs in Alzheimer’s to date. The findings, published in a Nature Medicine study, identified 34 circRNAs whose combined expression patterns accurately distinguished Alzheimer’s disease from healthy aging.

Unlike conventional RNA molecules, circRNAs form single-stranded closed loops that resist degradation and are abundant in the brain. Their stability and ability to cross the blood-brain barrier make them attractive candidates for blood-based biomarkers that reflect changes occurring in the brain.

The research indicated that a predictive model built from the 34 circRNAs achieved an area under the curve (AUC) of 0.945 for identifying biomarker-confirmed Alzheimer’s disease, outperforming the widely used plasma biomarker pTau217 (AUC 0.877). When circRNA measurements were combined with pTau217, diagnostic performance increased further to an AUC of 0.977.

Beyond diagnosis, the circRNA signature demonstrated exceptional ability to predict disease progression. Individuals with elevated circRNA scores were nearly three times more likely to progress to symptomatic Alzheimer’s disease than those with lower scores. The model also outperformed pTau217 in forecasting progression and remained highly specific for Alzheimer’s, showing limited predictive ability for other neurodegenerative disorders such as Parkinson’s disease, frontotemporal dementia, and dementia with Lewy bodies.

Importantly, the findings were independently replicated in two additional cohorts, including 551 participants from the Knight Alzheimer’s Disease Research Center and 1,767 participants enrolled in the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s Disease (A4) study. This independent validation demonstrates that the circRNA signature is robust across multiple populations and study designs.

The researchers also found evidence that circRNA changes begin approximately two to four years before the onset of clinical symptoms, suggesting that these molecules may capture biological processes closely linked to the transition from silent pathology to cognitive decline. Such biomarkers could become increasingly valuable as disease-modifying therapies enter clinical practice, where monitoring ongoing neurodegeneration is just as important as detecting amyloid pathology.

The work builds on intellectual property protected by patent PCT/US2026/017857, “Blood Circular RNA as a Noninvasive Biomarker of Alzheimer’s Disease,” which Circular Genomics has licensed. The company, based in San Diego, California, is developing next-generation molecular blood biomarker diagnostics for precision neurology. The patent covers the use of blood circRNA signatures for the diagnosis and monitoring of Alzheimer’s disease and supports continued development of clinically deployable blood tests.

While the authors emphasize that larger prospective studies are still needed before widespread clinical implementation, the findings position blood circRNAs as a promising new class of biomarkers for Alzheimer’s disease. By combining high diagnostic accuracy with strong prediction of disease progression using a simple blood sample, circRNA-based testing could help identify patients earlier, improve clinical trial enrollment, and provide physicians with new tools to monitor disease over time.

The post Blood circRNAs Can Predict Alzheimer’s Years Prior to Symptoms Onset appeared first on Inside Precision Medicine.

Achieving operational excellence with AI

Frameworks like Lean Six Sigma and business process management (BPM) first gained traction because they promised clarity in the chaos—a structured way to bring order to messy, sprawling operations. Lean Six Sigma emphasized statistical rigor and quality control; BPM created end-to-end maps of how work should flow across departments. Both offered a repeatable way to embed habits of measurement, analysis, and accountability into day-to-day company culture.

But today, those time-tested playbooks are evolving as companies seek to embed AI into established process excellence methodologies. By some estimates, the market for AI-powered process optimization is projected to exceed $113 billion within the next decade. In one study, a full 88% of business leaders anticipated increasing investments into AI-infused process intelligence in the next 12 to 18 months.

Yet without the right foundations, many of those investments may not fully deliver on their potential. Companies that already operate with discipline have an edge. They can channel new tools into proven systems rather than bolting them onto shaky foundations. Organizations with mature process disciplines are also better positioned to translate AI ambition into real outcomes, as they are already accustomed to data-driven decision-making and process discipline—precisely the cultural foundation AI systems need to deliver value.

Simply put: AI can accelerate process excellence, but existing process excellence is what makes AI truly impactful. Technology and process are no longer separate levers, and only organizations that pull them together stand to realize the full value of both.

Download the full report.

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.