Towards digital health: Real-time monitoring and personalisation of immunosuppressive therapies using 3D printing

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Around the world, 93,000 organ transplants are performed annually, with patients being maintained on lifelong immunosuppressive therapy. These narrow therapeutic index drugs require regular monitoring and dose titrations, a process which is highly expensive and time-consuming, costing the NHS over £136 million annually. To reduce the burden on healthcare services and improve patient outcomes, a new method of monitoring and drug dosing is required. As such, this project aims to engineer a non-invasive platform for real-time immunosuppressive monitoring and personalised dosing using three-dimensional printing (3DP). The project will be split into two parts: Part 1) development of a portable device for the rapid evaluation of drug levels in non-invasive biological fluids (e.g. saliva) using surface enhanced Raman spectroscopy (SERS), and; Part 2) Development of personalised 3D printed dosage forms containing therapeutic agent based on the clinical feedback from the SERS device. Via the intersection of these two cutting edge technologies, the management of immunosuppression will in the future be revolutionised, reducing healthcare costs and preventing the risk of severe drug toxicities. This project addresses key themes of the EPSRC (especially Developing Future Therapies grand challenge) with a focus on innovative engineering for the monitoring and personalisation of treatments. Within this project, the platform will be developed and applied to immunosuppressive regimes, which in the short term would be evaluated in in vitro and ex-vivo models to demonstrate proof-of-concept. In addition, the hybridisation of SERS and 3DP technologies could be applied to monitor narrow therapeutic index drugs in other disease areas.