Using Tech to Open the Door to Better Wastewater Testing for Outbreaks

By Matt Phillion

The healthcare industry continues to feel the impact of the COVID-19 pandemic, the way it changed how we look at infectious diseases, and how they spread through the populace. Specifically, a recent report from the Lancet noted that wastewater monitoring can anchor global disease surveillance systems in the future.

On this front, two organizations have partnered to shorten the time window for identifying viral load in wastewater within a community. Akadeum Life Sciences, a Michigan-based firm pioneering microbubble cell separation, has teamed up with Agilent Technologies to offer a viral DNA/RNA wastewater prep kit to provide faster, simpler sample preparation and analysis of total wastewater samples while requiring fewer steps compared to existing processes.

“For us, it all starts with asking ‘Why do we do this work? How do we use our training and experience to help other people?’” says Brandon McNaughton, PhD, CEO and founder of Akadeum. “When the pandemic broke out, we weren’t actively doing anything with viruses or capturing nucleic acids, but rather were in the cell separation space. But when the world turned upside down, we asked, how can we contribute here?”

One of the fascinating developments in this space during the pandemic was the type of monitoring occurring and how that monitoring was changing, even beyond detecting COVID.

“Any new novel virus is going to spread, so the fundamental question is: how do we even know how that virus spreads and how many people have it?” says McNaughton.

Individual testing has its uses but can lag by weeks or longer, which means detecting a novel virus in a population can be based on out-of-date information. What other options existed for monitoring and detection?

“The product we developed was intended to contribute to this idea of surveillance of wastewater,” says McNaughton. “What’s powerful about that is that it’s a real-time signal. You have a community of 10,000 or 50,000 people feeding into the same waste stream, so with a sensitive enough technology to grab nucleic acids out of that wastewater you can ask all sorts of questions.”

And by doing so, you can sample an entire community rather than just a fraction of that population, McNaughton notes.

“That’s a game changer for pandemic outbreak monitoring,” says McNaughton. “We recognize we needed a partner with a team like Agilent to realize this.”

Wastewater monitoring has found important use in healthcare for areas like antibiotic-resistant bacteria, but what’s changed, McNaughton says, is the recognition that wastewater can be tested for other things.

“There’s a question of why, if it’s so important, we don’t test more, and maybe that’s because it’s difficult or takes a long time—and that’s the status quo we’re responding to,” he says.

The question to begin with is: how do you fish out nucleic acids from within a complex sample?

“Pulling something out of a messy sample is a bit like fishing: you need a lure, and the bigger the volume, the harder it is to find the fish,” says McNaughton.

Right now, he says, wastewater monitoring usually deals with volumes of water of 50 ml, which means if you’re working with a lot of samples, this is a lot of wastewater to be handling, and can also be time-consuming.

“We allow users to do this with 3 ml instead of 50, so it’s faster and easier,” says McNaughton.

This is made possible through a next-generation way of pulling out what you’re looking for from the sample in a way that’s more sensitive, and works with lower volumes.

“Instead of using filtration or things like that, we use tiny floating particles made of silica called microbubbles, about a fifth the width of a human hair,” he says.

The nucleic acids in the wastewater attach to the surface of the microbubbles which allows the gas in the bubble to float to the surface. The bubbles are then collected and the team can perform the sequencing needed for monitoring and detection.

Akadeum’s YouTube channel has several videos highlighting the technology.

 

“This is scalable in any size you want,” says McNaughton.

New technology, new uses

The pandemic continues to, through need and awareness, increase the opportunity for new technologies to arise that allow researchers to look ahead and help prevent the next outbreak.

“We were already interested in epidemiology,” says McNaughton. “We talk about the pandemic as this novel thing—that nothing like this has happened before—but as a species, we’ve always had outbreaks. It’s meaningful to us to want to get this technology out there, to enable tests that weren’t possible before.”

This type of monitoring doesn’t have to stop with COVID or looking at nucleic acids, he explains.

“We could envision doing so much more with this technology,” McNaughton says. “It’s possible, for example, to test urine for diseases in a way that doesn’t require a blood draw to enable better compliance for patients. The potential is here for much bigger and broader uses.”

McNaughton envisions use cases for the microbubble technology that would enable researchers to capture proteins, antibodies, and cells. It all depends on what you’re looking for and what you want to pull from the samples.

“The first area I think of is diagnostics, capturing rare DNA or RNA in the blood where it’s otherwise very difficult to detect,” he says.

Another area, albeit outside of the healthcare arena, is forensics.

“We have scientists working on how to apply this technology to look for cadavers in ponds,” McNaughton says. This would enable, in the case of a missing person situation, to test the water for that person’s DNA to locate it through testing rather than a physical search.

Turning back to healthcare, diagnostics is a huge area to explore, a multibillion-dollar market looking for improvements in efficiency.

“There’s no limit to what it can do. We’re enabling tests that may not have been possible before, which could even simplify point-of-care testing in the future. If you simplify how you get something out of a sample, everything after that becomes easier as well,” says McNaughton.

This includes being easier on the patient, he says. The earlier example of testing urine over blood—a less invasive, less intense experience for the patient—can help with better compliance and adherence for patients.

As new methods are enabled, new tests can then be developed with higher sensitivity but lower volume extraction. Looking at the technology’s cell separation capability, instead of just getting nucleic acids from a sample, they can use the same process to extract T cells from blood and improve the workflow in the area of gene therapy.

“We’re creating a gentle way to separate cells, scalably and quickly, to reduce the price and complexity and make it more accessible as well as more effective,” says McNaughton. “I love looking at and being inspired by other industries and the way engineering and technology runs its course. When commercial aviation began, only jet-setters could fly, and now air travel is accessible to the vast majority of us. I feel like cell therapy is at a similar turning point. It’ll take time and different companies to make it accessible to everyone, but Akadeum is firmly on the road to making it efficient and cost effective so that anyone can benefit from this life-saving therapy.”

Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.