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Bosch to enter the medical technology sector – start-up culture meets proven expertise

Many of us have known the Bosch Group mainly as a technology company that is active in the automotive sector. Now, the multinational company is opening up a whole new field of business and is entering the medical technology market with a new subsidiary. Bosch Healthcare Solutions GmbH, which is headquartered in the city of Waiblingen, has developed an innovative breath analysis device that allows asthmatics to measure the severity of airway inflammation from their own home.

Asthma is a chronic inflammation of the airways that is often caused by allergic reactions. One in twenty people have the disease. © Robert Bosch GmbH

The Bosch Group is an international technology and service company with around 390,000 employees in 60 countries. In 2015, Bosch Healthcare Solutions GmbH was founded as a start-up subsidiary within the Bosch Group. More than 80 people are currently employed at the company’s headquarters in Waiblingen where they develop and manufacture networked products and services in the field of health and medical technology. Bosch Healthcare Solutions GmbH’s interdisciplinary team also includes medical doctors from the Robert Bosch Hospital in Stuttgart who support the company’s scientists. The first product will soon be placed on the market: Vivatmo me, a breath analysis device for asthmatics that allows those affected to measure the severity of airway inflammation from their home and save the data with the Vivatmo app, enabling them to share the data with their doctors. The doctors analyse the data, and are then able to adapt therapy to the individual requirements of their patients.

Breath analysis device measures biomarkers in exhaled breath

Worldwide, there are 330 million people who suffer from asthma. Asthma is a long-term inflammatory disease of the airways which is often caused by allergic reactions. The lungs of asthmatics are hypersensitive to a broad range of different stimuli. Exposure to such stimuli may result in anything from feelings of anxiety up to severe respiratory distress. The symptoms may be permanent or may only occur in combination with certain environmental influences such as the presence of pollen. The symptoms can be treated with medication, but also patient training or respiratory physiotherapy are available to help the patients.

Dr. Sonja Lauterbach is a biologist and has been Head of Therapy Management at Bosch Healthcare Solutions in Waiblingen since 2015. © Robert Bosch GmbH

“The level of suffering of those affected is high,” said Dr. Sonja Lauterbach, Head of Therapy Management at Bosch Healthcare Solutions and responsible for the Vivatmo system. “Our breath analyser, Vivatmo me, can make a meaningful contribution to improving the quality of life of asthmatics.” The principle of the device, which is based on innovative sensor technology, involves the measurement of a biomarker that is expressed in higher-than-normal levels in asthmatics. “Users blow into the device just like they would do to cool down their coffee,” said Lauterbach explaining the principle of the device. “This only takes a few seconds during which the breath sample is processed in the mouthpiece and measured by the sensor in the device. Despite the low concentration, measurement does not take very long.”

The concentration of fractional exhaled nitric oxide (FeNO) is used as biomarker and a direct measure of the degree of inflammation in respiratory diseases. The sensor in the device reacts directly to the biomarker – an innovation, as Lauterbach pointed out, that was developed mainly at Bosch and which draws on the group’s core competencies, i.e. sensor systems and miniaturisation. Dr. Lauterbach highlighted the fact that the new Bosch subsidiary will benefit not only from access to a promising market, but also from the ability to use the Bosch Group’s existing technological strengths.

Adapting therapy to the individual needs of patients

As the FeNO level reflects the inflammatory activity of allergic bronchial asthma, an increase in FeNO is a sign of worsening asthma. Therefore, lung specialists approached Bosch to inquire about the possibility of monitoring the quantitative course of the disease in the everyday lives of the patients and thus identify environmental influences that cause problems and worsen asthma symptoms. Lauterbach commented: “At present, physicians are only able to find out the conditions that worsen asthma systems when talking to their patients. It goes without saying that it is very difficult to remember the exact details of something that occurred many days ago.”

Asthmatics usually see their doctor once every three months in order to undergo a lung function test. In the time in between these visits to their doctors, many patients use simple peak-flow metres to monitor their lung function based on how well air moves out of their lungs. However, these devices only measure the peak expiratory flow. “The patients have to draw in breath and exhale forcefully,” explained Lauterbach. “The peak-flow metres do not provide quantitative data about biomarkers that would provide direct information about the inflammatory state of the lungs. Vivatmo, however, provides instantaneous information about the inflammatory activity of the lungs. The procedure is similar to the direct monitoring of the blood glucose level, which allows diabetics to better manage their condition.” Asthmatics can thus monitor the treatment process themselves and provide their doctors with information they need to quickly modify treatment should this become necessary.

Home use device is compact and easy to operate

Vivatmo me is a portable breath analyser with which asthmatics can measure the inflammatory activity of their lungs quickly from the comfort of their own home. © Robert Bosch GmbH

The system consists of three different components: the Vivatmo pro device for practices and hospitals, the Vivatmo me measuring device for home use, and the Vivatmo app, with which the data can be retrieved and transferred to the doctors treating the patient. “The measuring device for home use is very handy – similar to a remote control – and can be operated with normal AAA batteries,” said Lauterbach. “Such a compact measuring device for home use is completely new. Similar measuring devices have, up until now, only been available as expensive laboratory instruments for use in practices and hospitals.” Currently, only lung specialists and hospitals have such professional devices. However, this could change in the future. Lauterbach commented: “As the value of the biomarker for measuring airway inflammation in asthma increases, the FeNO-based device will be an excellent contribution to the diagnosis and management of respiratory diseases,” said Lauterbach.

The Vivatmo measuring device is still in the testing and approval phase, but it is expected that the professional version will be put on the market at the end of the second quarter of 2017. The devices will then be manufactured on the Bosch Packaging Technology campus in Waiblingen in quantities that are customary in the medical technology sector. Bosch will not market the devices on its own, but rather in partnership with established sales partners in the industry.

Something new is combined with proven expertise

The fact that the first products can be put on the market within a very short time, proves that the combination of a kind of start-up subsidiary within a large company works perfectly. "Having the Bosch Group behind us, allowed us to draw on many central functions right from the start,” said Lauterbach. “For example, Bosch’s R&D centre in Renningen works together with us on medical technology issues. Ideas also come from other departments, but actual product development is then carried out by our team.”

For future projects, Bosch Healthcare Solutions GmbH aims to focus on ideas that come from other competencies of Bosch. Lauterbach commented: “We are looking at areas where we already have technological strengths and which we can translate into a new medical technology product.” In addition to the breath measurement device, the company is already working on another propriety product – the Vivatar app with which people can be accompanied virtually by friends and family and ask for help and rescue if necessary.

Glossary

  • Diabetes mellitus is a disease which is characterized by an increased glucose level in the blood. It is caused by the lack of insulin. Two types of diabetes can be distinguished. Type 1 diabetes is an autoimmune disease caused by immune cells that destroy the beta cells of the pankreas. Type 2 diabetes is characterized by a resistance against insulin (the target cells are less sensitive towards insulin) and a delayed release of insulin from the beta cells.
  • Being lytic is the feature of a bacteriophage leading to the destruction (lysis) of the host cell upon infection.
  • Translation in a biological context is the process in which the base sequence of mRNA is translated into the amino acid sequence of a protein. This process takes place in the ribosomes. Based on a single mRNA molecule, many protein molecules can be synthesised.
  • Expression means the biosynthesis of a gene product. Usually, DNA is transcribed into mRNA and subsequently translated into proteins.
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