Wings-Enabled Device Targets Type 2 Diabetes in Duodenum
Endogenex, a medical device company founded in partnership with the Mayo Clinic, is presenting trial results demonstrating substantial and durable reductions in insulin resistance and improvements in beta cell function in type 2 diabetes patients treated with its investigational ReCET system. The system utilizes pulsed electric field (PEF) energy to target inflamed and dysfunctional tissue in the duodenum, the uppermost part of the small intestine.
The ReCET system, which stands for Re-Cellularization via Electroporation Therapy, delivers nonthermal PEF energy via a catheter to the mucosal and submucosal layers of the duodenal wall, initiating a process of cell regeneration. According to Stacey Pugh, CEO of Endogenex, the duodenum plays a critical role in type 2 diabetes and the new data reinforce this organ as a novel target for treatment. “We have known for some time that the duodenum plays an important role in type 2 diabetes, and these new data — along with other cutting-edge analyses being presented here at DDW — illuminate and reinforce the duodenum as a novel target in the treatment of type 2 diabetes,” Pugh said.
The approach is based on observations that bypassing the duodenum can lead to remission of type 2 diabetes in approximately half of patients within weeks, a phenomenon observed even before the advent of weight-loss focused procedures. Researchers noted that the benefits occurred independently of weight loss, suggesting a direct impact of duodenal function on metabolic control. ReCET aims to replicate this effect by directly influencing duodenal tissue.
Endogenex’s technology differs from other approaches targeting the duodenum, such as duodenal sleeves or coatings, by utilizing electroporation – a process of using electrical pulses to create temporary pores in cell membranes – rather than ablation, which involves scarring tissue. This distinction is significant, as ablation techniques, like those used in atrial fibrillation treatment, have different mechanisms and potential consequences.
Other companies are similarly exploring duodenal interventions for type 2 diabetes. Aqua Medical is investigating radiofrequency vapor ablation (RFVA) of the duodenal mucosa, a procedure called proximal intestinal mucosal ablation (PIMA). Aqua Medical’s system aims to deliver circumferential ablation to up to 70 cm of the proximal intestine without requiring fluoroscopy or surgical incisions. Early studies of PIMA have shown promising HbA1C reductions and, in some patients, the elimination of insulin employ, though safety and effectiveness have not yet been definitively established.
The ReCET system’s trial results were presented at a medical conference, with further details available through MassDevice. Endogenex is continuing to investigate the potential of ReCET as a treatment for type 2 diabetes, positioning it as a potential alternative to lifelong medication and invasive bariatric surgery.