Through the World Without Disease Accelerator (WWDA), a group within Janssen Research & Development, LLC, one of the Janssen Pharmaceutical Companies of Johnson & Johnson, Murray McKinnon, Ph.D., and his team are embracing an ambitious paradigm focused on disease prevention, interception and cure.
McKinnon, global head of the WWDA, is championing this mission to understand the genetic causes and triggers of disease. With a more than 35-year pedigree in drug discovery and development, McKinnon is working diligently with his team to understand the way this new approach could potentially change how we think about the future of healthcare.
In an interview, McKinnon discussed his goals for the WWDA, which reflect a convergence of deep disease understanding and a focus on the future of interconnected, digital health.
The underpinnings of disease
The WWDA is currently focused on three disease areas where both a high unmet medical need and potential for interception solutions exist: lung cancer, type 1 diabetes (T1D) and childhood allergic diseases. The fact that each of these diseases are underpinned by inter-related immunological mechanisms means that the group is comprised of cross-functional expertise in data science, biomarkers, immunosciences, the microbiome, sensors and wearables, and behavioral sciences.
Murray McKinnon
“What we’re trying to do is have that deep disease understanding so that we can get to potential novel targets and mechanisms that underpin the root cause of disease,” McKinnon said. “It’s about understanding how to select targets and molecules for intervention… and then drawing upon our Johnson & Johnson scale and science in pharmaceuticals, medical devices or consumer health, along with the external innovation ecosystem.”
A global view
One of the important aspects about the WWDA and how McKinnon approaches disease interception is the unexpected connections across disease areas and how the WWDA is working to address important health problems in different countries. During our conversation, McKinnon spoke to several examples of putting a disease interception approach into action.
Lung cancer cells, coloured scanning electron micrograph (SEM). Magnification: x12, 000 when printed at 10 centimetres wide.
One example of McKinnon and his team’s work leverages behavioral neurobiology research through the development of a smartphone app, currently in an active clinical study in China, to help people quit smoking and potentially prevent lung cancer. China has more than 300 million smokers and more than half of adult men in the country smoke. Moreover, 40 percent of the worldwide consumption of tobacco comes from China. Despite this high unmet need, there are only a handful of digital solutions on the market in China to help people understand smoking risk and help them quit.
Almost 4,000 miles northwest, Finland is experiencing a different kind of health crisis.
The country has one of the highest rates of T1D in the world, and according to McKinnon, the Finnish government is keen to understand why. The WWDA is exploring the genetic triggers leading to development of T1D and ways to delay or even intercept the disease in collaboration with Finnish universities, hospitals, biobanks, and other global pharmaceutical companies through FinnGen – a large public-private partnership aiming to collect and analyze genome and health data from 500,000 Finnish biobank participants.
Despite T1D being well-known by people in Finland, the rate of diabetic ketoacidosis (DKA) – a life-threatening condition at diagnosis – is quite high. Leveraging insights from FinnGen, the WWDA set out to help parents recognize when their child is at risk for DKA or progression to diabetes. Through the FinnGen study, the WWDA and other collaborators hope to gain insights into novel medical and therapeutic disease interventions that could apply not only to T1D, but to other diseases. “Broader applicability is key,” noted McKinnon.
In the U.S., the WWDA has strategically leveraged technology and key partnerships to further its mission.
For example, the Heartline™ study, a collaboration with Apple, is designed to detect and inform users 65 years and older of signs of atrial fibrillation (AFib), a common irregular heart rhythm and a leading cause of stroke in the U.S. The program enlists a user’s Apple Watch, connected to a smartphone, to detect abnormal heartbeats, then guide participants to a physician to diagnose and treat AFib earlier, with the goal of hopefully preventing a potential pulmonary embolism or stroke.
“For most people,” McKinnon observes, “we know that when AFib happens, the effect increases the risk of a thromboembolism – for example, a pulmonary embolism – which can be fatal. Think about that. If you didn’t know you had AFib, you would not receive an anticoagulant on that basis, and you could develop a clot which could, in turn, be fatal. By using digital devices and wearables to help patients understand and directly engage in their heart health, we hope to encourage them to have potentially life-saving conversations with their doctors and intercept potentially fatal consequences before they occur.”
Early childhood conditions
Through collaborations with Evolve Biosystems, Monash University and others, McKinnon and his team are also working to unlock the complexity of childhood allergic diseases, such as atopic dermatitis (AD), and celiac disease. The WWDA’s so called ‘Healthy Baby Initiative’ leads this work.
As many as 50 percent of children in the U.S. with AD experience the Atopic March, the cascade and progression of allergic conditions as a child grows up. Some recent studies support the causal link between AD and the onset of other disorders such as food allergies, celiac disease, allergic rhinitis, and allergic asthma.
This concept is gaining more attention within the scientific community. A recent manuscript from the Journal of Clinical and Cellular Immunology emphasizes the inner-workings of AD and the potential for disease interception. The research illustrates that targeting the skin barrier earlier, where allergic sensitization happens, may prevent subsequent atopic disorders. It is known that a dysfunctional skin barrier serves as a site for allergic sensitization to antigens and colonization of bacteria. The manuscript goes on to describe an optimal window of time to do this.
One of the areas the Healthy Baby Initiative focuses on is how a baby’s gut microbiome changes based on a variety of factors, including whether that baby is delivered vaginally or by Cesarean section, whether a baby is fed breast milk or formula, and if that baby has received antibiotics, all of which are known to alter the microbiome. These factors can impact a baby’s immune system and influence their propensity to develop allergies. The WWDA is working to understand whether targeted therapeutic solutions influencing microbiome balance can potentially intercept or prevent allergic conditions in children.
Spanning across geographies and diseases, the WWDA’s work is the definition of “interdisciplinary,” applying insights from different diseases to explore potential intersections of treatment and interception. For example, T1D and celiac disease share a genotypic risk, meaning that when screening for T1D, it is common to find cases of celiac disease.
“We’re trying to develop a new treatment paradigm for disease, employing global collaborations to develop the best science and by applying a deep understanding of disease to leverage all the information at our disposal – biomarker data, sensors and wearables – to prevent disease progression,” McKinnon said. “The WWDA’s work presents a novel approach to the intersection of drug development and digital health, working across borders and boundaries to ensure that the treatment paradigms reflect how deeply connected human health is.”
Photo: Niels Wenstedt/BSR Agency, Getty Images
