They look like earbuds, feel like earbuds—but when you put them in, they’re completely silent. That’s because these earbuds aren’t for playing music or listening in on a video call. Instead, they deliver a finely-tuned electrical field to the brain.Unveiled today, the earbud-like devices are a revolutionary rheumatoid arthritis treatment pioneered by neurotech startup Nēsos. These wearable therapeutics may sound like science fiction. Even Nēsos founder and CEO, Konstantinos Alataris, calls them a “moonshot idea.” But according to the data from Nēsos’s first clinical study, these devices are hardly far-fetched.

Introducing E-mmunotherapy

Normally, autoimmune diseases are treated with medication. In the case of rheumatoid arthritis, the current best treatments are over-the-counter pills like ibuprofen or prescription immunosuppressants like Humira. But these medications are not without side effects. And in the case of Humira, the medication must be injected under the skin, an uncomfortable routine for many patients. But what if there was a way to treat painful conditions like rheumatoid arthritis without pills or needles?What if the medicine was electric?That’s what Nēsos is aiming to achieve through a novel therapeutic approach the company is dubbing ‘e-mmunotherapy.’ If successful, this will be the first wearable, non-invasive treatment for an immune system disorder.

The Neural-Immune Connection

Neuroscience and immunology were once thought to be completely separate fields. But it’s now understood that these two systems are in constant communication with each other. The brain simultaneously generates thoughts and actions while taking care of critical functions like heartbeat and body temperature. It turns out that the brain also plays a major part in regulating inflammation. When these neural inflammation networks go haywire, it can result in immune system disorders like rheumatoid arthritis.

Nēsos’ first e-mmunotherapy proof of concept works by sending electrical signals to the brain to reinforce its natural pathways. “This is an opportunity to take a biological pathway, how the brain controls an overactive immune response, and restore it using an electrical field, mimicking the brain's language,” says Alataris. So far, the company’s wearable tech approach looks promising. Patients of the company’s pilot clinical trial reported reduced severity of their rheumatoid arthritis symptoms comparable to the results of current medications.

Possibilities Proven Through Data

Alataris already has deep experience in electrical therapeutics. He was previously the founder and CEO of Nevro, a company that produces subdural spinal cord stimulation devices for chronic pain. Similar startups, like Elon Musk’s Neuralink, rely on implanted electrode arrays. But this is the first time that electrical signals will be delivered through a fully external device.If approved, these devices could dramatically simplify the treatment for inflammation-driven conditions. The earbuds would only need to be worn for a few minutes each day and the positive effects would increase over time. By reinforcing the proper neural pathways, the devices ‘teach’ the brain to remember the positive changes. Not only does this provide sustained relief, it also hits closer to the root of the illness, addressing brain signals rather than chemical ones.Nēsos also recognizes the unique nature of each patient’s condition. Using machine learning, Alataris says the devices will eventually be able to deliver personalized electric fields depending on a patient's disease progression. “Your therapy, your electrical field, your path sequence, at the end will be different than mine,” says Alataris.With $16.5 million in funding led by Mayfield Fund, Nēsos is already in process to test their devices in randomized control trials. If successful, the results will be submitted for FDA approval. But Alataris is clear that it will be years before these devices can be prescribed for patients—validation through data comes first. “We don't want to step too far off. We’re putting one foot in front of the other based on the data,” says Alataris. With the increasing rise of scientific misinformation, establishing trust with the public through data is more important than ever.If Nēsos’ first devices are effective in retraining the brain’s inflammatory response, it could open the door to a wide range of therapeutic options. More and more conditions, from diabetes to mental health disorders, are being newly understood in the context of inflammation. Indeed, Nesos is already developing two more products to address migraine prevention and postpartum depression.For Alataris, this is the next level of neuroscience. “We are still at the very early stage of what is possible and what we can possibly do. To have these big dreams, you need data to stand on. We don’t want to go chasing dragons here, but it’s a very exciting time,” says Alataris. If validated, Nēsos’ technology may be the first step towards a new future of therapeutics.I’m the founder of SynBioBeta, and some of the companies that I write about are sponsors of the SynBioBeta conference and weekly digest, including the Mayfield Fund. Thank you to Desiree Ho for additional research and reporting in this article.

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