Therapeutics and Inflammation: What’s Coming Next?

Many of the major medical conditions that we face in our lives share an underlying cause: chronic inflammation.

In fact, it’s the single largest driver of disease and disability. For years, therapies have been aimed at treating the symptoms of chronic inflammation, but existing therapies do not act to prevent disease progression or directly treat the disease pathway without severely impacting the immune system.

There stands a large opportunity to develop preventative therapeutics that tackle chronic inflammation before it leads to disease progression and to treat diseases at their source. We will break down our analysis today by discussing startups that are tackling holistic approaches, which create solutions to treat and prevent chronic inflammation, as well as systemic approaches where companies are working to use specific pathways and an organ system to develop a curative treatment for chronic inflammation. And in today’s deep dive, we’ll really explore companies that are developing therapies to prevent and cure chronic inflammation.

What is inflammation?

Inflammation is a process where the immune system recognizes and removes harmful stimuli, whether that’s from infection or injury and begins the healing process and a normal acute inflammatory response. We’ll see increased activity in the immune system when a threat is present and that will resolve once the threat has passed.

In cases of chronic inflammation, there are factors such as social, psychological, environmental, or biological that prevent the resolution of that acute inflammation. The result? Systemic chronic inflammation. It’s essentially like a problem that never gets resolved, so it remains in an inflamed state waiting for resolution.

We see this in diseases ranging from cardiovascular, to autoimmune to neurological and more.

The trouble with chronic inflammation

Chronic inflammatory diseases have been recognized as the most significant cause of death in the world today, with more than 50% of deaths being attributable to inflammation-related diseases. This includes conditions such as heart disease, stroke, cancer, diabetes, chronic kidney disease, autoimmune and neurodegenerative conditions and more.

It is far more common – and deadly – than many people realize.

For example, LDL cholesterol is inflammatory and often gets recognized by the immune system after it’s oxidized, which can lead to heart disease. It’s the same thing in diabetes. Several large observational studies have shown that patients with high levels of C reactive protein, which is a measurement of inflammation, are more likely to develop insulin resistance. In addition, researchers have discovered that in patients with type two diabetes cytokine levels are elevated inside fat tissue and excess body fat, especially in the abdomen. This can cause continuous chronic low levels of abnormal inflammation, which alters insulin activity kind of contributes to diabetes.

Overall, chronic inflammation is a leading driver of the nation’s $3.5 trillion in annual healthcare costs.

The good news is that we already know what causes most chronic inflammation. Lifestyle factors including inactivity, poor diet, harmful environmental factors, industrial toxicants and psychological stress are at the root of most of these issues.

However, we’re not likely to see any decreases in these causes anytime soon. That’s because another key contributor to chronic inflammation is literally impossible to stop: aging. The aging process overall has been found to be a general inflammatory cause that involves the whole body and provokes the diseases we associate with age, including Alzheimer’s, atherosclerosis, cancer and more.

New therapeutic solutions

The fact is, the effects of chronic inflammation can be observed throughout life and are known to increase the risk of death. That means we really need to find strategies for early diagnosis, prevention and treatment of chronic inflammation.

Existing solutions to tackle inflammation are typically focused on treating symptoms and sometimes adversely affect the immune system. Steroids are among the more commonly used anti-inflammatories and they work by suppressing inflammation and treat symptoms but do not prevent the underlying inflammatory condition. This causes patients to often become reliant on them to manage their symptoms, and this can lead to unpleasant side effects. Steroids, for example, can cause fluid retention, weight gain and high blood pressure after just short-term use. Over the long-term, patients experience cataracts, high blood sugar, elevated osteoporosis risk and more.

There are alternatives, however.

DMARDs (Disease Modifying Anti-Rheumatic Drugs) are immunosuppressives that are designed to slow damage to tissues or organs. By targeting the immune system, they generally interfere in combinations of critical pathways in the inflammatory cascade.

Biologics are a subset of the DMARDs that are usually engineered drugs designed to block cytokines, which are the proteins needed to cause an immune response.

Regardless of the solution, the market for anti-inflammation therapeutics is large and growing, expected to reach $106 billion this year. Therapeutics are valuable because they can play a large role in helping to prevent and cure inflammation before disease progression can occur. This could represent a huge decrease in the cost of our healthcare system and an improvement in the quality of patient’s lives.

However, getting to this future will require new approaches to targeting inflammation. On this podcast we look at what this means for drug developers, physicians, patients and more, and what’s coming next in the world of inflammation therapeutics.

Consideration

With 2021 well underway and with public markets still strong, we think it is an important time to highlight some of the key private market, venture investment themes that iSelect fund has identified for the year. We believe technologies transforming the Agriculture, Food and Wellness markets will flourish, with a focus on four areas: technologies that enable better food choices to drive better health outcomes, technologies that drive better, more profitable farm operations, technologies that drive the Consumerization of Healthcare, and biome-based treatment technologies. At iSelect, we invest for impact AND performance. We offer qualified investors access to emerging growth companies through our national venture capital strategy. Our unique structure allows our investors to continue to invest in these companies as they develop.

Timing

Why is now the right time for venture? The answer is that now is not explicitly the right time. Venture is something we need in our economy at all times. Now is not better than any other particular time. The question is, why ever stop? When we look at the challenges we’re facing in food and healthcare the reality is there is someone, somewhere who has an insight about how to build a product that will solve those problems. And if they put the right resources to it, they will succeed. As long as we need new technology to make life better or make our lives more enjoyable, we need venture capital to help fuel those entrepreneurs.

What is iSelect as a product?

iSelect is a very unique product, but when you break it into its parts it’s fairly easy to understand. On the front end we’re a traditional venture capital fund. We have a diligence process. We have an investment process. We have categories of industries where we have focus and real expertise, and we invest in companies in those areas that meet requirements for the fund. On the back end we’re unique in that we don’t raise a large amount of capital at one time and deploy it over the life of our fund. Each deal that we bring onto the fund, our investors have to prove and determine to invest in that deal. We have to constantly prove our diligence standards. It’s accessible, transparent and easy for investors to come in and see our comprehensive process.

What is the ideal iSelect company?

We are looking for founders that are passionate and we want the problem they’re trying to solve to be big, real, and painful. We want the solution to be revolutionary and we want our capital to be able to help them solve that problem. We want to know that they have customers involved and that the solution they’ve come up with actually meets those customers’ and market needs. And we want the team to be capital efficient with the money they’re spending.

What does the ideal iSelect company look like?

We’re looking for a company that has an opportunity to have a 10x return to our investment or greater in a period of three to seven years. What excites us at iSelect are companies that are solving big problems. We want companies that are going to be the Monsantos of the future. Not just in the size and the scope, but the impact they have on people’s lives. We want to create positive impacts on people’s lives, so we invest in areas like agricultural production and areas like producing healthy foods for our kids. They are problems that impact real people’s lives on a daily basis. That’s what we’re trying to do at iSelect. We’re trying to solve the big problems out there. Find ways to bring capital to the entrepreneurs who are the real heroes out there getting up every morning, beating away at these things that are problems that you and me and everyone else faces in their everyday lives.

What is iSelect?

iSelect is a venture capital firm. What that means is we look at hundreds and hundreds of different companies and we apply tough diligence standards to each of them, looking at whether the team has a good plan for growing the business, whether the team is qualified and credible, and more. We do that to resolve the few who provide the best opportunities for investors. And then iSelect takes that smaller set of investments and goes to investors who are interested in venture capital and provides a way for them to invest in these companies, either individually or all at once. We co-invest alongside other venture capitalists. We source transactions through to an exit where the company would become public or get bought. And we manage that whole investment process on behalf of our investors.