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It is said that every newborn faces a potential risk until the baby has been screened for <keyword id="1144427" type="UNKNOWN" weightage="100" keywordseo="medical-conditions">medical conditions</keyword>. A <keyword id="2024251" type="UNKNOWN" weightage="100" keywordseo="Genetic-screening">genetic screening</keyword> of the newborn means enhanced <keyword id="2024262" type="UNKNOWN" weightage="100" keywordseo="Biotechnological-capacity">biotechnological capacity</keyword>, which ensures fast, accurate and expanded testing going beyond routine disorders. <keyword id="2024252" type="UNKNOWN" weightage="100" keywordseo="Newborn-screening">Newborn screening</keyword> (<keyword id="116258" type="ORGANIZATION" weightage="100" keywordseo="NBS">NBS</keyword>) has been made compulsory in 52 countries across the world, bringing down <keyword id="153995" type="UNKNOWN" weightage="100" keywordseo="infant-mortality">infant mortality</keyword> and disabilities in children. 
 Simply put, newborn screening (NBS) programme includes testing every newborn soon after its birth, to identify serious or life-threatening conditions which may lead to mental/physical retardation or even early death. The affected baby looks healthy at birth as there is no external defect and these disorders cannot be diagnosed until specifically tested for. However, India is yet to implement a <keyword id="2024264" type="UNKNOWN" weightage="100" keywordseo="National-newborn-screening-programme">national newborn screening programme</keyword> even though 5-15% of newborns fall prey to <keyword id="120871" type="UNKNOWN" weightage="100" keywordseo="Metabolic-disorders">metabolic disorders</keyword>. 
 Understandably, not too many Indian start-ups operate in the NBS space and the <keyword id="49685" type="UNKNOWN" weightage="100" keywordseo="Genetic">genetic</keyword> screening of newborns is rarely done in the country at a macro level. But here is one Mumbai-based start-up that has doing it for over a year now. <keyword id="2024246" type="UNKNOWN" weightage="100" keywordseo="Navigene">Navigene</keyword> has developed a unique and <keyword id="2024273" type="UNKNOWN" weightage="100" keywordseo="Non-invasive-preventive-genetic-screening">non-invasive preventive genetic screening</keyword> service for newborns and adults, which can be implemented at a mass scale. Its primary focus is <keyword id="2024274" type="UNKNOWN" weightage="100" keywordseo="Non-invasive-preventive-testing">non-invasive preventive testing</keyword> including <keyword id="2024278" type="UNKNOWN" weightage="100" keywordseo="Newborn-genetic-screening">newborn genetic screening</keyword>, <keyword id="2024275" type="UNKNOWN" weightage="100" keywordseo="Metabolic-fingerprinting">metabolic fingerprinting</keyword>, <keyword id="2024279" type="UNKNOWN" weightage="100" keywordseo="Prenatal-screening">prenatal screening</keyword> and more, besides offering <keyword id="2024280" type="UNKNOWN" weightage="100" keywordseo="Diagnostic-testing">diagnostic testing</keyword> (<keyword id="2024281" type="UNKNOWN" weightage="100" keywordseo="Cytogenetics">cytogenetics</keyword> &amp; <keyword id="1284857" type="ORGANIZATION" weightage="100" keywordseo="Molecular-Genetics">molecular genetics</keyword>). <keyword id="2024283" type="UNKNOWN" weightage="100" keywordseo="Navigene-Baby-Screen">Navigene Baby Screen</keyword>, the start-up’s flagship product, screens the newborns for 110 genetic and metabolic disorders on the very 3rd day after birth and the company claims it is one of the most comprehensive screening tests in the world. Here is a snapshot that captures the start-up’s operations, vision and viability. 
 
Who runs Navigene (navigene.in): Two co-founders – Dr <keyword id="2024250" type="UNKNOWN" weightage="100" keywordseo="Rishi-Dixit">Rishi Dixit</keyword> (MD &amp; CEO) and Dr <keyword id="1888201" type="PERSON" weightage="100" keywordseo="Vrushali-Joshi">Vrushali Joshi</keyword> (CTO) – and the early-stage incubation and <keyword id="6357097" type="COMPANY" weightage="80" keywordseo="venture-capital">venture capital</keyword> firm, <keyword id="720080" type="COMPANY" weightage="100" keywordseo="IncuCapital">IncuCapital</keyword>. An MBBS and MBA, Dr Rishi has a deep understanding of the healthcare marketing space and also worked with start-ups. Before starting Navigene, he was head of sales &amp; strategy at a start-up in the similar domain. Prior to that, he was manager, health analytics, with ICICI Prudential Life insurance. Dr Vrushali holds a Ph.D. from Mumbai University and is a leading geneticist with more that 15 years of experience. She is also a government-certified genetic counsellor. 
 Navigene was set up by the two co-founders in April 2012, along with IncuCapital’s senior venture partners’ team of <keyword id="2024248" type="UNKNOWN" weightage="100" keywordseo="Surojit-Nandy">Surojit Nandy</keyword>, <keyword id="6393254" type="PERSON" weightage="100" keywordseo="Manish-Kumar">Manish Kumar</keyword> and <keyword id="2024247" type="UNKNOWN" weightage="100" keywordseo="Prashant-Maharaj">Prashant Maharaj</keyword>. The company started operations in November that year. Currently, it boasts a state-of-the-art testing facility and central lab in Mumbai where all samples are flown in from different parts of the country and also from global destinations. This facility also serves as the head office while 2-3 sales people are assigned to each location. Weekly sales meetings are generally held at local CCDs – a good example of asset-light sales offices. 
 But going forward, the start-up plans to open sales offices in Delhi, Bangalore and Hyderabad – small facilities for operational and logistics management. As sample collection is generally done by the people themselves or the <keyword id="6355907" type="UNKNOWN" weightage="100" keywordseo="Medical-facilities">medical facilities</keyword>, the Navigene staff simply picks them up from homes/hospitals and courier them to the HO in Mumbai. 
 
What inspired the venture: The knowledge that non-traditional, highly accurate and revolutionary ways of medical diagnosis is possible through genetic screening and diagnostic techniques. Navigene was founded to bring these advanced <keyword id="684042" type="TECHNOLOGY" weightage="100" keywordseo="medical-technologies">medical technologies</keyword> to India. 
 
What’s the pitch: Early and accurate prediction/diagnosis of disorders and ailments in newborns and adults, through <keyword id="2024271" type="UNKNOWN" weightage="100" keywordseo="Preventive-genetic-screening">preventive genetic screening</keyword> – so that every individual has the opportunity to manage his/her health. “Over the years, we have learnt a great deal about how genes function and how they can cause certain problems. Now is the time to use that knowledge in exciting new ways to prevent and treat <keyword id="6377700" type="UNKNOWN" weightage="100" keywordseo="health-problems">health problems</keyword>,” says Dr Rishi. 
 
How it works: Navigene currently caters to the B2B segment – <keyword id="796241" type="UNKNOWN" weightage="100" keywordseo="corporate-hospitals">corporate hospitals</keyword>, high-end nursing homes with birthing facilities, NICUs (<keyword id="1145483" type="UNKNOWN" weightage="100" keywordseo="neonatal-intensive-care-units">neonatal intensive care units</keyword>) and state-of-the-art <keyword id="2024290" type="UNKNOWN" weightage="100" keywordseo="Paediatric-facilities">paediatric facilities</keyword>. It also works with individual obstetricians/gynaecologists and paediatricians. The start-up typically approaches medical facilities who, in turn, offer/recommend these services to their clients. Once a client registers for the tests, he/she is given the sample collection kit and the rest of the testing procedure follows. 
 
As for newborn screening, parents get the kit as soon as they register and after the birth of the baby, either the hospital staff or the parents collect the urine sample of the baby on the 3rd day. It is then sent Navigene’s central lab in Mumbai where the sample is analysed and reports are sent within 4 days. If the report detects any abnormality, the concerned doctor/hospital/parents are immediately informed and further consultation could be arranged with medical experts. Genetic counselling for the parents is also offered in such cases. 
 
Show me the money: As of now, the start-up has a B2B revenue model in place while the B2C space is essentially serviced through its partners who can reach out to more people. Navigene charges fee per sample testing and its flagship solution, Navigene Baby Screen (NBS), which tests urine sample for 110 disorders, costs Rs 5,000. But to make it more affordable for Tier II cities and smaller medical facilities, customised packages start from Rs 900 for tracking 3-4 basic disorders and can go up to Rs 2,700 for screening 31 commonest disorders that affect infants in the first few months. The company has also tied up with a leading stem cell company for instant access to a large B2C market. “Plus, we want to work with the state governments when they start running the NBS programme at the state-run hospitals, but we will keep the packages small,” says Dr Rishi. 
 
The market size is also huge as around 30 million babies are born in India every year. “As of now, we are targeting 40 cities in India where our addressable market (a fraction of the urban population in these cities) is around 30 lakh babies a year. We aim to cover most of them over the next 3 years through our proprietary sales channel,” adds Dr Rishi. 
 
Claim to fame: A value driver in a critical industry while expansion is its forte. Navigene is a pioneer of sorts, bringing crucial preventive health screening for newborn babies at an affordable price. The start-up is currently doing 500 samples a month and targeting 10,000 samples in the next 3 years. 
 Navigene raised an undisclosed seed round with the help of its institutional co-promoter IncuCapital in August 2012 and it will be raising Series A <keyword id="6357455" type="EVENT" weightage="100" keywordseo="Funding">funding</keyword> in the next 2-3 months. The money will be utilised to grow its presence pan-India and also in other geographies such as South-east Asia and <keyword id="48890" type="COUNTRY" weightage="80" keywordseo="Latin-America">Latin America</keyword>. “We can’t disclose the names just now, but these would be all bigger and more developed countries. We are also talking to a few players in Latin America, which can lead to substantial global expansion,” says Surojit Nandy of IncuCapital. As for pan-India expansion, the company plans to reach 40 cities in next the 3 years through its own B2B sales force. 
 The start-up has hit <keyword id="2024302" type="UNKNOWN" weightage="100" keywordseo="Operational-breakeven">operational breakeven</keyword> in December 2013, within 11 months from starting its sales operations. But it is not really looking at that as a landmark. “We don’t intend to remain operationally cash-positive as we are growing at a breakneck speed and want to keep investing in the growth. That’s the reason we are looking at the Series A funding soon,” says Dr Rishi. 
 “We are also working on some breakthrough <keyword id="2024304" type="UNKNOWN" weightage="100" keywordseo="Screening-products">screening products</keyword> around <keyword id="350054" type="TECHNOLOGY" weightage="100" keywordseo="metabolomics">metabolomics</keyword> in areas like oral &amp; <keyword id="16070" type="ORGANIZATION" weightage="80" keywordseo="breast-cancer">breast cancer</keyword>, and adult metabolic disorders. So a big chunk of the Series A money will be used for product development. We will <keyword id="47916" type="UNKNOWN" weightage="80" keywordseo="invest">invest</keyword> a good amount in Capex and Opex to further strengthen our testing portfolio,” he adds. 
 
Biggest challenge: According to Dr Rishi, there’s no real competition here as very few companies in India focus on genetics (metabolomics). As for the newborn screening business, a few labs who do screening through blood sample testing could be competitors, but they use an entirely different technology platform and can track a maximum of 45 disorders. However, creating awareness among prospective clients is currently the biggest challenge. <keyword id="1912844" type="UNKNOWN" weightage="100" keywordseo="patient-education">Patient education</keyword> is virtually non-existent in India while the cost of reaching them at a micro level could be huge. “That’s why we are opting for online registrations, which will reduce operational costs,” he notes. “Then there are other screening products we are working on. When they hit the market, we should be way ahead of others,” concludes Dr Rishi.

This Start-up Provides Genetic Screening For
Newborns, Adults; To Raise Series A Funding In 2-3 Months

COVID-19 can reactivate several latent viruses lurking in the body's cells following previous infections, particularly in people with chronic fatigue syndrome, according to a study. The findings, published in the journal Frontiers in Immunology, contribute to our understanding of the causes of myalgic encephalomyelitis/chronic fatigue syndrome, also known as ME/CFS, and the prospects of reaching a diagnosis. Severe, long-term fatigue, post-exertional malaise, pain and sleep problems are characteristic signs of the disease. The causes of the condition are not known with certainty, although it has been established that the onset in most cases follows a viral or bacterial infection. "Our study now shows that objective measurements are available that show physiological differences in the body's reaction to viruses between ME patients and healthy controls," said <keyword id="15544564" type="General" weightage="50" keywordseo="anders-rosen" source="Orion">Anders Rosen</keyword>, a professor at <keyword id="2846614" type="General" weightage="50" keywordseo="linkoping-university" source="Orion">Linkoping University</keyword>, Sweden, and leader of the study. The extensive spread of the SARS-CoV-2 coronavirus during the COVID-19 pandemic gave researchers a unique opportunity to study what happens in people with ME/CFS during a mild virus infection and compare this with what happens in healthy controls. The research team, in collaboration with the Bragee Clinic in Stockholm, initiated a study early in the pandemic, involving 95 patients who had been diagnosed with ME/CFS and 110 healthy controls. They provided blood and saliva samples on four occasions during one year. The researchers analysed samples for antibodies against SARS-CoV-2 and latent viruses and found a special fingerprint of antibodies against common herpes viruses in saliva. One of these viruses was the Epstein-Barr virus (EBV), which has infected nearly everybody. Most people experience a mild infection during childhood. People who are infected with EBV in their teenage years can develop glandular fever, also known as "kissing disease". The virus then remains in a latent condition in the body. The EBV virus may proliferate in situations in which the immune system is impaired, causing fatigue, autoimmune responses, and increased risk of lymphoma if allowed to continue, the researchers said. Around half of the participants were infected with SARS-CoV-2 during the first wave of the pandemic and developed mild COVID-19, they said. In more than one-third of cases, the infection had been asymptomatic, so the person had not been aware of the infection. After the SARS-CoV-2 infection had passed, however, the researchers detected specific antibodies in the saliva that suggested that three latent viruses had been strongly reactivated, one of them being EBV. The reactivation was seen both in patients with ME/CFS and in the control group but was significantly stronger in the ME/CFS group. This can have negative consequences, one of which is that the immune system attacks certain tissues, such as nerve tissue, in the body, the researchers said. Previous studies have also shown that the mitochondria, which produce energy in the cells, are affected, which suppresses the energy metabolism of people with ME/CFS, they said. "Another important result from the study is that we see differences in antibodies against the reactivated viruses only in the saliva, not in the blood. This means that we should use saliva samples when investigating antibodies against latent viruses in the future," said Rosen. He noted that there is a great deal of overlap between the symptoms of ME/CFS and those of long COVID, which is experienced by around one-third of patients who contract COVID-19. Exhaustion after light exercise, brain fog and unrefreshing sleep are common symptoms, while impaired lung capacity and abnormal senses of smell and taste are more specific for long COVID. The findings can contribute to developing immunological tests to diagnose ME/CFS, and possibly also long COVID, the researchers added. SEE ALSO: <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/science/health/news/health-ministry-rejects-claim-covaxin-was-rushed-due-to-political-pressure/articleshow/95576897.cms">Health Ministry rejects claim 'Covaxin was rushed due to political pressure'</a> <a target="_blank" class="c-link c-message_attachment__title_link" href="https://www.businessinsider.in/science/health/news/novel-artificial-enzymes-could-help-kill-covid-virus-study/articleshow/95575741.cms">Novel artificial enzymes could help 'kill' Covid virus: Study</a>

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This Start-up Provides Genetic Screening For Newborns, Adults; To Raise Series A Funding In 2-3 Months

Sanghamitra Mandal

Covid-19 can reactivate latent viruses lurking in the body's cells

PTI

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