For decades, science fiction writers have imagined the possibility of shrinking humans to microscopic size and injecting them into the body to observe biology up close. Stories such as Fantastic Voyage (1966) have sparked the imagination, raising a question that remains compelling today: what if scientists could really go inside the human body to diagnose or treat disease, without invasive surgery?
That fantasy may be inching closer to reality. A recent UCalgary study - Observational Small Intestine and Blood fingerprint study in Parkinson's Disease (SmIle) - is trying a new approach in the treatment and understanding of Parkinson's disease, which results in symptoms such as tremors and slow movements .
A prescription drug, Levodopa, has long been used to alleviate Parkinson's symptoms by increasing dopamine levels in the brain, compensating for the loss of this critical neurotransmitter in patients. A fundamental part of treatment, nearly all patients with Parkinson's disease use Levodopa at some point during the course of their illness.
Capturing data on gut's critical role in neurological disorders
Researchers have discovered, however, that the gut, specifically the small intestine where nutrients get absorbed, may be interfering with the medication's delivery.
"In recent years, it has been revealed that some bacteria living in the small intestine are converting the Levodopa into dopamine before it can be absorbed by the body," explains Dr. Davide Martino, MD, PhD, a professor of neurology and co-lead of the Calgary Parkinson's Research Initiative at the Hotchkiss Brain Institute at the Cumming School of Medicine.
"Because of this, the drug is essentially being wasted in the small intestine, resulting in reduced efficacy and a reduced benefit for the patients."
This development underscores a growing awareness of the gut's critical role in neurological disorders. In Parkinson's disease, the gastrointestinal system is now believed to be involved very early in the disease's progression.
The composition and function of gut microbiota the trillions of bacteria living in the digestive tract may not only influence symptoms but could be central to understanding how the disease begins and evolves.
Study uses micro capsule for sample collection
Until recently, studying the small intestine was invasive, uncomfortable and expensive, involving endoscopic procedures and fluid aspiration (a medical procedure where fluid is withdrawn from the body using a needle and syringe). But this is changing thanks to a groundbreaking medical device. Nimble Science, a Calgary-based company, has created the SIMBA capsule, an elongated pill designed to collect gut samples.
Once swallowed, the pill travels down the gastrointestinal (GI) tract until it reaches the small intestine, where its specialized gel coating dissolves. This triggers the capsule to gently gather intestinal fluid. Before it exits the small intestine, the capsule self-seals, safely containing the sample.
It is then excreted naturally and collected for analysis, giving researchers a rare window into the small bowel environment without the need for invasive procedures.
As part of the SmIle study, the research team used Nimble Science's SIMBA capsule to investigate the role of small intestinal microbiota in patients with Parkinson's, its composition in relation to disease and its impact on the effectiveness of Levodopa.
The study was conducted in collaboration with MRM Health, a clinical-stage biopharmaceutical company based in Ghent, Belgium, with Martino serving as the principal investigator.
The Smlle study recently concluded, and while results are still pending, it offers an exciting opportunity to deepen understanding of the gut's role in Parkinson's and could help pave the way for more effective treatments.
"Nimble Science is proud to enable groundbreaking research through our SIMBA GI platform and the SIMBA capsule," says Dr. Gwen Duytschaever, PhD, clinical operations manager at Nimble Science. "Supporting this collaborative study with the University of Calgary and MRM Health reflects our commitment to advancing new discoveries in human health. Not only does this work provide critical insights into the composition of the small intestinal microbiome and the pathophysiology for Parkinson's Disease, it also helps us unlock new possibilities for clinical applications."
Collaborative innovation sits behind breakthrough
Studies like SmIle demonstrate that research especially clinical trials relies on strong collaboration across multiple teams.
This real-world clinical study was made possible through the combined efforts of several University of Calgary groups, including the W21C Research and Innovation Centre, the Calgary Centre for Clinical Research (CCCR), the Heritage Medical Research Clinic (HMRC), and the Centre for Mobility and Joint Health (MoJo).
Participants in Smlle attended the Foothills campus for a day, meeting with all groups involved in the study.
In the first part of the process at HMRC, the study team completed physical assessments and collected bloodwork. Participants then ingested the SIMBA capsule, before moving onto the MoJo facility for imaging. Using x-rays, the team could visualize the capsule location in the intestines and monitor the capsule closure.
The research and innovation group, W21C, coordinated the SmIle study from start-up to close-out, serving as the primary liaison with Nimble Science. The team provided ethics support and full study management, including participant recruitment, data collection, ongoing coordination, and acting as the main point of contact for all participants.
"Working closely with Dr. Martino's team, CCCR, HMRC, and MoJo has been a great example of how strong collaboration and shared infrastructure can drive innovation," says Michelle Wright, program manager for Clinical Trials at W21C.
"It's amazingly rewarding to support research that is opening new possibilities for treatment and improving the future for people living with Parkinson's."
Martino echoes the sentiment. "It takes a lot of people and parties to develop translational projects," he says. "It's never the idea of a single person. Clinical research works well when there's a good triangulation between a solid coordinating machine like W21C, the clinician or researcher, and either industry MRM Health or technology Nimble Science offers a solution."
At the heart of this innovation is a reminder that medical progress often begins with a conversation. Martino encourages Parkinson's patients to speak openly with their care teams. "I always recommend that patients talk to their clinicians and any clinical researchers they meet about their own observations and challenges, because that's how we get ideas for new research, essentially by listening to our patients."
Blending cutting-edge science, smart technology, and multi-partner collaboration suggests that medicine may not need to shrink scientists to explore the human body. A tiny capsule powered by big ideas might just be enough.
International clinical trials day
This article is being published today, May 20, in recognition of International Clinical Trials Day a day dedicated to acknowledging the contributions of clinical research professionals and highlighting how collaboration and clinical trial participation can shape the future of care.
Davide Martino is a professor in the Department of Clinical Neurosciences at the Cumming School of Medicine (CSM). He is co-lead of the Calgary Parkinson's Research Initiative at the Hotchkiss Brain Institute, and a member of the Alberta Children's Hospital Research Institute, and the Mathison Centre for Mental Health Research & Education at the CSM.
