Theranos, Bioquark and Biohype

Science post, folks. Just stop now if that's not your groove.

Yesterday Forbes re-listed the net worth of one member of their richest women in the world. Well, formerly one of the richest women in the world. Elizabeth Holmes, the founder of the embattled biotech Theranos, had a net worth estimated at 4.5 BILLION dollars last year, based in large part on her controlling interest in her company which carried a 9 billion dollar valuation. Forbes has trimmed back that net worth estimate to... well, zero. This reflects the new valuation of the company at 800 million (the 750-ish million raised plus a modest amount of intellectual property - whatever that says for the people valuing companies, it ain't good). With the investors preferentially getting back their seed money, that leaves just enough for a cup of coffee for the person who was recently one of the richest self-made women in the world.

What's striking is how drastically public perception has shifted towards the once-darling company. Here is an article about Theranos from a couple years ago. You can almost wipe the admiring drool of the author off of it. Here is an article from last week. One of many, actually. 

Those of you who follow my Facebook posting know that I've been a critic of Holmes and her company for some time. I first learned of her existence through one of those stupid "A Mighty Girl" posts that get forwarded around Facebook. I thought it dubious that a college dropout with no scientific training could invent a revolutionary blood testing machine and create a company worth billions by the age of 32. 

So I dug into it. Theranos, for those not familiar, is a blood testing company whose technology is based on combining two ideas: miniaturization and multiplexing (running multiple tests on the same amount of blood). The idea was that the patient should go to a drugstore or health center and provide little more than a drop of blood. The company claimed they'd invented a machine (which they had the gall to call 'The Edison') that could run something like 250 tests on a single droplet. Makes for a nice-sounding headline, yes? 

To outsiders, the idea was apparently revolutionary - venture capital poured in and valuation soared. As a scientist, my reaction was no shit. Scientists already do this all. the. time. in routine research techniques. Miniaturization isn't particularly special either. I regularly work with fluid volumes in the single microliter range (there are about half a million microliters in a can of coke). 

What would make or break the company wasn't the idea but the technology. How would the company accomplish this in a way that eclipsed existing methods? Interestingly, this was the part Theranos was most secretive about. You'd think with patents filed the company would be eager to show off their fancy, cutting-edge technology. But the company remained mute, even when they were sitting on a giold mine in the form of a multi-billion dollar valuation.

Always be wary of a biotech company that won't let you look up their skirt after signing a nondisclosure agreement. 

But back to the narrative: Even though I wasn't privy to proprietary information, it didn't mean it that didn't exist - surely venture capital firms had seen the technology up close before forking over hundreds of millions of dollars. Surely Walgreens had performed due diligence before entering into a partnership to use the Edison to analyze samples in their stores. 

Turns out... not so much. Once the first infusion of venture capital was made, other investors apparently thought the technology was sufficiently de-risked to invest. Maybe they forgot that the first VC to give Holmes money was a close family friend. Elizabeth Holmes was just 19(!) when the first million rolled in. Years later, Walgreens rushed into a partnership in part to prevent CVS or another chain from snatching away the deal. Oops. 

Turns out I wasn't alone in my suspicions. The WSJ reported the story as well, though they arrived there through an entirely different route - one of the principal scientists of the company committed suicide; the man's widow tipped a reporter that there were big problems with the company. From there things unraveled famously - the Edison machine, to make a long story short, didn't work as intended. Theranos was using machines from other companies to run most of their tests. When they did use the Edison, the results were often substantially off (a consequence of poor design or the forced dilution of the samples). They faked results, covered things up, yada yada yada. Under harsh external scrutiny triggered by the WSJ article(s), the company has rapidly crumbled into dust. Currently, several members of the executive board are facing the specter of criminal charges.

Theranos lasted more than a decade before it hit the skids. I'm shocked it lasted as long as it did - the whole affair was a lie that just got bigger and bigger. 

But I'm not writing this to say ""I told you so. There's more to Theranos than a cautionary tale. Like the mortgage bubble, it's easy to lay this on a few unscrupulous individuals and forget that millions of other people bought into a fundamentally flawed concept. In this case, there were loads of VCs, media, and even scientists who signed off blindly on unsubstantiated, shit technology. Particularly members of the media, whose job it is to scrutinize the facts. Much of the steam that Theranos gathered came by dint of favorable reviews of a wunderkind who dressed like Steve Jobs. I increasingly find that reporters - even science reporters - are drawn into credibly reporting terrible, terrible stuff all the time (remember when the Raelian cult cloned a human?). Often, it's innocuous, easily-forgetten mistakes; a report on a press release from a shitty academic group that oversells a fairly mundane finding (these are the sources of many of those optimistic 'we're two years from curing every kind of cancer articles' you see about in the paper). But other times, they buy into a start-up that's trying to use publicity to raise money like Theranos. I've taken to calling this Biohype. 

I've been waiting to publish this article until I had a good current example in the news. That happened recently when I  saw this classic biohype story today on Youtube. The narrative is a classic nonstory. A company received permission from an Institutional Review Board to inject a mishmash of stem cells and trophic factors into the brains of brain-dead patients, ostensibly in an attempt to reanimate them. 

Scientists Aim to Reverse Death!!!

Makes for a catchy headline, no? Problem is, this is a probably (and I only qualify this for legal reasons) bullshit company that at best has no idea what it's doing and at worst is an active scam. Check out their website. The group's raison d'etre seems to be, well, a lizard can regrow a limb; let's just blast the same shit into a human's brain and see what happens. It's a different, vastly more complicated organ in organ in a distantly-related species, but fuck it. I'll say this in plain english: There is no basis whatsoever that this approach will work. 

Time for a hard truth: maybe in 50 or 100 years we'll be able to help brain-dead people, but not anytime soon. Protect your head. Bioquark, if they're able to get the money to do this, will torture 20 families who will furtively believe this non-treatment will bring their Grandpappy back after a major stroke.

Maybe you think I'm too skeptical. Maybe you think that I'm not in a position to judge other scientists. Maybe they - gasp - just know a little more than me. Maybe I'm harping on them because I'm jealous. 

So let's take a look at the crew attempting to reanimate the near-dead. Their CEO, Ira Pastor, last engaged in scientific training in 1991, when he got an BS in pharmacy from Rutgers. Their CSO, Sergei Paylian doesn't even have a PhD and has a degree from Armenia, which, last I checked, was not a hotbed or research on anything. His last recognizable job before Bioquark was a visiting scientist at the University of South Florida. I strongly recommend checking out their executives page for an example of the kind of people this enterprise has drawn. You can see their "executives" are a mishmash of ill-qualified misfits who either don't know that they're the D-team or don't care (though I will say that their VP of aesthetic medicine looks like Angelina Jolie). 

Yet, amazingly, reporters take them seriously. Even this non-story (the press release is that the company got approval to inject their crap into almost dead people). There are no results, no real scientific information. Just stupid ideas and paperwork. 

Here's another thought: This could be done in animals, mice or nonhuman primates. We could aggressively determine what, if anything, worked by immediately sacrificing the animals and analyzing their brains. Why is Bioquark rushing this into humans? Biohype. And money. The fact that I struggled to find even a single scientific article on the company's website suggests this is nascent tech at best. Perhaps no one has ponied up to do this experiment in mice. However, if you announce you're swinging for the fances by jumping straight into humans, it only takes one rich guys with a vegetable relative to put them in business. All for waving their hands and promising the world to desperate people. 

The really scary thing is that this thing could scale, if the media really sinks their teeth into it. If a few angel investors read the story and throw a few bucks Bioquark's way, the whole sketchy crew might get rich quick before the whole thing implodes. The ride can last for years - just ask Lizzy Holmes. All because of Biohype.