Beyond wearable and implantable devices, the potential of ingestible devices is being explored for precision medicine, as well as for food safety, emergency solutions, and even as emergency food.

Edible electronics is a promising scientific field that has been the focus of research for some time. It encompasses a range of tools, from smart pills to edible robots, and is consistently advancing, offering new opportunities for diagnosis and treatment. This technology goes far beyond wearable devices or implantable devices, such as cardiac pacemakers or retinal implants, which have been in use for decades.

Scientists are working to enable and target the use of small, ingestible electronic devices, driven by the potential these technological solutions offer. Applications range from non-invasive diagnosis of gastrointestinal disorders to the ability to monitor vital signs, create personalised medicines for individual patients, and even invent life-saving foods through the development of edible robots.

The edible electronics sector is witnessing growing interest and market value: the global smart pill market alone, valued at $1.79 billion in 2023, is projected to reach $4.78 billion by 2032 [source: Polaris Market Research].

However, figures and estimates alone cannot fully convey the extensive opportunities offered by ingestible devices, which form a significant part of the future of medicine.

Electronics and digitalisation are integral to Medicine 4.0, providing tools and solutions for more targeted and less invasive diagnoses and treatments. In this regard, edible electronic devices have long been a focal point of research.
Edible electronics have roots dating back to the second half of the twentieth century. Today, they are at the centre of research not only for their potential in telemedicine but also for food safety, as anti-counterfeiting tools.
The main focus is on the safety of patients who have undergone trials: so far, tests have shown promising results for human safety. Moreover, the precision of these devices is continually improving.

Edible electronics: a journey that began over 70 years ago

The history of edible electronics dates back to the 1950s when it was first introduced through clinical studies supporting its ability to measure pH, temperature, and pressure. In 1957, R. Stuart Mackay, a professor of physics and biophysics at the University of California Medical Center, and Bertil Jacobson, a professor of medical engineering at the Karolinska Institute, created a «device capable of transmitting information about the internal conditions of a living person».

This was detailed in their article “Endoradiosondes” published in Nature. The device was a small ingestible capsule containing a detection transducer and a radio transmitter.

Further developments in the 1980s and 1990s led to the creation of the first ingestible sensors for temperature assessment, quickly followed by the video capsule endoscopy system. Over time, ingestible electronic devices have continued to evolve (with the first FDA-approved application emerging in 2001 – Source: FDA) and today represent a highly active area of research, constantly improving year by year.

Wireless pills and artificial intelligence: a fascinating combination

In recent years, advancements in edible electronics have been promising. One of the latest innovations is the development of a smart pill. This pill, equipped with intelligent sensors, can detect intestinal gases and provide real-time positional tracking. Developed by the Khan Lab, the capsule is specifically designed to identify gases associated with gastritis and stomach cancer.

Researchers from the Khan Lab and the Institute for Technology and Medical Systems Innovation (both part of the University of Southern California) created the device by placing a wearable coil that generates a magnetic field on a shirt.

This field, combined with a trained neural network, allows the team to locate the capsule within the body.

The capsule contains electronic components for position tracking, including an optoelectronic sensor for gases, a magnetic sensor for localisation, and control electronics, all integrated into a single printed circuit board encased in a 3D-printed biocompatible resin shell.

Additionally, it features a special membrane for selective optical gas detection, made of materials whose electrons change behaviour in the presence of ammonia gas. This gas is a significant indicator of the presence of Helicobacter pylori, a bacterium linked to the development of gastric cancer, peptic ulcers, and irritable bowel syndrome.

Scientists have also developed an AI-based system to detect tiny devices monitoring disease markers in the intestine. The AI system analyses the signals received from the pill, pinpointing the device’s location within the intestine to within a few millimetres.

Edible electronics: life-saving devices

The medical application of edible electronics is undoubtedly the most significant, with numerous use cases where ingestible devices can be lifesaving. An Italian scientist, Giovanni Traverso, Associate Professor of Mechanical Engineering at the Massachusetts Institute of Technology and a gastroenterologist at Brigham and Women’s Hospital, along with other researchers from MIT and West Virginia University, has developed an ingestible device capable of monitoring vital signs such as respiratory and heart rates.

This wireless device, capsule-sized, contains integrated circuits and electronic sensors for internal measurements within the gastrointestinal tract. The complete system includes the capsule, a receiver, a laptop, and a magnet. The technology devised by the team allows for the monitoring of patients suffering from obstructive sleep apnea, a condition affecting 90 million people severely in Europe [source: European Respiratory Journal 2018].

Diagnosing sleep disorders like sleep apnea typically requires patients to spend the night in a sleep lab, connected to various sensors and monitors. This technological capsule could make the diagnostic process significantly less invasive and disruptive to the patient’s life. Tests conducted on several patients have shown that the technology is accurate and safe, with no adverse health effects observed in those who used the device.

The MIT and West Virginia University team is also exploring the potential use of the capsule to prevent opioid overdoses, which have claimed over 600,000 lives in the United States and Canada since 1999. Projections suggest another 1.2 million overdose deaths by 2029 [source: The Lancet].

To address this grave issue, the Stanford – Lancet Commission has called for research to develop a system that can autonomously administer an opioid antagonist when opioid-induced respiratory depression is detected. As the scientists explained in the article “First-in-human trial of an ingestible vitals-monitoring pill,” a significant aspect of opioid overdoses is that 63% of them occur when the individual is alone.

In the future, Traverso and his team aim to incorporate an anti-overdose drug into the device, to be released when the parameters indicate the onset of respiratory depression. They are also refining strategies to extend the capsule’s residence time in the stomach.

Ingestible and digestible devices: an italian initiative

Italy is also at the forefront of edible electronics research with two projects: ELFO and RoboFood, both actively involving the Italian Institute of Technology (IIT). 

The first project, ELFO (an acronym for Electronic Food), slated for completion in 2025, involves IIT as the sole participant and aims to create circuits and sensors that can decompose within the body once their function is complete. As the researchers explain on the project’s official site, these components can be «digested or even metabolised».

The need to create a range of technological solutions to trace the food supply chain and monitor gastrointestinal health is highlighted in the project’s documentation. ELFO aims to provide «the foundations of a new enabling technology for edible electronic systems».

The devices that comprise this technological platform will facilitate the prevention, diagnosis, and treatment of gastrointestinal diseases, as well as act against food counterfeiting, a practice that not only harms health but also the economy.

The research team, led by Mario Caironi, coordinator of IIT’s Printed and Molecular Electronics Laboratory, has developed the first rechargeable edible battery, cited among Time magazine’s Best Inventions of 2023, and presented as a technology capable of changing our way of life. Natural substances were used to develop the battery: riboflavin (vitamin B2, found in almonds) as the anode, and quercetin (a flavonoid found in apples) for the cathode.

To enhance electrical conductivity, the researchers used activated charcoal, and nori seaweed to prevent short circuits. The electrodes were encapsulated in beeswax. This edible battery can be used to monitor health conditions or verify food storage conditions.

Edible robots: an italian concept and a US telemedicine solution

The battery is designed as a potential component of future edible robots, a promising branch of edible electronics.

An Italian-led project, RoboFood, coordinated by Dario Floreano, Director of the EPFL Laboratory of Intelligent Systems, is exploring which edible ingredients can be used to create components and assemble them into edible robots. Caironi, along with Remko Boom from Wageningen University in the Netherlands and Jonathan Rossiter from the University of Bristol in the UK, are part of the research team.

One of the most ambitious challenges, as explained in their article “Towards edible robots and robotic food” published in Nature Review Materials, is «combining parts that use electricity to function, such as batteries and sensors, with those that use fluids and pressure to move, such as actuators».

Edible robots could serve various purposes: they could act as lifesaving foods in emergency situations, assist patients with swallowing disorders, and create unprecedented interactions with humans and animals to achieve dietary goals or influence eating habits.

Meanwhile, in the United States, the startup Endiatx (founded in 2019) has developed a motorised ingestible robotic capsule called PillBot, equipped with cameras, sensors, and wireless communication capabilities. This device allows doctors to examine the gastrointestinal tract with high precision.

PillBot aims to be an alternative to traditional endoscopy, enabling doctors to perform stomach endoscopies via telemedicine. It uses pump thrusters (similar to those used in marine applications) to move like a drone. The doctor remotely guides it through the patient’s stomach using an app. Once its task is complete, it powers down and is expelled 6-24 hours later.

The current prototype measures 13 x 30 mm and can transmit high-resolution video at 2.3 megapixels per second. The goal is to obtain Food and Drug Administration approval and launch commercially in the United States by 2026.

Glimpses of Futures

As we have illustrated, research projects are envisioning various potential applications for edible electronic solutions across different uses.

To anticipate possible future scenarios, we aim to provide insights into the impacts these solutions could have on social, technological, economic, political, and sustainability aspects through the STEPS matrix.

S – SOCIAL: the research in medical science is focusing on the development of edible electronic devices to enable less invasive and more precise diagnoses. A particular area of interest is the diagnosis of stomach cancer, which affects nearly 15,000 people in Italy alone [source: AIRC Foundation for Cancer Research].

T – TECHNOLOGICAL: the advancement of digital solutions in medicine is furthered by ingestible electronic devices, contributing to the development of Medicine 4.0. This integrates digital technologies, data analysis, and AI systems in healthcare. The Internet of Medical Things is becoming more prevalent, manifesting in connected medical devices and applications linked to healthcare IT systems via online networks.

E – ECONOMIC: edible electronic devices for telemedicine and diagnostics hold significant economic implications, potentially reducing healthcare costs through early diagnosis and targeted, personalised medical treatments. In recent years, stomach cancer cases have decreased, partly due to improved diagnosis and detection of Helicobacter Pylori [source: AIRC Foundation]. Edible robots also offer a substantial opportunity to combat food counterfeiting, with the counterfeit Italian food market alone valued at €120 billion [source: Coldiretti, 2023].

P – POLITICAL: edible electronic devices received initial approvals from the US Food and Drug Administration as early as 2001, with an ingestible diagnostic camera, and in 2015, with the first integrated circuit microsensor for daily patient ingestion [source: “Edible Electronics: The Vision and the Challenge“, Advanced Materials Technologies]. In Europe, the European Food Safety Authority (EFSA) and the European Medicines Agency (EMA) have set acceptable daily intake (ADI) limits for substances that showed side effects with chronic or excessive consumption. «The ADI becomes a fundamental variable in designing edible electronic systems».

S – SUSTAINABILITY: sustainability is a crucial parameter in the development of edible electronic devices concerning patient health and environmental impact, including food safety. Efforts are focused on solutions that avoid side effects, using natural and fully biocompatible materials. Edible electronics aim to integrate food-grade materials into complex systems such as robots, helping reduce electronic waste. «Beyond sustainability, biocompatibility, and biodegradability, using food-grade materials in electronics offers benefits of minimal toxicity, especially when ingested», write Italian scientists from IIT in the article “Edible Electronics and Robofood: A Move Towards Sensors for Edible Robots and Robotic Food“.

Written by:

Andrea Ballocchi

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