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An inhaler delivers medication directly to the lungs when an asthma attack starts but what if there was a way to prevent the attack even starting? That’s what University of Otago Associate Professor Yusuf Cakmak and his colleagues are working on – and it just might be a small wearable device.
The project of a wearable smart-device to detect and relieve asthma attacks using nerve stimulation became reality as a masters student project by Joseph Balfe with the supervision of A/Prof. Yusuf Cakmak. And Balfe won the Falling Walls Lab Aotearoa New Zealand competition with this project in 2024.
Balfe himself is asthmatic. He told the Otago Daily Times newspaper he “became very interested in this therapeutic application called non-invasive neuro modulation, which is any means of interacting with the nervous system through external agents. For example, electrical stimulation - that’s what I use.
"During my very first meeting with my master’s supervisor [Yusuf Cakmak], we came up with this idea that we could perhaps interact with the airways non-invasively."
"Because I have asthma, I thought if this works, it could make a huge difference."
New Zealand has one of the highest rates of asthma in the world with 600,000 people taking inhaled medication and 7,000 hospitalisations each year that costing the country $1 billion annually. Globally, asthma affects over 338 million people. There’s also another group of people who need inhalers – athletes – where it’s called exercise-induced bronchoconstriction (EIB) and affect up to 50 per cent of athletes, particularly those in high-intensity or endurance sports.
Balfe says the device has the potential to save thousands of lives around the world because it acts immediately, whereas inhaled medication has only a short time to reach the lungs before bronchoconstriction makes this impossible.
Balfe and Cakmak joined forces to create the VentiMate, an innovative bronchodilator device that is rapid acting and pharmaceutical free. The stimulator/sensor unit is designed to be worn between the shoulder blades. While the prototype is a little bulky, Cakmak is confident that miniaturisation will enable them to reduce the size to something approaching your average sticking plaster.
“It’s all about the muscles and balancing the sympathetic and parasympathetic systems so that we prevent bronchoconstriction before it starts,” says Cakmak. He collaborated with biomedical engineer Dr Brian Russell at the University of Auckland on the sensor component development.
“VentiMate will detect the onset of an attack before the patient is even aware of it and send an electronic stimulus to dilate the bronchial tubes before medication is needed.”
It’s not just the onset of an attack but also where it happens. “The Asthma + Respiratory Foundation estimates 360,000 school days lost each year due to asthma-related symptoms. This means parents and children must rely on teachers to help manage asthma attacks, and that requires asthma policies, emergency medicines and kits, and teacher training. Cakmak also sees potential for people in remote or rural areas where accessing physical medical services can be difficult.
Repetition is also a problem for asthmatics where repeated constriction can trigger inflammation; Cakmak says by reducing attacks, inflammation is lowered, and the patient relies less on inhaled medication. He also makes the point that inhalers aren’t perfect; they can act on other organs, such as the heart and the heartrate.
RAPI and RAPII grants have enabled the team to collaborate with the University of Auckland in running small-scale trials using inhalers, VentiMate and combinations of both. The team will work with Associate Professor Amy Chan, Clinical Director for Asthma New Zealand on a pilot clinical trial across all three options. This is scheduled for completion in Q32026 and Cakmak hopes this will provide evidence to move onto a larger scale trial and, eventually, regulatory approval.
Balfe, who will start studies at Oxford University in England later this year, won first prize for a “novel wearable bronchodilator device” project at Te Tītoki Mataora’s national forum during HealthTech Week in July 2025. The neurotechnology awards were sponsored by the Aotearoa Brain Project – Kaupapa Roro o Aotearoa.
