“Precision translation as the name suggests: translating DNA, translating information related to certain microorganisms.” said Asia Pathogenomics founder Chun Hao Liu confidently, “Currently, only the USA, China, and Taiwan offer this testing, and in Taiwan, it’s only us.”

Asia Pathogenomics’ main business is employing Metagenomics Next-Generation Sequencing (mNGS) technology to sequence all microbial pathogen genes in patient samples. Through a self-developed intelligent pathogen analysis system and a localized pathogen database, they perform comparative analysis to identify the pathogenic cause. mNGS can analyze over 20,000 cross-species pathogens in one run, with a detection rate 62% higher than traditional blood culture methods. Reports can be generated within 24 to 48 hours

A patient with a central nervous system infection had a headache and unclear consciousness and sought medical attention at a medical center. All routine tests and new molecular examinations were negative, unable to identify the cause. The medical institution sent the sample to Asia Pathogenomics, and within 24 hours, results identified an extremely rare Angiostrongylus cantonensis found in Taiwan, with a mortality rate of 20% and a neurological sequelae rate as high as 70%. After switching medication treatment, the patient regained consciousness within a few weeks, progressing from immobility to being able to walk independently to subsequent appointments.

“Taiwanese doctors are competent; once the pathogen is identified, treatment is possible. Previously, due to technical limitations, testing for various pathogens could take days or even months. For TB (tuberculosis), it might take two months, and physicians depended solely on experience, progressing antibiotics from first-line to third-line options. Gene sequencing does not require assumptions. It identifies what the sample contains, supplementing the limitations of clinical routine tests and assisting physicians in timely diagnostics and precise medication delivery.” Chun Hao Liu positions their product as “an excellent clinical application tool for doctors.”

Born in 1980 and graduating from Taipei Medical University with a degree in Nutritional Sciences, Chun Hao Liu was influenced by classmates entering the biotech industry, leading him to join a biotech company founded by Academia Sinica genetic sequencing scholars, starting as a salesperson. Having studied molecular biology and an introduction to biotechnology in college, entering the world of gene sequencing was not difficult for Chun Hao Liu. But to adapt quickly, he moved close to the company, spending daily hours in the lab pestering senior colleagues, inquiring about operational procedures, and spent two months completing his knowledge of first-generation gene sequencing.

“My boss later assigned me to the Academia Sinica region, where I constantly heard scientists discussing new technologies. One day, I heard about NGS (next-generation sequencing) and felt it had potential.” That year, Chun Hao Liu focused on reading books, perusing papers, and attending bioinformatics training sessions, eventually establishing a related department within the company, primarily focusing on plant and animal research, eventually becoming general manager and entering the board. In 2012, he founded BIOTOOLS CO., LTD., collaborating with academic and research institutions on reagents and services, gradually expanding the market, and concentrating on microbiology and next-generation sequencing technology.

“The first research case using sequencing for microbial pathogen genes from an infected patient was at the University of California, San Francisco, saving a 14-year-old boy. The boy had fever and headaches, underwent three hospitalizations over four months without a cause found, gradually falling into a coma. Professor Charles Chiu suggested sequencing cerebrospinal fluid, uncovering ‘Leptospira,’ allowing precise treatment. This highlighted the method’s potential in diagnosing acute and severe illnesses.” Cost and incomplete databases hindered immediate application, with commercial labs emerging in the USA around 2017. Chun Hao Liu determined readiness and committed in 2019.

In January 2020, BIOTOOLS CO., LTD. established its subsidiary “Asia Pathogenomics,” targeting clinical unmet needs in identifying unknown infectious disease pathogens and providing mNGS services. By April the same year, they announced the establishment of Taiwan’s first mNGS P2 negative pressure laboratory.

Asia Pathogenomics handles samples primarily from acute and severe cases, requiring strict lab control to prevent pathogen leakage. The lab features compartment designs, utilizes HEPA filters, with UV lamps installed in ceilings for sterilization. Samples are transmitted via transfer boxes to another compartment to reduce personnel movement. Testing step-by-step includes sampling, nucleic acid extraction, DNA fragmentation, PCR amplification, and sequencing analysis. Stringent quality control is needed throughout processes to ensure reliability and accuracy of results. Sequencing analysis and AI diagnostics are Asia Pathogenomics’ proprietary, confidential technologies.

Asia Pathogenomic laboratory utilizes partition designs and transfer boxes to reduce personnel movement. Photo by Xie Junyi. — Asia Pathogenomics laboratory utilizes partition designs and transfer boxes to reduce personnel movement. Photo by Jean Hsieh.

“Samples include environmental, human, and pathogenic genes, so we first eliminate low-quality fragments, human-related DNA, and environmental contaminants,” Chun Hao Liu vividly compared, “like finding and sorting different beans from a mix on the beach.”

After sorting, a comparative database is needed. Asia Pathogenomics selects from authoritative gene public databases worldwide, screening based on geography, choosing regions related to Northeast Asia, Southeast Asia, and Taiwan, eventually establishing a pathogen microorganism database suited to Taiwan’s ecological geography. Presently, the database includes over 17,800 types of bacteria, more than 3,000 fungi, over 5,500 viruses, and more than 700 parasites, totaling over 20,000 pathogen genes.

When they first established the company, they anticipated that building a localized pathogen database and the corresponding analytical algorithms for Taiwan would be challenging. Although the initial setup faced a pandemic, impeding collaborations with hospitals and collecting clinical cases, the team gradually accumulated instances and adjusted testing methods. However, the real challenge lies in strict Medical Law regulations and subsequent promotion.

With hospitals having their testing units, it’s not easy for physicians to seek external assistance. However, gene sequencing’s novelty and complexity in hardware and software establishment may not align with healthcare institutions’ efficacy, allowing Asia Pathogenomics to seize an early position. Physicians, to protect patients, require more clinical validation over 2 years. Chun Hao Liu and his team participated in conferences and approached medical centers, securing clinical trial opportunities. Results backed by papers could convince medical practitioners and patients. Genuine trust and willingness to collaborate with medical institutions arrived after securing registration under the Ministry of Health and Welfare’s precision medical molecular testing laboratory accreditation (Laboratory Developed Tests and Services, LDTS), making Asia Pathogenomics the first and only company in Taiwan capable of providing clinical mNGS testing services.

Chun Hao Liu and the team spent over two years attending conferences and visiting medical centers, securing opportunities for clinical trial cooperation. Provided by Asia Pathogenomics.

Discussing application difficulties, Chun Hao Liu smiled wryly, “The certification application required conducting dozens of samples, examining test limits, and finding an equivalent laboratory to prove the capability, but there was no equivalent laboratory in Taiwan!” A lab in the USA was found, and despite an eight-month wait before commencing operations, they continued to invest and wait. Fortunately, in January 2023, they received their certification. As of now, Asia Pathogenomics has conducted over 3,500 tests and signed cooperation agreements with over 20 medical centers and regional hospitals in Taiwan, including Tzu Chi, National Taiwan University Hospital, Taipei Veterans General Hospital, and Far Eastern Memorial Hospital.

“According to WHO data, over 10 million people globally die from preventable infectious diseases. Pathogen gene sequencing demand often arises among acute, severe, and obstinate patients. Identifying the pathogen for targeted treatment improves treatment success rates, shortens hospital stays, and reduces healthcare resource consumption.” Beyond Taiwan, Asia Pathogenomics plans to collaborate with Japan’s biomedical community, where this technology is yet to be available, aiming for its product to become an optimal tool for clinical physicians worldwide, saving numerous lives.

Profile

Award: 27th National Biotechnology and Medical Care Quality Award Bronze Award
Institution: Asia Pathogenomics
Name: PawerDetect | Infectious Pathogen Gene Sequencing Detection
Application Category: Medical Peripheral Services and Products, Precision Testing Group