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Lithuania possesses one of the oldest languages still in use today, a tree which is amongst the most ancient in Europe, and the designation of being the final country in Europe to convert to Christianity. But amongst such historic heritage, a modern wave of biotech and medtech innovation is ushering the Baltic state to the forefront of scientific advancement in the twenty-first century.

The capital, Vilnius, and second largest city, Kaunas, act as two spearheads of proliferation in biotech and medtech companies that are transforming the country into a cradle of life science ingenuity in the European Union.

In a meeting with business management consultancy Innovation Agency Lithuania, it told Medical Device Network of how the Lithuanian government is placing a spotlight on the life sciences industry. Indeed, the government has set a goal to have 5% of Lithuania’s GDP driven by the life sciences industry by 2030.

And with Lithuania at the geographical centre of Europe, many foreign companies are opting to manufacture in the country. Government incentives, a large talent pool and tight links to research institutions are aiding Lithuania to become a hotbed of innovation and a central hub for cutting-edge science and technology.

Cutting edge biotech

Psylink, based in Sunrise Valley Science and Technology Park, Vilnius, is a biotechnology company offering a new solution to psychedelic drug development. There has been a wave of recent optimism that psychedelics could become a central pillar of mental health therapeutics. Their ability to modulate functional brain connectivity means that they could be used as a facilitator alongside traditional treatments, such as cognitive behavioral therapy.  

“As research progresses and regulations evolve, the development of standardised protocols for psychedelic-assisted therapy and the integration of these substances into mainstream mental healthcare practices may become more feasible,” Psylink CEO Laura Korsakova told Medical Device Network.

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A challenge, however, is sourcing and manufacturing the substances, meaning research and development has an inherent ceiling based on limited cost-effective material supply. Psylink, who in 2021 gained a licence to work Schedule I substances, aims to provide sustainable, scalable, and cost-effective means for psychedelic drug development using genetically modified yeast cells to recreate biosynthetic pathways that lead to psychedelic compounds. The company currently focuses on psilocybin production but is identifying new targets for psychedelic compounds.

Another challenge for this field, which is still in its infancy, is regulatory hurdles. Territories have varying stances on psychoactive drug application in medicine. While countries such as Canada are open to more liberal drug laws, Europe is stricter.

“The therapeutic use of psychedelics is still in its early stages and requires further research and it’s important to consider that the legal status of psychedelics varies across countries, and is subject to change. As societal attitudes and scientific understanding continue to evolve, we may see shifts in legislation to facilitate further research and therapeutic applications,” said Korsakova.

Drugs that have historically been associated with recreational-use also carry stigma and individual perceptions can vary according to cultural attitudes. There has, however, been a notable shift, said Korsakova.

“Evidence-based scientific research has played a crucial role, with studies demonstrating the potential therapeutic benefits of psychedelics and shedding light on their mechanisms of action. Additionally, the increasing number of clinical trials and their promising results have helped break down scepticism and reduce the stigma associated with these substances. Moreover, personal testimonies from individuals who claim that psychedelics have positively transformed their lives have been influential in shaping perceptions.”

Indeed, psychedelics are not a panacea, and their use must be approached with caution and proper guidance, said Korsakova. Psylink’s leading-edge technology will help research and development into potential psychedelic therapy that is safe and medically backed.

Commercialised medical devices

Nearly 100km to the west of Vilnius is Kaunas, the heart of Lithuania’s medtech industry. Vilimed, based at Kaunas University of Technology, is the developer of a handheld device that helps patients with tremors. Its VLIM ball is a certified Class IIa medical device that creates mechanical vibrations which change nerve signals being transmitted between the cerebral cortex and the arm, which leads to suppression of hand tremors.

The ball also has an artificial intelligence component that can record and analyses a patient’s tremor to produce personalised vibrations. Not only does the device address a therapy area that is unpicked, CEO Mantas Venslauskas told Medical Device Network that no other such certified device exists in Europe, but the technology also taps into a growing trend of personalised healthcare.

“Personalised approach is one of the key targets nowadays as it mainly helps to provide more efficient treatment. Even technology like deep brain stimulation can improve treatment efficiency with a personalised approach so it says a lot,” said Venslauskas.

“I believe personalisation is the future of medicine as we all are different, and we need different treatments or individual adjustments. We still know very little about our bodies, but it seems that personalisation is one of the keys to more effective treatment.”

The company has also released an app to measure and assess hand stability. The app contains a range of tasks such as drawing and touching quickly appearing dots. It can be used to assess tremor degree in users with Parkinson’s disease or essential tremor. The device is also able to transmit data to the app. Health mobile apps have soared in popularity over the past few years, and medical devices are increasingly being developed with an associated app in mind. GlobalData predicts that the medical app market will reach $12.1bn by 2030.

“App technology in medical therapeutics is extremely important as it unleashes so many capabilities of our smartphones for medical purposes. Some countries have fast-track reimbursement for such digital solutions, and I believe it has to be promoted even more. App technology can increase treatment or diagnostics effectiveness, reduce treatment costs, help in patient monitoring, and many more. There are plenty of areas in medicine where apps can help,” said Venslauskas.

Gene-editing frontier

Caszyme, located in Sunrise Valley in Vilnius, is a biotech company researching and developing applications of CRISPR-based molecular tools and was founded by scientists at the frontier of CRISPR-Cas9 gene editing technology. Co-founders Professor Virginijus Šikšnys, Dr Monika Paule, and Dr Giedrius Gasiūnas are heading the company that, in the future, could have its technology used to treat some of the most complex diseases. It also has potential applications in agriculture and the ability to help fight climate change.

“I think we’re at the very beginnings of employing CRISPR for gene therapies. Some are going through clinical trials whilst some applications are just entering, there are so many disease areas and indications that CRISPR could be used for. When the first successes start coming through and getting approved in the market, that’s when we will see even more CRISPR-based therapies,” Caszyme co-founder and CEO Monika Paule told Medical Device Network.

Caszyme laboratory in Sunrise Valley. Image credit: Robert Barrie

It is fair to say gene editing has captured public interest as its applications become more viable. The ability to manipulate the genome is one of the biggest scientific discoveries in recent times but, with it, has come public hesitancy, entangled in the unknown capabilities of this new frontier. A study investigating reactions to the potential use of gene editing to reduce a baby’s risk of serious disease produced more worry than enthusiasm. And whilst there have been some calls from within the scientific community to impose limits on genomic engineering, the regulation on gene therapy trials has remained stable and 2023 will potentially see the first approval for a CRISPR gene therapy.

“As with any new technology, whether it’s in biology or physics, can have a range of different attitudes. In the case of gene editing technologies and CRISPR, society is, let’s say, less concerned when it’s tied to medical use,” said Paule.

“Each of us wants to be healthy and free of disease. People will take treatments because they want to live. Compared to discussions around applications that are not about life and death, such as an improved plant species or new animal varieties, there is the potential for mixed publicity when it doesn’t concern our own lives.”

According to Paule, there is no need to make regulations stricter. The more clinical trials that are conducted, the more data that becomes available that could back the technology.

“For some disease areas, there’s already quite a lot of data, but then everyone’s targeting the same application. Throughout time, we will have more data for different applications and that will make the process to some extent, easier but I don’t see the need for stricter regulations.”

Gene editing is perhaps one of Lithuania’s leading technologies and the country has the potential to attract interest in its favourable investment climate.

“Lithuania is currently very strong at all the foundational research and novel discoveries in the gene editing field in general, which then can be applied to gene therapies, agriculture, and diagnostics,” Paule added. “I think this leadership can attract more possibilities to commercialise these discoveries and innovations. Lithuania can be the place to transform fundamental knowledge of gene editing into novel products and novel therapies.”