Yoko Nagai: Redefining the Benchmarks in Healthcare


We are survival machines – robot vehicles blindly programmed to preserve the selfish molecules known as genes. – Richard Dawkins, The Selfish Gene

The current pandemic has hit the businesses in almost every industry, making it a deep fall of the economy to witness. In such difficult times, we as in the world are in great need of some exceptional and young leaders that can set examples by inspiring buds. This edition focuses on avid leaders, who possess the ability to inspire and motivate others thus it’s entitled, “The 10 Young and Inspiring Businesswomen to Watch in 2020. ”

One such entity is Yoko Nagai, Co-founder and CTO of Varinos, Inc. —a specialist in next-generation sequencing (NGS) based genetic testing with the goal of using the genomic information that shapes life to advance reproductive and perinatal medicine related to the birth of life. Her unique ideas and methods helped her to achieve many milestones in her pathway.

A Glimpse into Yoko’s Life

She studied embryology, the study of the birth of life, and used model organisms to research the mechanisms of hereditary diseases. After her PhD, she moved into the programming world of bioinformatics so that she could do genetic research more related to human diseases.

At that time, human genome research was flourishing all over the world and she was inundated with new knowledge every day. She was building a database of disease-related genes, with the aim of applying this scientific knowledge to healthcare for people and treatment for patients. However, she was struggling to connect this knowledge to a useful service, and then she was recruited as a sequencing specialist at Illumina Inc.

Joining one of the pioneering companies in genome technology has expanded her horizons. As she learned that services using genome sequencing technology were being developed and established as an industry around the world, her desire to launch a genomic medicine business in Japan grew stronger and stronger.

This led to starting up a company with Yoshiyuki Sakuraba, who shares the same passion. In the first two years, they both concentrated on research and development, and in the third year, they focused on branding the company as a new kind of genome testing company and expanding overseas and new business.

One-Step ahead of the Competition

In Japan, there are very few biotech ventures that can develop genetic tests based on genome analysis technology. Despite the progress of genome research in Japan, clinical application and practical use of genome technology has been delayed compared to the rest of the world. Especially in Japan, the genome industry has not developed because no one has challenged the development of a new market, which is small and risky at the time of its launch. Therefore, the company aimed to capture a large share of a new market by targeting a niche area with few competitors.

The Pre-implantation Genetic Testing for Aneuploidy (PGT-A), which uses genome analysis technology to detect chromosomal abnormalities that cause miscarriage and increase the success rate of pregnancy, was expected to become a very large market if it was introduced in Japan, a country that is one of the most infertile countries in the world.

While Japanese societies were researching the clinical usefulness of PGT-A, Yok o’s company developed an “endometrial microbiome testing” that could lead to an understanding of the causes of implantation failure and a strategy to retain customers. By quickly initiating collaborations with opinion readers who are sensitive to new technologies, it has increased employees’ technical capabilities and expertise, and its clients themselves have become pioneers in the field.

The company’s unique strategy of using the endometrial microbiome testing to optimize the environment in the uterus and transfer optimal embryos with PGT-A to dramatically increase the success rate of pregnancy received global attention.

Eradicating the Challenges

Yoko states that the development of testing services using genomic analysis technology has not been easy. The company’s greatest challenge in the development of endometrial microbiome testing is how it can minimize the effect of environmental bacteria, which could confuse when reporting the results. It has been establishing a method to analyze low-biomass endometrial microbiota since the uterine bacterial load is estimated between 100 and 10,000 times fewer bacteria than the vaginal one, thus, has been thought as sterile until several years ago.

NGS technology is so sensitive and exhaustive that it can detect bacteria in the uterine, which contains extremely low biomass. On the other hand, bacteria exist everywhere, even in reagents used for the analysis. “If you don’t eliminate the noise come from environmental bacteria, it could result in the false results, not as it really is,” says Yoko.

With her distinctive inventions on the protocol and data analysis method, the company has achieved to minimize the effect of environmental bacteria and to establish a special method detecting the uterine-derived bacteria very sensitively.

As Yoko and her team tried to use the customer network and genomics knowledge they had built up in its previous jobs to commercialize preliminarily based technologies, what helped us the most was an investor who could assess the value of its services without a scale. “Without investors who understand science and reproductive medicine, we wouldn’t be in business,” quotes Yoko.

For Her

Yoko believes that by having young female executives talk about the diseases and physical characteristics unique to women, it can help to remove the deep distrust, anxiety and sexual taboos that women suffering from female-specific diseases think they shouldn’t talk about. Also, half of her employees are women.

The company does not give preferential treatment or restrict voluntary and autonomous behavior because of gender. If there’s one thing its executives do specifically for female employees, it works with them sympathetically to come up with solutions when they are struggling with female-specific health problems or illnesses. Yoko and her team also consider pregnancy and childcare to be a top priority, regardless of gender, as a valuable time and experience that enriches a person’s life outside of work.

When asked about the myth of meritocracy, Yoko emphasizes that this is a difficult question to answer and states that she didn’t know about the myth of meritocracy until today. She believes that being justly rewarded by individual merit and increasing corporate value through company sales and growth is a way forward, not a goal to be reached. Various wants to continue to be a company with a sense of mission that uses the capital it raises to develop even more breakthrough products and services to innovate in medicine and industry so that the development of human society benefits its descendants.

Embracing Technology

Yoko states that in today’s mature society, technological innovation is happening every day, and it is difficult to keep track of all the vast amounts of the latest technology and research results, but she wants to be a “Type T” person who can look into other fields of technology, not a “Type I” person who delves into one field only.

There are many researchers and developers who are working hard to solve the various problems that surround us in our daily lives, such as environmental pollution, energy problems, physical disabilities, and loneliness. She was always impressed by the breakthrough ideas and solutions they come up with. Yoko actively collects technological trends in the hopes that they will one day provide her with hints for the business.

Peek into Future

The company has established the world’s first clinical laboratory endometrial microbiome analysis test service and has already analyzed more than 8,000 samples. Using in-house data, it continuously updates its tests to be more accurate such that it can detect “species” level microbiome. It is aware that the human reproductive organs have a unique species of bacteria that are unique to each person.

By revealing more details about the genital microbiota of patients who are not improved by uniform treatments, it hopes to be able to select the most effective antibiotic treatments, probiotics or prebiotics that is personalized for that patient. It also wants to remove the seeds of genetic diseases from families through genome analysis. And, are planning to develop the following tests: preimplantation genetic testing for monogenic diseases designed for the Asian population, and preimplantation genetic testing for breast cancer and other polygenetic diseases.

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