When we first met the leaders at Apreo Health, we saw a team tackling one of the most significant unsolved problems in pulmonary medicine with clarity, clinical rigor, and ambition.
More than 3 million Americans live with emphysema, a progressive and debilitating lung condition. For many, each breath is a struggle. While severe emphysema is one of the most common causes of chronic respiratory failure, there are currently no effective medical therapies for these patients. Even though there have been some notable procedural advances made over the past two decades, fewer than 1% of patients receive any form of interventional treatment today because the existing solutions are either too risky or narrow in their applicability. The unmet need is clear.
Apreo Health is helping patients with severe emphysema breathe better and improve their quality of life with its BREATHE Airway Scaffold. The minimally invasive bronchial device has shown promising results in the company’s early human clinical studies, including demonstrating its potential to address the safety and procedural limitations of the first-generation therapies.
Apreo Health is helping patients with severe emphysema breathe better and improve their quality of life with its BREATHE Airway Scaffold.
Norwest is proud to co-lead Apreo’s $130M Series B round alongside Bain Capital Life Sciences to support the company as it launches its pivotal BREATHE-3 trial and prepares for early commercialization.
Breaking The Mold
The BREATHE scaffold is a minimally invasive, tissue-sparing implant that elegantly and safely addresses the core underlying pathophysiology of severe emphysema that makes it difficult for patients to breathe: lung hyperinflation.
In patients with emphysema, chronic irritation and inflammation, usually caused by smoking, leads to the destruction of the small air sacs (alveoli) and tubes (bronchioles) in the lungs. This destruction of lung tissue not only reduces the amount of healthy lung tissue, but it also weakens the support structure of the remaining bronchioles and alveoli. As a result, when an emphysema patient exhales, some of the bronchioles collapse and air is trapped inside the lung. Over time, these collections of trapped air coalesce to form large air-filled sacs, known as lung hyperinflation. It is these areas of hyperinflation that make it difficult for emphysema patients to breathe because they limit the ability of the remaining healthy lung tissue to fully expand.
All existing surgical and interventional therapies for emphysema aim to reduce the amount of hyperinflation in the lungs by either removing or collapsing the most hyperinflated areas. However, because the lungs of emphysema patients are so fragile, there are significant safety issues with the current approaches, and they are limited to only a small portion of the overall patient population.
Apreo’s BREATHE Airway Scaffold, on the other hand, works by gently “tenting” open the damaged airways without destroying or collapsing the lungs. As a result, the procedure allows more healthy lung tissue to remain functional. It has been shown to be significantly safer than the existing therapies and has the potential to treat a meaningfully larger portion of the patient population. The device is placed via standard bronchoscopy in under an hour and delivers near-immediate symptom relief for patients.
Apreo’s BREATHE Airway Scaffold has been shown to be significantly safer than the existing therapies and has the potential to treat a meaningfully larger portion of the patient population.
In data from the company’s early human studies, the BREATHE‑1 and BREATHE‑2 trials, patients experienced significantly improved lung function. In addition, the trials demonstrated that the BREATHE scaffold does not carry the significant complication risks associated with current therapies. Most importantly, there were no post-procedure pneumothoraxes — an unfortunately common complication associated with current interventional treatments where air leaks outside the lung into the chest cavity and causes the lung to collapse which, if not caught in time, can be fatal.
What most sets Apreo’s approach apart is its broad applicability. Unlike currently available therapies like lung volume reduction surgery (LVRS) or one-way endobronchial valves (EBVs), the BREATHE scaffold is not limited to treating certain patient phenotypes — we believe the BREATHE scaffold has the potential to expand the addressable market by 3-4 times. Today, lung centers have lists of patients waiting on the sidelines who currently have no treatment option available to them, and whom Apreo is looking forward to helping in the future.
In short, we believe this breakthrough solution has the potential to become the standard of care in treating the millions suffering from emphysema.
Engineering a New Standard in Pulmonary Care
Apreo Health was incubated at The Foundry — one of the most respected medtech accelerators in the world — and was built by a team with deep expertise in pulmonary innovation. CEO Karun Naga is a proven entrepreneur with a strong engineering and operating background. He’s helped build and scale multiple medical device companies, including Allay Therapeutics, Altura Medical, and Ardian. More than that, he’s a steady, forward-thinking leader who surrounds himself with excellence.
During one of our early site visits to Apreo’s office, just down the road from our own in Menlo Park, we were able to hold the BREATHE Airway Scaffold ourselves, and at that moment, we knew it was different from anything else on the market.
Seeing it up close made it clear just how different the BREATHE scaffold really is. The lungs aren’t static; they move, expand, and compress thousands of times a day. Designing a scaffold that can function reliably in that kind of environment requires a level of conformability, durability, and biomechanical nuance that only a team like Apreo’s could develop.
Designing a scaffold that can function reliably in the lungs requires a level of conformability, durability, and biomechanical nuance that only a team like Apreo’s could develop.
Why Apreo Aligns with Norwest’s Healthcare Strategy
At Norwest, we focus on category-defining solutions that are grounded in strong clinical data with real-world usability, such as Route 92 Medical and SetPoint Medical, two companies that recently achieved FDA approval on the heels of best-in-class clinical data. Apreo Health checks all those boxes, building the foundation to transform emphysema treatment as we know it.
We’ve been watching the interventional pulmonology field gain traction for years. The expansion of platforms like Intuitive’s ION robot for bronchoscopy has helped democratize access to lung procedures, and we believe that momentum is creating a foundation for broader procedural innovation.
Apreo fits squarely into that vision. By addressing the physical mechanics of hyperinflation without introducing more surgical risk, the BREATHE device meets pulmonologists and their patients where they are.
Looking Ahead: What’s Next for Apreo
Apreo is rapidly changing how emphysema is seen and treated. As the team builds on the momentum of its first two trials and advances toward the pivotal BREATHE‑3 trial, we see strong potential for meaningful, real-world impact.
With its ability to serve a broader patient population through a safer, more scalable approach, the BREATHE scaffold stands to transform care for those who’ve long been underserved. We’re proud to support Apreo on this journey and eager to see more patients breathe easier and live better.
