The revolutions rewriting medicine, and the European companies building them

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Last week in London, we attended the Digital Irish flagship event at the Irish Embassy. The evening included a panel from three Irish founders who are making waves in their respective fields. It included Luke Mackey, co-founder and CEO of Kota, the Dublin-based employee benefits platform that closed a $14.5 million Series A led by Eurazeo last year. Jack O'Meara, co-founder and CEO of Aerska, an Irish biotech developing RNA medicines for diseases of the brain. And Dr Jan Cosgrave, founder of Neurotype, a UK company using AI to compress the autism and ADHD diagnostic process from a multi-hour clinical exercise into a forty-five minute clinician review.

On paper they are working on quite different problems. O'Meara is engineering molecules to silence the genes that cause Alzheimer's. Cosgrave, an Oxford PhD and Fulbright scholar trained in clinical psychology at UCL, is building software to clear diagnostic waiting lists that, in some parts of the UK, now stretch beyond three years.

There was a clear theme that came through across the panel, however. Two technological shifts, RNA medicine and AI, are starting to do something the life sciences industry has been promising for two decades: meaningfully change to the trajectory of patient outcomes. Both are now showing up in European venture capital data that show that the industry believes a breakthrough is coming and worth backing with plenty of capital. 

So this edition is partly an explainer on what the breakthroughs actually are, and partly a tour through the European companies trying to build on them. After hearing about the impact of startups like Aerska could have on the lives of potentially millions of people, we felt compelled to dive into the trends driving that potential.

What RNA medicine actually is

To understand why people are excited about Aerska, you need a working model of what RNA interference is and why it took so long to get here.

The Nobel Prize for the discovery of RNA interference, known as RNAi, was awarded in 2006. The mechanism, observed first in a microscopic worm called C. elegans, is elegant. Genes in your DNA are transcribed into messenger RNA, which then instructs your cells to produce proteins. Some of those proteins cause disease. RNAi is a natural cellular process that uses a short strand of RNA to find and destroy a specific messenger RNA before it gets translated, effectively silencing one gene with surgical precision while leaving everything else untouched.

The therapeutic implication was immediately obvious. If you could design a short RNA strand to match any disease-causing gene, you could in theory treat almost any genetic disorder by switching off the gene at the source. The scientific impact of this would be significant, but delivery was the ultimate challenge to overcome.

A naked RNA molecule injected into the bloodstream is degraded within minutes. The body's defences treat foreign RNA as a viral threat. And even if you can keep the molecule intact, getting it inside the specific cells where the disease lives, rather than the cells where it doesn't, is a separate engineering problem. For the better part of two decades, RNAi sat in the same category as nuclear fusion: scientifically real, commercially elusive.

The breakthrough was a piece of chemistry called GalNAc conjugation. By attaching a small sugar molecule to the RNA strand, scientists found they could direct the molecule almost exclusively into liver cells, which carry receptors that recognise GalNAc. The first RNAi-based drug, Onpattro, was approved by the FDA in 2018. There are now six approved siRNA medicines on the market, treating conditions including a rare neurodegenerative disorder, acute hepatic porphyria, high cholesterol, and hereditary kidney disease. All of them target the liver, because that is where the GalNAc trick works.

The race for the past five years has been to crack the equivalent trick for every other organ. Aerska is one of the companies trying to do it for the brain.

The blood-brain barrier, and why brain shuttles matter

The brain is the holy grail of drug delivery and the graveyard of most attempts. A specialised layer of cells called the blood-brain barrier protects the central nervous system from toxins, pathogens, and, unhelpfully, most therapeutics. It is the reason Alzheimer's, Parkinson's, ALS and the broader category of neurodegenerative disease remain among the hardest problems in medicine. By 2050, more than 150 million people are expected to live with dementia globally. There are no cures. Existing treatments slow decline modestly in some patients, often with significant side effects.

Aerska's platform attaches its RNA payload to an antibody that the brain's natural transport system mistakes for cargo it is supposed to let through. The technical term is antibody-oligonucleotide conjugate, the colloquial term is "brain shuttle". Once across the barrier, the RNA can silence the genes that drive disease in neurons.

The company launched out of stealth in October 2025 with a $21 million seed round co-led by age1, Backed VC and Speedinvest. Four months later, in February 2026, it closed a $39 million Series A co-led by EQT Life Sciences from its dedicated Dementia Fund, with age1 returning. Headquartered in Dublin with research operations in London, total funding to date sits at $60 million. The co-founding team is unusually credentialed: O'Meara previously co-founded Ochre Bio, an RNAi company for liver disease that signed pharma deals worth over $1 billion in potential milestones. Stuart Milstein led brain delivery efforts at Alnylam, the company that pioneered the RNAi category. Mike Perkinton was formerly head of discovery at AstraZeneca Neuroscience.

It is exactly the kind of European biotech profile that, five years ago, would quietly have been built in Boston. That it is being built in Dublin and London is itself a signal of where the centre of gravity is shifting.

What AI actually changed about drug discovery

The parallel revolution is happening upstream of all of this, at the point where drugs are designed in the first place.

For most of the history of pharmaceutical research, the bottleneck has been figuring out the three-dimensional structure of proteins. A protein's function is almost entirely determined by how it folds, and traditional methods, X-ray crystallography and cryo-electron microscopy, take months or years per structure. In 2020, DeepMind released AlphaFold, an AI model that solved this problem at a scale and accuracy that was, by the standards of computational biology, science fiction. AlphaFold 3, released in 2024, extended the same capability to predict the interactions between proteins, DNA, RNA, and small molecules, effectively giving researchers a working map of how the molecules of life fit together.

This matters commercially because the failure rate in drug development is staggering. Of every 10,000 candidate molecules screened, roughly one becomes an approved drug, and the average development cost is in the billions. If AI can identify which candidates are most likely to bind their target, behave well in the body, and survive clinical trials, the economics shift dramatically.

The category leader to watch in Europe is Isomorphic Labs, the London-based DeepMind spinout founded by Demis Hassabis. Isomorphic raised $600 million in March 2025 as its first external round, then a further $2.1 billion in Series B in May 2026 from Thrive Capital, Alphabet, Temasek, MGX, CapitalG and the UK Sovereign AI Fund. The company has partnered with Eli Lilly, Novartis and Johnson & Johnson, and is preparing to take its first AI-designed candidates into human trials. Its internal pipeline is focused on oncology and immunology.

Neurotype sits at the other end of the AI-in-medicine spectrum. Not drug design but clinical workflow: an autism and ADHD diagnostic assessment that currently takes a senior clinical psychologist five to seven hours to complete becomes a forty-five minute review. The clinical reasoning, the interpretive authority, the sign-off, all stay with the clinician. The AI just removes the bottleneck. In a UK system where some assessment waiting lists stretch beyond three years, addressing that bottleneck will have transformative outcomes on the diagnosis and lives of patients.

A tour through European biotech's frontier

Beyond Aerska and Isomorphic, here is a sample of European companies taking on different parts of medicine's hardest problems. They are markers of where significant amounts of capital is being deployed across European private markets.

Verdiva Bio (UK, obesity and cardiometabolic) London-based Verdiva launched in January 2025 with a $411 million Series A, the largest first-round biotech financing in European history, co-led by Forbion and General Atlantic. Its lead asset is an oral, once-weekly GLP-1 receptor agonist, competing directly in the category currently dominated by Ozempic and Wegovy. Global GLP-1 sales are projected to clear $80 billion in 2026 alone.

Tubulis (Germany, oncology) Munich-based Tubulis closed a €308 million Series C in October 2025, the largest Series C ever raised by a European biotech and the largest private financing for an antibody-drug conjugate (ADC) developer worldwide. ADCs combine a targeting antibody with a potent cytotoxic payload, delivering chemotherapy directly to cancer cells while sparing healthy tissue. The lead candidate, TUB-040, is in Phase 1/2 testing for platinum-resistant ovarian cancer.

Trogenix (UK, glioblastoma) Edinburgh-based Trogenix raised €80 million in Series A in October 2025 to advance a gene therapy programme for glioblastoma, the most aggressive primary brain cancer, where only around a quarter of patients survive beyond a year of diagnosis.

BioNTech (Germany, mRNA cancer vaccines) The mRNA pioneer best known for the Pfizer-partnered COVID vaccine is now a $30+ billion-market-cap public company with a deep oncology pipeline. Its FixVac platform produces ready-to-use mRNA cancer vaccines targeting tumour antigens. Late-stage trials are running across melanoma, head and neck cancer, and non-small cell lung cancer.

Bioptimus (France, AI foundation models for biology) Paris-based Bioptimus is building a foundation model for biology, the biological equivalent of what GPT did for language. The thesis is that integrating biological data across scales, from molecular structures to whole organisms, requires a single large model rather than a stack of specialised tools. It’s backed by Sofinnova, Frst and Cathay Innovation.

Maxion Therapeutics (UK, ion channel antibodies) Cambridge-based Maxion raised $72 million Series A in March 2025 from General Catalyst, Eli Lilly, British Patient Capital and others. Its platform targets ion channels, a class of proteins implicated in pain, inflammation, and cardiovascular disease but historically very difficult to drug with antibodies.

It’s worth flagging that no single European biotech has reached the scale of a Helsing in defence or a Mistral in AI. The reasons are structural: drug development cycles are longer, capital intensity is higher, and exit liquidity, as we will come to, is materially weaker.

The European biotech funding picture, honestly

European healthcare and biotech raised around $13.4 billion in venture capital in 2025, making it the second-largest sector in European tech behind AI itself. The UK accounted for roughly 30% of all European biotech venture financing, with Germany, France, Switzerland and the Netherlands rounding out the rest of the table.

But the picture is more uneven than the headline implies.

In Q1 2025, just two UK deals, Isomorphic Labs and Verdiva Bio, accounted for the majority of UK biotech capital deployed. Mid-stage growth financing for everyone else remained thin. The European Life Sciences Coalition, launched in February 2026 by Novo Holdings, Sofinnova Partners, Forbion and others, made the underlying problem explicit. European VC funds currently account for just 7% of the global market against 63% for the US and 14% for China. Of the 67 EU-based biotechs that went public in 2025, only one listed in the EU. Five of the world's top ten pharmaceutical companies by revenue are European, and the industry supports 29 million jobs across the EU. The continent designs, but it consistently fails to scale and retain.

There is capital being raised on the GP side. Sofinnova closed a €650 million fund in November 2025. Medicxi closed €500 million the same month. Jeito Capital raised over €1 billion earlier this year. Kurma Partners closed €215 million for biotech investments. The European Investment Bank is co-investing €150 million across ten biotech, medtech and digital health companies alongside Angelini Industries. Servier launched a €200 million venture arm primarily focused on European startups.

The structural intent is there. The execution gap is real.

What this means for private market investors

A few honest observations.

First, biotech is a category of long timelines, high failure rates, and binary outcomes. A single Phase 2 readout can move a valuation by an order of magnitude in either direction. This is not a sector to hold single concentrated positions in. Portfolio thinking matters more here than almost anywhere else in venture.

Second, the structural tailwinds are real but unevenly distributed. RNA medicine, AI drug discovery, ADCs, GLP-1s and AI-enabled clinical infrastructure are pulling disproportionate capital. Companies outside those categories raise more slowly, at lower valuations, and from smaller syndicates.

Third, the European versus US dynamic is shifting in ways that may matter for deal flow. Aerska is headquartered in Dublin with backers including Norrsken VC, Speedinvest and Backed alongside US-based age1 and Netherlands-based EQT Life Sciences. That mix would have been unusual five years ago. It is now closer to standard. US capital increasingly looks to European clinical infrastructure, scientific talent and regulatory pathways, and European biotech rounds are pulling international syndicates earlier than previous waves did.

Fourth, the genuine constraint on returns in this category is exit liquidity rather than deal availability. Until more European biotechs can list on European exchanges at scale, or until the M&A pipeline from large pharma incumbents picks up materially, the gap between paper value and realised returns will remain wider in biotech than in software ventures.

Back to the Embassy

What struck us walking out of the Embassy that evening was both the technical content of the panel and the demographic of the room. Founders, scientists, late-stage clinicians, family office capital and VCs. People who, ten years ago, would mostly have been in San Francisco or Boston. The reasons they are now building, advising and investing out of Dublin, London, Cambridge and Oxford are partly economic, partly regulatory, and partly the accumulation of highly credible teams that have actually built things before.

Aerska is one of those teams. It will take years to know whether the brain shuttles work in patients. The same applies to Isomorphic's AI-designed candidates, to Tubulis's ADCs, to Trogenix's glioblastoma programme etc.. None of these are sure things. But the underlying science is no longer the limiting factor. Delivery is being solved. Discovery is being compressed. The question for private investors is not whether RNA medicine and AI in healthcare are real. They are. The question is which companies, in which geographies, and at which stages, are worth backing while the science is still in trial.

The answer, increasingly, includes Europe.

What we’ve been working on at Shuttle

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The Unsophisticated Investor is brought to you by Scott & Rob, the founders of Shuttle. We’re both sick of private markets being a playground exclusive to the ultra-wealthy so we started a company to challenge the status-quo. Shuttle’s singular focus is to unlock private markets for Millennial and Gen Z tech professionals and help them build wealth through the highest performing private market opportunities.

Scott & Rob
Shuttle Co-Founders