Genomic and Molecular Medicine

After many attempts over the past two decades, genetically modified mosquitoes may finally have a chance of helping to eradicate the dengue fever with which mosquitoes annually infect 100 million people and cause 500,000 cases of dengue hemorrhagic fever and 22,000 deaths, mostly among children.

For the disease of choroideraemia (rarer and less devastating than dengue, but devastating enough to those who contract it) an experimental gene therapy now being used to save a man’s sight could become standard. “Glue ear” (otitis media) has also been successfully treated with a molecular approach, but only in mice, using a VEGF inhibitor anticancer drug. Hemophiliac mice too have been successfully treated with an engineered protein molecule that has safely restored blood clotting and reduced blood loss after injury.

All of these examples illustrate that molecular medicine is advancing rapidly. It will advance even faster as we become more sophisticated at molecular-level engineering. Understanding how proteins fold is key to engineering proteins and developing molecular medicine, so the discovery of a new way to study folding is an important step.

Genomic and molecular medicine of course are a major component, along with regenerative medicine, of personalized medicine—diagnosis and treatment tailored to the individual patient. And it, too, is advancing, as these examples show:

• An individual cancer genome sequencing test became available recently. (I shall write more about this significant development, in my December column for H&HN Daily (ç links to my August article about Genomic Medicine.))
• A test under development might be able to tell whether chemotherapy will work in *your* case.
• Eliminating senescent cells (cells that stop dividing) from your body could delay the onset of age-related disorders if done early in life or at least slow their progression if done later in life.
• Steering wheel sensors that monitor the driver’s temperature, blood pressure, heart rate, skin conductance and oxygen saturation will stop the car and call for help if the driver becomes impaired.

Something that is not exactly “personalized medicine” in the sense we mean it here, but close, is a laser treatment that will turn brown eyes blue. It has undergone animal and some human testing and may be on the market in about 18 months.

Digital Medicine, Robotics, Bionics

Hospital patients who received their discharge instructions from a “virtual nurse” adhered more closely to the instructions than did patients who received them from a real nurse. The virtual nurse will quickly evolve to get even better. Will the real nurse? I do not mean to be flippant. The question is a serious one for nursing schools, in my opinion. Virtual reality could help the real nurse compete by taking on new roles and tasks—for instance, they could train for surgery using Microsoft’s Kinect 3D virtual reality system. But then the virtual nurse could fight back by acquiring a stunningly natural humanoid body covered in a stretchy carbon nanotube sensor skin (which could also be used for touch-sensitive prosthetics and pressure-sensitive bandages.) “But people will always want the human touch” is the last desperate cry of people who just don’t or won’t understand that eventually you won’t be able to tell the difference, or you will be able to tell—and find that the non-human touch is actually preferable.

Systems biology is a different form of digital medicine, in which the patient’s body, rather than the nurse’s, is turned into bits and bytes for manipulation by a computer. A recent important advance in systems biology is a digital model of early embryonic development in vertebrates.

Digital medicine of any form of course depends on computers. The more powerful the medicine, the more powerful the computer must be. The recent emergence of Fujitsu’s K supercomputer (which is intended for use in medicine, among other things) as world champion at over 8 petaflops (8 thousand trillion floating point operations per second) going on 10, is a sure sign of some pretty powerful digital medicine up ahead.

Regenerative Medicine

There is also some pretty powerful regenerative medicine up ahead, including a fountain of youth, even for centenarians; a new and improved artificial blood produced from stem cells; and a “viro-assembler” which may ultimately be a step toward the Holy Grail of a universal assembler that can build anything, from the atom up, and which in the meantime offers excellent potential for tissue engineering.

Acceleration

Other interesting items tweeted on @hfdigest this period included the news that…

• Google’s self-driving cars are performing fabulously. (We think there’s a health implication in self-driving cars.)
• In pharmaceuticals: A synthetic heparin has been more cheaply and efficiently produced than the animal-derived drug, works better, and points to a whole new paradigm for the industry.
• In patient self-care: As one would expect, charlatans are muscling in on the trend, with unreliable HIV home test kits.
• In the “Science and the Cellphone” soap opera: Cellphones cause brain cancer. No they don’t! Yes they do! Don’t! Do! Don’t! Do! Don’t! Do! Don’t! Do! Don’t! Do! Don’t!

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Thanks for reading. Comments are very welcome.

David