Over the past quarter century medicine has changed radically. In the late twentieth century doctors could even dream of diagnostic capabilities of today self-respecting medical centers. Achievements pharmacology surprise no less. What would happen to medicine? Experts argue that success is possible only through a synthesis of knowledge from different disciplines. Undoubtedly, the approach to patients will be more personalized. But will in the near future medicine prevent diseases, remains in question.
Ahead of the rest
“It is better to prevent than to cure” – this truth is taught medical students and one hundred and fifty years ago. ‘t lost it relevance today. It would seem that the human genome and the advancement of fundamental biological disciplines gave information that helped to understand how the human body and what is “failure”, which lead to diseases. “Advances in genomics outrun their clinical application,” said Professor, member-correspondent. RAMS, head of the laboratory of prenatal diagnostics of hereditary and congenital diseases of the Institute of obstetrics and gynecology. D. O. Ott RAMS (St. Petersburg). For example, we can discover reliable markers of risk of developing cardiovascular disease in young and completely healthy person. But, to avoid the occurrence of the disease, the doctor cannot offer anything more effective than tips for a healthy lifestyle”.
However, medical science is moving towards prevention and early treatment of diseases.
Experts believe that the medicine of the future will be personalized. “This does not mean that, figuratively speaking, “medicine choose to man”, but rather “the man picked up the medicine,” says Vitaly Prutsky, PhD head of information support of R&D AstraZeneca in Russia and Eastern Europe. In fact, it is the identification of representatives of subpopulations that demonstrate a unique or disproportionate sensitivity to a particular disease or response to a treatment method. To understand what is personalized medicine, you need to remember about genomics. It is known that genes can differ slightly, with just one nucleotide (gene polymorphism). In this case, patients who are “slow” alleles of genes of biotransformation, the liver will metabolize drugs or toxic substances several times weaker. Will have the effect of an overdose, even death. In clinical practice has included molecular genetic test on the metabolism of the anticoagulant warfarin. The study of drug metabolism from the point of view of genomics is successfully engaged academician Vladimir kukës and his staff. But still the majority of personalized medicine is associated with the creation of targeted agents (the very first and famous of them is Herceptin, which is very effective in the treatment of HER2-positive breast cancer).
The medicine of the future will be personalized.
What conditions are necessary for the development of personalized medicine? “First, the presence of drugs targeted actions,- said Vitaly Prutsky. – Secondly, reliable, interpretable and effective biomarkers and diagnostic tests for correct identification of patients, medications and doses, as well as the infrastructure for testing biomarkers”. However, there are difficulties economic order. In the development of targeted therapies invested as much as in the creation of blockbuster. But the latter is designed for millions, and targeted drug – for thousands. You must have an appropriate legislative framework, and patterns of reimbursement of the cost of drugs and diagnostics. In some countries, the tests shall be paid by the patients, the costs could be partially takes health care system. Strategy of health care development and provision of medicines, which were approved in Russia in recent times, personalized medicine is not mentioned.
Dr. cell phone
New technologies will help in the diagnosis of the condition and control of drugs. Mr. Osterley, Vice President, technology in medicine ” company “Medtronic”), believes that this will help make health care not only cheaper but also better. “The U.S. each year spends about $40 billion for inpatient care. This is the main item of expenditure in health care. I think that in Russia the situation is similar, ” he says. – If to obtain the necessary data, when patients are out of hospital, it not only would have saved a lot of money, but also improve the diagnosis”.
In the U.S. spent about $40 billion on hospitals.
Head of the research center of Nokia in SKOLKOVO mark Bailey predicts within the next 5 years device that will combine mobile technology and medical equipment.
The future starts today
So far, we have discussed ways of development of medicine and pharmacology, which is already more or less beaten path and have achieved some success. What research can determine the development of medicine in the near future? According to Oleg Medvedev, it is worth noting at least three directions. First, the prolongation of life. “In Science magazine (may 2014, vol. 344) were published, which return us to the times of alchemy,” he says. – When connecting the vascular network of young and aged rats, the body is rejuvenated last”. What factors influence this process, remains to be seen, but the studies themselves are of great interest in connection with the increase in life expectancy in developed countries. If, in fact, extended the old age, these studies may extend the period of active life. The second direction is connected with the stem cell research. “Despite the fact that working with pluripotent stem cells are a very long time and consumed a huge financial investments, the practical result was very modest,” said the scientist. – However, recent developments in the treatment of diabetes, are very encouraging”. (Journal Of Science, 2014, December 19, Vol. 346, Issue 6216, p.1446). And finally, the third direction is the creation of the interface, brain-machine for the purpose of neuroprotective. (Eric C. Leuthardt, Jarod Roland L., and Wilson Z. Ray, The Scientist, november 1, 2014).
Promising areas of future medicine: the extension of the active period of human life; stem cells; creation of interface brain-machine.
These are only some of the promising directions. The amount of information about the discoveries of different scale will only increase.