If you want to select the hot words of science and technology in the first half of this year, " precise medical care " is likely to be on the list.
At the beginning of this year, US President Barack Obama put forward a large-scale medical research plan for "precise medical treatment " in the State of the Union address, announcing that he will invest $215 million in the fiscal year 2016, hoping to "lead a medical era."
This news, which is closely related to life and health, has spread to the country and has caused countless conjectures and has attracted the attention of all parties.
What is precision medicine? What revolutionary changes will it bring to human health? Are you ready for precision medicine?
What is precision medicine?
Find the pathogenesis mechanism to achieve personalized and precise diagnosis and treatment
Speaking of precision medicine, Wang Qianfei, a researcher at the Beijing Genomics Institute of the Chinese Academy of Sciences and head of the Hematology and Oncology Genomics Research Group, cited a case in which Lucas Wattman, a scientist at the University of Washington, participated in the world's first tumor genome (leukemia). The sequencing work, but unfortunately in this process suffer from the leukemia that I have studied. After the traditional chemotherapy, the condition was temporarily controlled, but it relapsed after 5 years. After the recurrence, all the means of chemotherapy, hormone therapy and even bone marrow transplantation were completely lost, and Lucas' survival chance was negligible. At this time, Lucas's laboratory acquired his cells for whole-genome DNA and RNA sequencing. From the massive data, a gene called FLT3 was found to be "abnormally active" in tumor cells. Accordingly, the doctor added a drug, sunitinib, for the treatment of advanced kidney cancer, which inhibits FLT3. After two weeks of continuous medication, the leukemia cells in Lucas disappeared and he returned to scientific work.
In the view of Zeng Changqing, a researcher at the Beijing Genomics Institute of the Chinese Academy of Sciences and director of the Key Laboratory of Precision Genomics Medicine of the Chinese Academy of Sciences, the so-called "precise medical care" is based on the genomics and metabolomes of a large number of people (including transcriptomes, epigenetic groups, The proteome and other data) analyze the phenotypic characteristics of the disease, and on the basis of understanding the molecular mechanism of disease development, find the diagnosis and treatment target, and finally achieve the purpose of personalized and precise diagnosis and treatment.
The expression “precise medical care†can be traced back to the report “Towards Precision Medicine†published in the United States in 2011. The concept is based on "humans have discovered that certain genetic changes can lead to the development of certain diseases."
For the first time in the report, the “precise medical treatment†was comprehensively and elaborately elaborated. The main point is to re-classify the disease based on molecular mechanism and “symptomatic medication†based on it.
"This 'classification' is classified from the perspective of molecular biology, not based on the location of the disease, and then determines the diagnosis and treatment." Wu Jiayu, deputy researcher and director of the Science and Technology Department of the Beijing Institute of Genomics, Chinese Academy of Sciences explained, "I For example, in the case of tumors, the occurrence and development of diseases is the result of the interaction of multiple genes and the environment. Finding the molecular mechanism of tumorigenesis is the premise of accurately treating complex diseases. We can explore the multi-gene mutations of tumors and the environment through comprehensive omics data analysis. The molecular mechanisms of action make disease treatment more accurate and more individual."
In fact, the key words in the US version of "Precision Medicine" are gene sequencing , tumor, and personalization. Obama has interpreted this as "normalizing genetically-matched cancer therapies like blood transfusion-matched blood types, making it as easy to find the right dose to measure body temperature."
Is precision medicine useful?
People are expected to be told that they may be suffering from certain diseases in the future, so that they can be better prevented.
"Use of gene sequencing to find the target of gene mutation in certain cancer patients, supplemented by targeted drug treatment, the so-called 'precision strike', instead of radiotherapy, chemotherapy, surgery and other carpet bombing in traditional cancer treatment. Means can not only improve the treatment effect, but also reduce the patient's pain level and economic burden." Wang Qianfei said.
"Of course, accurate cancer treatment is not limited to precision strikes on key targets." Wang Qianfei added, how the drug is resistant and relapsed after being hit, and the impact of the entire body, especially the immune system, on the disease itself. Complexity and so on are all areas of precision medical research.
Experts generally believe that precision medicine will fundamentally change the current medical treatment model. If people have a deep understanding of their genetic and genomics information, predictions of disease, especially disease susceptibility, will be realized.
“First of all, people are expected to be told that they may have certain diseases in the future, so that they can be better prevented; secondly, once they have a disease, their diagnosis will be easier and more timely. Also, after diagnosis. The targeting is also stronger, each patient will receive the most appropriate drug, and the drug will be used under the premise of optimal dosage and minimum side effects, as well as the most accurate medication time. In addition, the effect on the care and prognosis of the disease will also be obtained. Accurate assessment and guidance." Wu Jiaxuan said, "In Obama's words, it is 'to give the right person the right treatment at the right time. And this is the second time.
However, many experts have emphasized that care should be taken not to mythology of precision medicine, which does not solve all problems. "There are some diseases that have been rescued through precision medicine, but for most diseases, it is far from achieving the level of precision medicine." Wang Qianfei said.
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