The dis­eases pre­dic­tive and per­son­alised medicine will send into the past

Guru Magazine - - Bi­ol­ogy -

Per­son­alised medicine is still a work in progress. As we learn more about how genes and cells work to­gether, per­son­alised medicine will be shaped and fine-tuned so that it can be used by all doc­tors. Even­tu­ally each per­son’s ill­ness should be treat­able on an in­di­vid­ual level. Even now, though, ge­netic tests can be used to pre­dict and treat sev­eral con­di­tions and sit­u­a­tions:

The screen­ing of new­born in­fants is one of the most im­por­tant ar­eas of cur­rent ge­netic test­ing. It is pos­si­ble to test new­borns for fa­tal ge­netic dis­eases such as phenylke­tonuria and con­gen­i­tal hy­pothy­roidism; the fe­tus or em­bryo can even be tested be­fore it is born. Risk screen­ing for can­cer (as in the case of An­gelia Jolie) is fairly com­mon­place as is test­ing to see whether par­ents-to-be are car­ri­ers of a ge­netic dis­ease. If a ge­netic con­di­tion (such as spinal mus­cu­lar at­ro­phy, cys­tic fi­bro­sis and Frag­ile X Syn­drome) runs in a fam­ily then car­rier test­ing can let cou­ples know whether their chil­dren would be at risk of hav­ing the dis­ease. Per­son­alised medicine has a long his­tory of use in treat­ing var­i­ous can­cers (in­clud­ing breast, ovar­ian, pros­trate, lung, colon, etc); a ge­netic test of the can­cer can guide doc­tors to­wards the best course of ac­tion to take. In­creas­ingly, doc­tors can use ge­netic in­for­ma­tion to de­ter­mine how well cer­tain drugs will work in an in­di­vid­ual – an ex­am­ple be­ing the use of war­farin as a ‘blood thin­ning’ drug: if the genes CYP2C9 and VKORC1 are de­tected in the per­son’s genome then the drug will be in­ef­fec­tive. Var­i­ous other drugs have been screened in this way, in­clud­ing Tras­tuzumab (for breast can­cer), ce­tux­imab (for col­orec­tal, head and neck can­cer) and gefi­tinib (for lung can­cer). Ar­eas of pre­dic­tive and per­son­alised medicine be­ing re­searched right now in­clude HIV de­tec­tion, car­dio­vasvu­lar dis­eases and, most in­ter­est­ingly, neu­ro­log­i­cal dis­eases such as Alzheimer’s, Parkin­sons, HIV-in­duced de­men­tia, mul­ti­ple scle­ro­sis and schizophre­nia.

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