The human body is stereotypically defined by having one heart, one brain and multiple sets of appendages: arms, legs, eyes, ears… Even if all mammals, including humans, start out with the same female body construct in-utero— men’s nipples are a vestige of the original female body plan—the interplay of genetics and environmental factors give us the diversity that we all take pride in. However, this diversity that gave us brilliant minds and super athletes also causes some people to respond differently to the same medicinal treatments. In a world where we can personalize everything in our lives from phones, to the type of smells we would like circulated throughout the air conditioning system, some still aim to find the cure all in the little white pill that saves all of us. But all is not lost!
There is a sweeping trend in science and medicine to investigate each ailment on a patient-by-patient basis. For example, cancer cells can be grown in the lab to imitate a tumor’s architecture (1). These cancer cells can then be submitted to multiple drug cocktails to investigate which drug or combination of drugs will prove to be most efficient against the cancer without bombarding the patient’s entire body with poisons on the whim of a statistical guesstimation of fingers crossed. The personalized approach: test the specific cells causing the disease for an effective treatment, then treat the patient as a whole!
Tissue engineering approaches have also been at the forefront of this type of personalized medicine. In 2008, a study published in the Lancet, used a donor trachea and substituted its cells with those collected from the patient receiving the implant (2). This resulted in a fully functional airway that requires no immunosuppressive drugs and which was transplanted into a 30 year old mother of two from Colombia (3).The personalized approach: convert donor tissues into a rejection free implant using the recipient’s own cells!
Although most of the focus of personalized medicine relates to the treatment and prevention of disease for adults, our current knowledge of genetics and related fields could be applied to an individualized approach for the fetus as well. New technologies that have the ability to sequence the entire genome of a fetus using fetal DNA found in the mother’s blood can provide parents with an informed decision about pregnancies and help them determine a course of action (4). However, this type of fetal personalized medicine is riddled with ethics concerns: mistaken paternity, coercion for DNA testing, revealing information about adult onset diseases, informed consent etc. The personalized approach: although we don’t have the savoir-faire at the moment, this type of testing could afford the chance to treat the fetus in-utero!
Another branch of science is currently investigating transferring the whole human body on chips that are analyzed and regulated by computers. The idea: to create an organ on a chip and connect these chips to represent an interacting human organism (5).
These organ chips would reduce the need for lab animals as the effect of a new drug would be available as a computer printout. Although this futuristic type of science is still in its infancy, the impetus for success is underway. The European Commission (6) is funding the Body on a Chip project- a collaboration between 14 European partners, while Sony has partnered with the Wyss Institute at Harvard University in order to advance Organs-on-Chips technologies (7). The personalized approach: your stem cells will be made to differentiate into heart cells, liver cells, and other organs and their interaction will be monitored by a computer which will verify which treatments are best suited to you!
Although Nay-Sayers believe that the rise of personalized medicine is the end of cost effective healthcare, here are some points to consider:
- the end of one size fits all drugs would result in safer and more effective treatments
- lower cost marketing due to targeted patients
- faster clinical trials
- less focus on animal trials
- reduce wasted time for patients and resources with futile treatments
- early identification of conditions before the onset of symptoms
What would you rather: test your own cells for drug efficacy or trust that you are average enough to profit from the power of statistics?
If you want to read more about each type of personlized medicine, here are our resources: