Personalised medicine
We live in the amazing time of high technologies, breakthrough innovations and revolutionizing discoveries when the sci-fi miracles turn into a daily routine and change our understanding of the well-known things and events generally in nature, and particularly in medicine. The personalised therapy became such a revolutionizing event for the late 20th century, although they have been discovered in the very beginning of the century, by Prof. Alexander A. Maximov, a Russian immigrant to the USA (04.02.1874–04.12.1928). In 1908 Prof. Maximov presented his new theory of hematopoiesis at the meeting of the hematologists in Berlin and for the first time proposed the term “personalised therapy” to explain the mechanisms of rapid self-renewal of the blood cells. But only almost a hundred years later his fundamental ideas have been reborn and acknowledged. The year of 1908 can be considered the beginning of the personalised medicine that had the thorny way of rises and falls, from complete negation and neglect to acknowledgement and legalization.
The success of contemporary science that studies the cells have radically changed our deeply-rooted traditional biological and medical notions. New evidence about the cells made the scientific community doubt the credibility of some ubiquitous biological dogmas and medical patterns and mechanisms of the pathogenesis of the incurable diseases and injuries. The standards along with the ineffective conventional therapeutic approaches had to be revised. Personalised therapy have radically changed our understanding of cancer. It just suffices to mention the scientifically grounded claims of the leading oncologists that “cancer is a genetic disease of the nucleus of the SC” and that all cells of cancer population are the progeny of one cancer CS (Zaridze, 2004).
Apart from a huge interest, the discovery of the cells caused discord, arguments and disagreement in the followers and opponents of new ideas and evidence. Premature claims of the pioneers (frequently incorrect as they were based on the overestimated experimental and clinical data) about the unlimited capacities of the cells in the clinics have been repeated too often without appropriate reservations and proofs. To date, these limitations are known and have been experimentally confirmed. Precipitance, crudity and absence of fundamental approach in the early research of the personalised medicine have delayed positive development of this new field by two decades as the first benefits from the SC therapy have been overshadowed by the iatrogenic tumors. Now we understand the reasons for the development of the tumors from the embryonic cells and the pluripotency and plasticity of the cells as well as their functional multifacetedness and effector ambiguity at the level of the genome, transcriptome and proteome. Moreover, today we have studied the amazing regulatory anti-tumor characteristics of all tissue-specific cells. That time, in early 90s, the researchers’ “golden rush” of the personalised therapy led to the dead failure of the plans, ideas and loss of perspectives as well as hopes for public funding of further research.
Absence of understanding and methodological approaches of the personalised medicines and ban for the public funding of the cells have led to the rejection of everything that seemed to have connection with the personalised therapy by the academic community and conservative university professorate. Moral and ethical issues of early personalised medicine made some of the scientists conclude that use of the personalised therapy has no future and no sense and is only a history of another scientific fraud. The medical and scientific community split into two groups: those who considered the personalised medicine good, and those for who it was evil. Absence of public funding led to the speculative spread and migration of the personalised medicine from the university laboratories and hospitals to the commercial medicine where its use was not secured by the proper formalism and quality control. These tendencies have been erroneously perceived as the signs of pseudo-science and academic impotence by the leading experts. The para-academic arguments about low benefits, absence of safety and impracticality of the therapy, that were popular in the surgical fields of medicine (neurosurgery, traumatology, esthetic surgery etc.) in the 90s, have negatively influenced the specialists of other fields of medicine where absolutely different tasks have been considered.
By now, we have accumulated a huge amount of unique scientific facts and evidence on the nature and fate of the cells. A contemporary concept of the cells has been developed, the role of the SC in the embryogenesis, ontogenesis and self-renewal in the humans have been shown. The advances of the fundamental biology validated a novel methodological platform of knowledge and the databases of cell cultures permitted decoding of the genome of a somatic cell of the mammalians and develop the biodegradable polymer matrixes that function as the scaffolds for growing cells in order to grow artificial organs and tissues and manufacture new cell products through molecular, peptide, gene and tissue engineering. Genome and post-genome technologies opened new unlimited opportunities for the research of transcriptome, proteome, metabolome and secretome of the mammalian cells and paved the way for the personalized medicine.
The successes of molecular and personalised biology, genomics, and proteomiсs of the cells forced mediсal community and experts to revise the present viewpoint on the cause and nature of carcinogenesis and of hereditary diseases as well as mechanisms of development of some of the incurable metabolic and vascular diseases (diabetes mellites, diabetes insipidus, myocardial infarction, stroke, vasculitis and others) and neural disorders (brain and spinal cord injuries, Alzheimer’s and Parkinson’s diseases and others). It became obvious that the progress in biology and medicine has made another biotechnological spin and gave birth to a novel field that has bright future and that has finally acquired the name of “personalised medicine”
The personalised medicine is a unique fusion of the frontier theories, novel concepts and the most advanced high immunotherapy technology. If the personal computers and telecommunications have revolutionized computer engineering and communications in the middle of the previous century so that we witnessed the era of mobile phones and the global Internet, the progress in healthcare brings us to a new era of the personalised medicine. The personalised medicine is a regular newsmaker in mass media presenting the achievements of personalised therapy that stir the imagination of the doctors and ordinary people. We read loud titles that tell us about the unbelievable opportunities o the cells in rejuvenation, anti-ageing and restoration of the damaged organs. The personalised therapy in the regeneration of the organs and tissues is really a scientific breakthrough in contemporary biology and medicine. The journalists and popular science communicators keep impressing us with the news of paraplegics starting to walk, artificial liver implanted to the patient, or a transplantable artificial bladder grown in bioreactors.
The official term “personalised medicine” only partially reflects the clinical meaning and the nature of the phenomenon. The regeneration of the damaged organ or tissue initiated by the personalised therapy preparations is only one of the mechanisms of their therapeutic effect. Probably, it is more correct to speak of the regulatory medicine, as to date we have found such important functions of the cells as the regulatory functions. They are able to induce proliferation and differentiation of the somatic target cells and apoptosis of the pathological cells. Such important functions of the mammalian cells as anti-tumor have also been shown, as well as many others that are far from regeneration.
You can read about the personalised medicine in 2 volume Manual for Doctors personalised therapy and personalised medicine in the therapy of nervous diseases in more detail.
