The molecular biological revolution is just around the corner
Scientists expect a revolutionary development of molecular diagnosticsIrina Vlasova, GZT.RU
The 7th International Conference "Molecular Diagnostics" once again brought together in Moscow the heads and authoritative specialists of medical institutions of infectious diseases hospitals, AIDS centers, blood services, hygiene and epidemiology centers, clinical diagnostic centers, leading research institutes.
The talk at the symposiums and round tables is about the possibilities of molecular diagnostics in the field of medical and pharmacogenetics, in the recognition of infectious diseases of humans, animals and birds; in ensuring the biological safety of the population. In particular, food and animal feed, diagnostic technologies in forensic medicine and criminology, new areas of molecular biology and genetic engineering.
More than 1,500 specialists from all regions of Russia and foreign countries can get acquainted at the specialized exhibition with algorithms for using modern laboratory methods in clinical practice, with innovations in the field of diagnosis and treatment of infectious diseases of humans and animals, with novelties of laboratory equipment, consumables, test systems (including ELISA, PCR, NASBA, etc.).
Biorevolution is coming
The latest achievements in the field of molecular diagnostics in the world, including in Russia, are being implemented so rapidly that it is difficult even for international forums to have time to generalize the experience and achievements of scientists in order to transfer them to healthcare practice, the Chief infectious Diseases expert of Russia noted at the meeting "Current state and prospects for the development of molecular diagnostics", Academician of the Russian Academy of Medical Sciences Viktor Maleev. German Shipulin, Head of the Department of Molecular Diagnostics and Epidemiology of the Central Research Institute of Epidemiology of Rospotrebnadzor, believes that "biomolecular revolutionary changes" can be expected in this area in the next 3-5 years.
Today, the epidemic situation in the Russian Federation is monitored, pathogens of infection are detected, 85 surveillance centers, 29 research institutes and a laboratory network of indication and diagnostics in all regions provide healthcare with various types of laboratory tests. According to the most modern bio-technologies, a quarter of them work, and 100% are provided with equipment for diagnostics using polymerase chain reaction in order to isolate a fragment of genetic material in a bioassay for research on the presence of single pathogens.
According to German Shipulin, the PCR technology used in real time for healthcare and for ensuring biological safety will remain leading and will be actively developed in the coming years. So only the production of microchips for such molecular research in the United States is growing by 20% annually. and only in the Laboratory of Molecular Genetics of the Central Research Institute of Epidemiology of Rospotrebnadzor, 25 thousand test systems are manufactured per month.
By trains, planes
In the modern world, no country, no matter how safe it is in the infectious sense, is not guaranteed from the import of dangerous infections or from their presence in the natural environment. "There are more than 100 such pathogens of infections of hazard class 1-2, they are tracked by 16 nosologies in the Russian Federation, and outbreaks always have a great public response," said Vladimir Kutarev, corresponding member of the Russian Academy of Medical Sciences, Director of the Research Institute of Rospotrebnadzor "Microb". "In 2009-2010, there were more than 20 major outbreaks of dangerous infections in the world. So when there was an outbreak of plague in China, when 12 people fell ill, quarantine had to be declared in a large city, Kutarev said. In 2010, 3 cases of cholera were imported to Moscow from India, and several cases of polio were imported from Tajikistan. Cases of West Nile fever and Congo Crimean fever were reported from natural foci in 8 subjects of the Russian Federation."
Academician Kutyrev noted that outbreaks of anthrax with high mortality in Scotland, Great Britain, Germany were caused by the importation of heroin infection into these territories, which should alert the relevant services. Specialists in the Russian Federation especially need laboratory standards for especially dangerous infections. And they should appear before the end of this year. we need sensitive environments, test systems. Today, laboratories have to switch to multi-studies, including those conducted not only in stationary, but also in mobile laboratories that travel directly to the foci of infection. There are not many such laboratories yet. Mobile laboratories may also be required to ensure biosafety in venues of mass events, including Olympic competitions.
The introduction of polio cases into the territory of the Russian Federation. Source: Germ Institute, Saratov The introduction of cholera cases in the territory of the Russian Federation.
Source: Germ Institute, Saratov
In vain they sinned for Love
Scientists use methods of molecular genetic diagnostics to test the DNA of a bioassay, a tumor, water or even an ancient animal. The latest sequencing devices, on which biologists conduct tens of thousands of "readings" of bioassays, make it possible to read the genome of a human or animal. So, in 2009, when an amazing exhibit was shown in different countries, which, according to scientists, was 40 thousand years old, the mammoth Lyuba, suspicions arose that the exhibit was infected with anthrax. "Biologists checked the microbiome of the exhibit, 11310 readings, finding 1219 different microbes, said Academician of the Russian Academy of Sciences, director of the Bioengineering Center of the Russian Academy of Sciences, Russian scientist in the field of molecular biology and biotechnology, Konstantin Scriabin, but pathogens, including bacillus anthracis – anthrax, were not detected." Moreover, scientists were able to establish that the mammoth did not live long, Lyuba did not even become a herbivore (there were no typical bacteria in the intestines), apparently, the animal choked on its mother's milk and died.
Tomorrow for personalized medicine
Molecular biologists in the next 10 years will understand which diseases are associated with which specific gene mutations. This will make it possible to predict future diseases by blood analysis, accurately select medications for a specific patient. In principle, the technologies are already clear, except that they still remain very expensive. According to Academician Scriabin, such mutations may be different in different ethnic groups. Now in the West, the genomes of a Chinese, European, African have already been "read", and Russian scientists this week finished "reading" the genome of a Russian patient suffering from kidney cancer for the selection of an individual treatment drug. Apparently, diseases such as Crohn's disease and cancer arise from the effects of bioagents on human genes. According to scientists, it is for such individual treatment, selected according to the sample of the patient's saliva or blood, that the future lies. So far, however, there are only 260 geneticists in the Russian Federation.
Individual medicine
If Russia is not yet economically ready to build the practice of completely individual treatment, said Vladimir Kukes, director of the Institute of Clinical Pharmacology, Academician of the Russian Academy of Medical Sciences, then it is absolutely necessary to conduct an analysis of enzyme activity when prescribing antibiotics. He gave several examples when, with insufficient enzymatic activity in individuals, drugs create a concentration in the patient's blood that is dangerous to life and health, causing a side effect. The side effect of drugs is now ranked 4th among the main causes of hospitalizations in the United States. In the Russian Federation, according to Academician Vladimir Kukes, Roszdravnadzor recorded thousands of such facts; and hundreds of patients died from taking medications that, as it turned out, were personally contraindicated to them. According to the US Food and Drug Administration (FDA), the side effect of drugs ranks 5th among the leading causes of death in the United States. The cost of treating the consequences of the adverse effects of drugs exceeds the cost of the treatment itself.
But as the pharmacogenetic databases are replenished, individual selection of medicines will become possible. Tests for enzymatic activity, as well as tests for the carriage of bacteria, viruses, diagnostic screening of pregnant women and newborns, sexually transmitted infections, as well as genetic predisposition to hereditary diseases are still quite available today, in particular in the laboratory of molecular diagnostics.
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01.12.2010