Biomedicine today and tomorrow
Bio of good offices
Medicine of the near future is preparing for unprecedented success
Ekaterina Pichugina, Moskovsky Komsomolets
Biotechnologies only at first glance seem to be something from the field of very high science. In fact, the production of bread or cheese, known for thousands of years, is also examples of biotechnologies – after all, their production is impossible without fermenting microorganisms. And the term "biotechnology" itself appeared in 1917 in Hungary for a rather mundane reason – this is how the method of reproduction of pigs by fattening sugar beet was called.
Of course, there is some joke in the above. Modern biotechnologies are the most advanced frontiers of science. In Russia, they have been recognized as a priority direction of the innovative economy. And although so far our country's contribution to the global biotechnology is tenths of a percent, this area of science has a huge potential. The MK columnist learned about the present and future of biotechnologies in medicine, about how people will be treated in a few years.
Diagnosis at the highest mini-levelAccording to Musa Khaitov, head of the Department of Biomedical Technologies of the Federal State Budgetary Institution "SSC Institute of Immunology of the FMBA of Russia", modern biotechnology studies processes at the molecular and cellular levels, it is based on working with the DNA molecule – the biological code of all living things.
And first of all, biotechnologies have found wide application in the diagnosis of diseases. More than 1,000 DNA-based biotechnological test systems have already been developed in the world, which are valued for unprecedented accuracy and simplicity, which no research could provide before their appearance.
In 1983, American scientist Cary Mullis received the Nobel Prize for a revolution in diagnostics – he invented the genetic analysis of PCR (polymerase chain reaction). PCR allows you to detect DNA sites of viruses and bacteria in any biological material (saliva, blood, semen, etc.), even if infections occur in a latent form. Today, with the help of PCR, chlamydia, mycoplasmosis, HIV, hepatitis C, tuberculosis, etc. are diagnosed.
One of the latest achievements of biotechnological diagnostics is the method of biosensors that "catch" disease–related molecules and send signals to sensors. Biosensory diagnostics is often used in the ambulance. For example, it is used to determine glucose in the blood of diabetic patients. It is assumed that over time it will be possible to implant biosensor sensors into the blood vessels of patients in order to more accurately monitor their insulin demand. And if the biosensor can be connected to a mini-pump so that it introduces insulin, the patient will receive a virtually automatic pancreas. In addition, such control will reduce the secondary effects of diabetes, for example, damage to the eyes and kidneys, resulting from a sharp increase in the concentration of insulin during injections. Today at the Institute of Bioorganic Chemistry named after M.Shemyakin and Yu.Ovchinnikova RAS creates a new generation of biosensors using quantum nanoparticles – they easily penetrate the protective barriers of the body and fluoresce. Due to this, many diseases (cancer, autoimmune) can be detected already at the stage of origin.
Well, microchips are now considered the most advanced technology in diagnostics. They are used for early diagnosis of infectious, oncological and genetic diseases, allergens, as well as in the study of new drugs. The University of Toronto is currently working on a microchip for cancer diagnosis – the device contains nanowires and DNA targets that attract molecules whose presence in the body indicates the development of cancer. The analysis lasts half an hour. The device itself fits in a pocket (the current analysis equipment takes up an entire room). In Russia, biochips have already been developed to detect tuberculosis, smallpox, influenza, hepatitis, herpes – these test systems can reduce the diagnostic time from 6-8 weeks to 1 day.
Bioagents against cancerAnother area in which biotechnologies have found wide application and for which they see a great future is the treatment and prevention of diseases.
The first biotechnological medicine – recombinant human insulin – appeared in 1982. Over the past 40 years, more than 200 biotechnological drugs have been created, and more than 400 are at the research stage. Today, the largest pharmaceutical companies in the world are throwing all their efforts into the development of biotherapeutic drugs. "For example, now our portfolio of new developments includes 4 vaccines and 27 biological drugs – this is more than a quarter of all programs under research. This indicator shows a significant increase since March 2009, when the company was developing 1 vaccine and 16 biological molecules," says Kirill Tverskoy, medical director of the representative office of a well–known Western pharmaceutical company in Russia.
Doctors call the recent appearance of bioagent drugs, or monoclonal antibodies, an event equivalent to the invention of antibiotics in the middle of the last century. These drugs are mainly used for the treatment of severe autoimmune and oncological diseases. Unlike "chemistry", they act pointwise, killing only tumor cells and not harming other body systems. That is, they do not plant immunity and do not cause hair loss. And this is a real breakthrough, because today most cancer patients die from the effects of chemotherapy. New monoclonal antibodies are registered almost every month in the world. Today there are already medications for the treatment of lymphoma, colorectal cancer, breast cancer, lung cancer, leukemia... In addition, monoclonal antibodies began to be used for the treatment of rheumatoid arthritis, multiple sclerosis, a number of infectious diseases, etc. Many drugs are registered and used in Russia, which allowed once incurable patients to get a chance at life.
Gene SurgeryScientists call gene therapy one of the most promising areas in biomedical science.
It is based on the principle of influencing the disease with the help of genes transferred to the cells of the patient's body. The first successful experience of gene therapy took place on September 14, 1990 – a 4-year-old girl was transplanted with her own lymphocytes, into which a gene was artificially implanted that did not reproduce in her body (the child had severe immunodeficiency). The patient has already grown up and feels well. Now gene therapy is included in the practice of medicine. Hopes for the treatment of many hereditary and incurable diseases (hemophilia, Parkinson's disease and even AIDS) are pinned on her.
The first gene therapy drug was registered in 2003 in China – it is an antitumor drug for the treatment of severe forms of neck and head cancer. In France, gene therapy cured two 7-year–old children from adrenoleukodystrophy - a disease in which the brain is destroyed due to a congenital defect of stem cells. Researchers took stem cell samples from patients, infected them with viruses carrying therapeutic genes, and returned them to the body again. A year later, the condition of the patients improved noticeably, their nervous system is gradually getting in order.
The Human Stem Cell Institute is conducting research on the country's first gene therapy drug for the treatment of critical lower limb ischemia – when blood vessels become impassable and the surrounding tissue dies. This diagnosis is made to 300 thousand patients annually. The medicine contains a gene that produces a substance in the patient's cells that stimulates the growth of new blood vessels. For many such patients, the drug can become a real alternative to amputation.
Among the technologies of the future, scientists also include the method of cell transplantation of stem cells. This area of science is still causing a lot of controversy, but the success of stem therapy is already evident in the replacement therapy of damaged tissues (for example, it is used in burn centers).
In addition, many scientists around the world are working on the ideas of so-called therapeutic cloning. The point is to learn how to grow organs from human stem cells (liver, lungs, heart) in case they ever come in handy. Scientists say that there is nothing fantastic in this idea, but it is too early to talk about successful experiments in this area. Although, according to some reports, kidney biohybrids have already been created.
Another area that torments the minds of researchers is xenotransplantation. That is, the transplantation of organs and tissues from other animal species to a person. For example, pigs that are close to us in spirit and structure. Research is already underway. Photos of wonderful piglets, whose gene responsible for the synthesis of sugars was removed, flew around the whole world to see if this would cause a correction of their immune system. If not, their liver can be transplanted to patients with cirrhosis and liver cancer.
Medicines by the standards of the customerBut doctors consider the creation of personalized medicines to be much more interesting – it is believed that this is not far off.
Veronika Skvortsova, Deputy Minister of Health of the Russian Federation, believes that biotechnology is the most important strategic direction for the development of medicine, which allows us to approach the formation of personalized medicine that reflects the characteristics of each person. "This will not only improve the results of treatment, but also make curable those diseases that are incurable today," the deputy minister said.
"We are all different from each other, and therefore everyone reacts to the same medicine in a special way. Someone has side effects, someone has allergic reactions, some drugs do not help... Therefore, scientists are focused on creating drugs that could be used depending on a specific human gene type," explains Khaitov.
It has been proven, for example, that people with different genetic material react differently to taking the same statins (cholesterol-lowering drugs). Personalized medicine is based not on the treatment of a specific disease, but on a specific patient. There are even new sciences – pharmacogenetics and pharmacogenomics. And although this area is still referred to as the medicine of the future, there are already unique developments in this area. For example, the CYP 150 test has been developed, which allows selecting medications for the treatment of heart diseases based on blood analysis and the obtained gene information. In addition, a drug is already being used to treat breast cancer if it is caused by blocking HER-2 receptors. That is, it is suitable for a group of patients united by one genetic feature – specifically, they recover against the background of such treatment.
– We hope that in the near future the tablets will not bear brand names, but the names of each patient, – says Khaitov.
NanobiotechnologyNanobiotechnology is also an extremely interesting and very rapidly developing area of medicine.
"Size is very important," scientists say knowledgeably. The evolution of scientific thought from studying the world at the macro level to studying it at the micro level can be demonstrated by the example of influenza vaccines. The first ones, which appeared 40 years ago, contained a viral particle and caused many side effects, and besides they were ineffective. They were replaced 20 years ago by subunit vaccines that included the influenza virus protein (of course, they have become more effective and safer). The latest generation of vaccines – subunit polymer nanovaccines, which include not even a protein, but its most important immunogenic particle – are considered the most effective in the world.
Today, scientists are working on the creation of new microscopic drugs that will be delivered directly to the diseased cell, treat it and be excreted from the body. The dosages of such drugs will be microscopic, the effectiveness will be increased, and the side effects will be practically reduced to zero. In addition, they can also act as diagnostic tools – doctors will be able to observe how drugs work over time. "Nanopreparations are delivered in nanocontainers – liposomes, which dissolve when they reach the target cell and release the drug. At the same time, the toxic effect is significantly reduced, which is very important, for example, for the treatment of oncology, because cancer patients often die not from the disease itself, but from the effects of chemotherapy," says Tatiana Nikolenko, Director of Infrastructure Programs at RUSNANO. According to Nikolenko, RUSNANO is currently considering several projects of breakthrough drugs with so-called controlled delivery, and in 3-4 years they may appear in the clinical practice of doctors.
The Institute of Immunology is also conducting a nanobiological project – scientists are working on the creation of an antiviral drug, the mechanism of action of which is based on the protection of cells from foreign genetic information (that is, the virus). This medicine is planned to be used for the treatment of respiratory viral infection. The experiment lasts about 3 years. Successful studies have already been conducted on cells, as well as on mice. Scientists are almost ready to create a nanopreparation, however, it remains to be decided what will become its shell – it is she who plays a crucial role in delivering the drug directly to the cells. Researchers say that the medicine will be cheap and will be able to cope with any viral cold.
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19.01.2011