Is predictive medicine future of medicine?

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Clinician Delivering Healthcare Via DNA Analysis Unrecognizable clinician targeting the genome sequence of a female patient in order to deliver better healthcare via personalized treatment. Pharma concept for pharmacogenomics, pharmacogenetics. Medicine Stock Photo

Over the past two decades, the genetic and genomic revolutions have meant that many aspects of health have become objects of technological and scientific scrutiny. In the medical field, the discoveries on the human genome have allowed the birth and consolidation of a new sphere of medicine, specifically of a branch called “Predictive Medicine”. It is a medicine that, based on the information obtained from the genetic constitution of an individual, is able to develop an estimate of the risk of the latter of contracting a certain pathology over the course of life . In the course of this article we will see in detail what is meant by predictive medicine and what are the advantages and disadvantages that it entails in the life of the patient (or future such).

The importance of prevention: genetic testing and personalized medicine

There are different definitions of predictive medicine, as each emphasizes one or more aspects of a certain field of investigation. In general, it can be defined as that sector of medicine which, by analyzing the genetic makeup of an individual before and / or after birth, studies the probability of risk of developing a disease and monitors its growth with the aim of identifying the most appropriate therapies. to be followed when the disease occurs. Personalized medicine is based on a fundamental premise: the difference between people, their genetic heritage and the response that each group of cells gives to a genetic variation. On average, humans differ from each other by about six million nucleotides(the units that make up a DNA molecule) in their genomes. Therefore, each person should be treated as unique and not as a statistical average.

Unlike what happens with curative medicine – the one we are used to – predictive medicine is aimed at healthy individuals , in whom it looks for the weakness that can predispose them to develop a certain disease. It follows that predictive medicine is first of all probabilistic and, secondly, individual. As such, it is essential to the personalization of the interventions: a tailor-made medicine, we could say.

One of the primary fields of action of predictive medicine is that of diseases such as arterial hypertension , diabetes and cancer . The study of the chromosomal patrimony, facilitated by the mapping of the genome, allows to predict in an early way which subjects are more predisposed to develop these diseases (and many others) with advancing age. The ultimate goal of predictive medicine is to implement a series of prevention and early diagnosis measures to prevent or delay the onset of the disease. In the case of cancer, for example, genetic tests they can lead to diagnosis at an early stage (fundamental for the treatment to be effective) or even avoid it with a series of interventions such as the increased frequency of check-ups and the adoption of healthier lifestyles.

Predictive Medicine: Advantages and Disadvantages for the Patient

From what we have seen so far, it is clear that the advantage provided by predictive medicine consists in the fact that, thanks to the integration of the data obtained from the patient’s medical history (personal and family medical history, lifestyle, etc.) with the genetic test , it is possible to estimate a risk predisposition towards certain pathologies. From this point we can start to outline adequate and timely therapies in order to reduce the possibility of contracting the disease. As you can imagine, the preventive process is inevitably long-lasting : it continues over the years and sees the doctor and nutritionist work together for the patient’s health and well-being.

Furthermore, the current availability of genomic knowledge makes it possible to make the process of discovery of new drugs more effective, by identifying new biological targets and to improve the efficacy and tolerability of the drug by personalizing the therapeutic treatment based on the characteristics. genetics of the patient (it is possible to identify the most appropriate drug for each patient).

At the same time, it is good to highlight some ethical, legal and social issues that, in recent years, have sparked the debate in the medical-scientific community in relation to the effectiveness and limits of this type of preventive approach to caring for people. Here are 4 examples:

  • Genetic tests do not always make it possible to establish with absolute certainty if, when and at what level of severity the person concerned will fall ill.
  • healthy people could become “pre-patients” for a long time before developing the pathology for which they are predisposed, with possible psychological repercussions, social discrimination, in the workplace, etc.
  • How to ensure equity in access to medical care.
  • How to manage genetic information and aspects relating to informed consent, privacy and confidentiality.

Towards the future of medicine

In the last decade, the results produced by genomic research have allowed the development of predictive medicine and the introduction into clinical practice of new technologies capable of identifying susceptibility to diseases and predicting the response to a pharmacological treatment. If, in principle, predictive medicine can have enormously positive effects in the lives of patients, other practical considerations related to the available preventive interventions, the ethical, social and legal implications and the adequate training of doctors, ethics committees, operators health care, citizens and patients need an in-depth study that will characterize the debate in the years to come.

One thing is certain: or ggigiorno are developing personalized medicine strategies now in all fields , from complex diseases (neurodegenerative, cancer, etc.), To diets. Personalized medicine is revolutionizing practical medicine and within a few decades it is very likely that each of us will have the genome sequenced as part of their medical records and will therefore be able to receive the most appropriate drug for their needs.

 

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