February 23, 2023
Scientific findings fill thousands of pages of specialist journals, but rarely make it to the front pages of the popular media. Among the multitude of disproportionate news that is spread, there are a handful that really deserve to stand out because they can change human life. What are the 5 advances that promise to revolutionize the field of health?
1- Genetic editing
The technology to “cut and paste” genes is already several decades old. However, the recent invention of the technique known as CRISPR (for Clustered Regularly Interspaced Short Palindromic Repeats) convulsed scientific laboratories. It allows using a family of bacterial enzymes to edit any type of genetic sequence with ease.
Already applied in the field of agriculture and veterinary medicine, CRISPR not only earned him the Nobel prize to the scientists Jennifer Doudna and Emmanuelle Charpentier in 2020 but also promises to improve the treatment of various human diseases and even cure them from the root, if implemented in early embryos affected by pathologies that depend on a gene.
While there are ethical issues that advise walking with a lead foot when intervening in the human genome, it is difficult to get scientists not to use the various DNA and RNA technologies that have been developed sooner rather than later most recently to repair mutations that cause lethal disorders.
DNA in the sights of scientists
Thus, today different types of genetic modifications are being tried in the cells – even modifying, “letter by letter” the DNA book – to try to cure from the excess of cholesterol that leads to heart attacks members of certain families to muscular dystrophy that leaves some children in wheelchairs.
A number of DNA-altering gene treatments are already available to treat certain types of hemophilia and muscle atrophy. But they are not always successful and the price – between 1 and 3 million dollars – is still prohibitive for the majority of the population. However, costs are expected to fall in the coming years.
The possibility of having machines that quickly read a person’s complete DNA for less than $100 already opens the door to multiple diagnoses and treatments. By knowing which genetic sequence is altered in a patient (or in a specific tumor obtained through a biopsy) it is possible to use a drug capable of remedying it. There are already attempts to send a virus with the correct sequence of a gene so that it is incorporated into the tissues of an organ as if it were a Trojan horse, bringing the solution to each patient’s particular problem. This type of “precision medicine” is also used today to read the particular characteristics of a tumor and treat it with the appropriate formula, instead of “shooting the bunch”.
2. Immunotherapy and CAR-T cells
Cancer – or, rather, cancers – have been the subject of study and treatment for a long time. To the battery of chemotherapies and monoclonal antibodies that are administered, new strategies are added today, which seek to modify immunological mechanisms that the tumor manages to co-opt in order to extend its dominance over the organism.
Thanks to new discoveries about the defensive system, different types of immunotherapies are being developed today that make it easier for the body itself to reactivate its defenses to fight against tumors and autoimmune diseases.
While most immunotherapies are drugs made with small molecules or highly sophisticated monoclonal antibodies, researchers are also testing new cell therapies “tailored” to the patients’ immune system. It is the case of CAR-T immunotherapywhich is beginning to be used today against certain blood cancers.
Understanding CAR-T immunotherapy
Researchers take certain defensive cells (T lymphocytes) from a cancer patient, modify them in the laboratory using genetic techniques so that they acquire a synthetic receptor (which will stick to the tumor cells), and reintroduce them into the diseased body Thanks to this transplant of modified T lymphocytes, the immune system’s defenses against cancer are reactivated.
So far, CAR-T (Chimeric Antigen Receptor) cells have worked to fight leukemia and other blood cancers in about 20,000 patients. However, they are very expensive to develop (each cell infusion is estimated to cost half a million dollars) because they are made specifically for each patient. In addition, they need to be replenished regularly because they wear out.
Very soon, scientists will develop cells that work as “living drugs” and that can be stored and used in diseases beyond cancer. After all, T lymphocytes are cells that specialize in destroying all kinds of invading agents, such as viruses and bacteria. Just tell them where to act (and where not to).
In addition, the genes in the CAR cells can be “turned on” or “turned off” using the CRISPR technique. Finally, scientists already envision the possibility of inserting synthetic biological circuits into CARs that order the production of different defensive proteins.
Of course, all these cellular manipulations will need to be shown to be safe before millions of reformed lymphocytes are infused into patients.
Organ transplant researchers have always used animals as models to experiment with surgical techniques and replacement treatments. But today they are starting to take one step further: using animal organs (mostly pigs, which are the closest) to treat human diseases.
The first xenotransplantations (from one species to another) will be of heart and kidney, experts anticipate.
Will organs be developed on demand and eliminate long transplant waiting lists? Organ bioengineering has been saying yes for years, but the challenges remain huge. Although there are encouraging developments.
In 2022, a pig’s heart was transplanted into a human, which survived for two months. In the future, scientists will modify the genes contained in animals to “humanize” them and not generate rejection when transplanted into humans. In fact, a group of Argentine researchers, led by Daniel Salamone, has just announced that they managed to produce a litter of piglets that lack one of the genes responsible for triggering the cataract of organ rejection responses. When all these rejection genes are removed in pigs, their organs will be more suitable for transplanting into humans.
In addition to cross-species transplants, bioengineers are 3D printing organs that they then cover with human cells. There are no artificial organ factories yet, but some scientific laboratories are experimenting with low-scale elaborate “organoids”. The truth is that the demand for transplants is increasing worldwide and advances in biotechnology and bioengineering are promising.
4. Artificial Intelligence (AI)
For many decades, science fiction imagined machines capable of thinking better than human beings. But only the advent of the Chat-GPT platform seems to have convinced humanity that this is possible. The program that allows you to ask and converse with a computer is on everyone’s lips. He handles a language style that mimics the human and delivers information on any subject without hesitation. Although, in truth, the program often makes mistakes or invents answers, its consistency and wisdom seem greater – or at least equal – to those of many experts.
On the other hand, the ability to store, add and compare data is beginning to have effects in the field of health. Telemedicine today streamlines medical consultations, while electronic medical records are becoming an efficient way to manage patient health in hospitals in several countries, including Argentina.
Very soon x-rays, magnetic resonances and tomography will be “read” by intelligent software. Intelligent algorithms will help doctors make decisions about the diagnosis and treatment of their patients, based on the latest scientific evidence. Bots can even sign lab reports, tissue biopsies and prescriptions for basic illnesses, taking into account each patient’s history in their medical history.
Artificial intelligence will also be useful in the prognosis of diseases and in predicting the evolution of ambulatory or hospitalized patients. It will make it possible to distinguish in an electrocardiogram whether an arrhythmia is dangerous or will only generate transient palpitations. It will select prediabetic patients to reinforce lifestyle changes and prevent them from progressing to chronic diabetes. It will analyze colonoscopies to assess possible cancerous lesions and detect melanomas just by reviewing a photo of the skin. Very soon, Artificial Intelligence may catch the first signs of Parkinson’s while a person sleeps with a helmet.
Doctors tremble at the prospect of a robot replacing them. However, some software will soon be able to pinpoint what patients have based on their lab test results or from data from wearable devices (mobile apps, brain-computer interfaces, and smart watches).
For most cases, of course, the clinical judgment of the experienced physician will always be required. But artificial intelligence promises to be the best possible assistant and free up the time that doctors spend on routine tasks to apply to more relevant issues.
The COVID-19 pandemic reminded humanity of the benefit of vaccines in preventing, if not viral and bacterial infection, the serious diseases they cause. The messenger RNA technology that gave rise to the most effective vaccines against SARS COV-2 now promises to be used to obtain vaccines against multiple diseases.
New vaccines against coronaviruses and against respiratory syncytial virus (RSV) for adults and children are already anticipated. A universal vaccine against influenza or flu, vaccines against different strains of dengue, against malaria or malaria and a new vaccine against tuberculosis are also on the horizon.
The pandemic also taught us that it’s not just a matter of having a drug or a vaccine to end a disease. It is also necessary to have access to it and to get communities to trust its effectiveness.
Finally, it must be recognized that technological and pharmaceutical innovation are formidable, but many times it is more important to prevent the most widespread diseases with basic hygiene measures and vaccines than to cure the rarest diseases of the time.
By Alejandra Folgarait @alefolgarait
EDITORIAL THINK HEALTHY
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Tags: 3D bioprinting | science | genetic editing | immunotherapy | CAR-T immunotherapy | Innovation | artificial intelligence and health | new vaccines against the coronavirus | panvacuna | health of the future | xenotransplantation