Τετάρτη, Ιανουαρίου 12, 2005

Predictions for 2015 (continued)

I skipped predictions on biology and medicine. Here they are (2015 is still quite far ahead, so I'm not that late!). Read at the bottom for a short explanation of some terms.

The function and importance of many more genes will be elucidated by 2015. This is just the linear projection of a current trend. Much has to be done when it comes to gene polymorphisms--the variations between genes that are almost identical. Several common human diseases like hypertension or dyslipidaemia or diabetes are multifactorial and a clear genetic component can be hard to identify. However, polymorphic gene variants may confer slight susceptibility and their accumulation leads to a substantial risk, even though each of them is insignificant clinically. Understanding the impact of various polymorphisms can be very hard. The genome has ~30-40 thousand genes, according to most experts, but many of those can have several polymorphisms and their differences in function can be very slight.

Artificial biological organisms, even complex ones, will definitely be created. They might even become the "machines of the future". Researchers are already capable of building virii from scratch by assembling components of the viral genome. Microorganisms that do a specific task will be highly efficient and may be used in the industry. We are already making crude use of "genetic engineering" for several purposes but the fine tuning that will become possible will multiply the applicability of these methods. I am, of course, worried about the prospect of ultra-efficient biological weapons but progress is never withouth danger.

Stem cells are definitely an ultra hot issue right know. A lengthier discussion is warranted at some later date. Roughly speaking, think of easy tissue transplantation (new kidneys, heart, lungs) and even the structural remodelling of destroyed tissue (in situ repair of damaged tissue, e.g. brain or spinal cord). It is early to say whether stem cells will deliver on their promises, but if they do 2015 and later will be a very very interesting place to live.



The significance of viral infections is--in my opinion--understated. The majority of the population suffers from repeated viral infections (flu, common cold, gastroenteritis, infectious mononucleosis, childhood diseases). Even though bacterial infections can be noisy and produce a fulminant clinical picture, a huge percentage of everyday infections are usually attributed to viruses and much less information is available. Several viruses are able to produce oncogenic transformation (i.e. cause tumors), others turn to a chronic latent state from which they occasionally emerge (e.g. herpes simplex, varicella-zoster virus and many others) and new ones are found frequently. A complex symbiotic relationship between viruses, humans and several other species is now beggining to be explored (e.g. SARS attributed to an animal reservoir). Our understanding of viral infections may illuminate several non-infectious diseases that have a genetic and an unknown environmental component (i.e. some people are vulnerable but not all vulnerable people get the disease).

I won't offer a specific prediction on AIDS, but it a lot of research is happening and the stakes (=money for pharmaceutical industries) are now VERY high. The progress in this field has been extraordinary, for a disease that was discovered just over 20 years ago.

Main advances in cancer will come from cancer prevention and early cancer detection. Cancer is a very complex disease and the therapies we possess are relatively crude. There can never be a universal drug (or class of drugs, or combination of drugs) that will cure all cancers. Instead, we will get an ever increasing knowledge on several cancer sub-types and their associated optimal drug regimens which will slowly but steadily lengthen the life expectancy for cancer patients. At some point we might even be able to discern specific cancer "genotypes" (i.e. analyze the gene patterns in that specific malignant tissue from a specific patient) and choose an optimal matching therapy for that one patient. This will cost a real lot of money because the components of that therapy will have to be tailored to the patient, like a hand-made suit. Cancer detection will improve and instead of curing stage IV patients--which is very hard--we might simply be able to readily detect curable stage I disease (think Pap smear).

Hot research
The most popular fields of medical/biologic research appear to be--in no particular order: alzheimer's disease, AIDS and cancer. You should expect to see major advances in those fields. Cardiovascular diseases are now a relatively mature field and almost optimal prevention strategies are available for patients and the general population (their actual application can be very hard, judging for example by the percentage of obese people in western countries). The drug pipeline for non-terminal diseases can be quite long (for safety testing etc) and a 10-year period won't allow us to witness tremendous improvements in these diseases. Instead I expect stepwise steady improvements and perhaps a few spectacular discoveries.

Anyway, this is just my view of things and since there are many things I don't know, there are even more things I couldn't possibly predict, so prepare to be surprised. I apologize for errors and omissions, this is something I wrote in an afternoon, not a doctoral thesis!

Short explanation of terms:
  • wild-type gene: found in a normal population, considered "normal"
  • mutant gene: a gene with an altered sequence (compared to the wild-type) that does not appear frequently in the population and is (usually?) associated with a disease or abnormal state
  • gene locus: the actual position on the DNA strand where the gene resides
  • gene polymorphism : a group of similar but not identical wild-type genes that are not apparently associated with some disease and are found frequently in a normal population. Their small differences may explain the differences between organisms, like hair color, stature or intelligence.
  • idiopathic diseases: those that do not have an identifiable cause (idion=self, therefore idiopathic roughly equates to self-inflicted)


Blogger vvas said...

As mentioned, a lot of research will take place on genes and their use, and a lot will be discovered during this period. However, these discoveries will be hidden away behind patents and other "intellectual property" mechanisms, mostly controlled by large pharmaceutical corporations. Of course, said corporations will be able to cross-licence their "property" for wider access to the available knowledge, while academic and independent researchers will be unable to afford the associated royalties.

Naturally, the research on genes and other areas of biology and medicine will lead to the discovery of new and/or more effective drugs. Emphasis will be given to terminal diseases, or diseases that have a serious effect to the patient's life, while much less research will be devoted to "life-long little annoyance" types of diseases. In addition, emphasis will be given to treatments that sustain the patient and address the symptoms, rather than outright curing them, since the former is a much more profitable enterprise.

Finally, as the methods for combating diseases progress, so will the diseases themselves; new virii will appear now and then, cancer levels will continue to rise, and allergies will start becoming a serious issue, especially for urban populations. An optimistic prediction would be that, thanks to the advances of medicine, people will on average remain equally healthy as they are today; however, I'm not much of an optimist when it comes to this area.

5:12 π.μ.  

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