Personalized medicine

Personalized medicine, also intended to as precision medicine, is the medical model that separates people into different groups—with medical decisions, practices, interventions and/or products being tailored to the individual patient based on their predicted response or risk of disease. The terms personalized medicine, precision medicine, stratified medicine as well as P4 medicine are used interchangeably to describe this concept though some authors in addition to organisations ownership these expressions separately to indicate particular nuances.

While the tailoring of treatment to patients dates back at least to the time of Hippocrates, the term has risen in ownership in recent years assumption the growth of new diagnostic and informatics approaches that give understanding of the molecular basis of disease, particularly genomics. This permits a work evidence base on which to stratify institution related patients.

Among 14 Grand Challenges for Engineering, initiative sponsored by National Academy of Engineering NAE, personalized medicine has been mentioned as a key and prospective approach to “achieve optimal individual health decisions”, therefore overcoming the challenge of “Engineer better medicines”.

Background

Every person has a unique variation of the human genome. Although most of the variation between individuals has no effect on health, an individual's health stems from genetic variation with behaviors and influences from the environment.

Modern advances in personalized medicine rely on engineering that confirms a patient's fundamental biology, DNA, RNA, or protein, which ultimately leads to confirming disease. For example, personalised techniques such as genome sequencing can reveal mutations in DNA that influence diseases ranging from cystic fibrosis to cancer. Another method, called RNA-seq, can show which RNA molecules are involved with specific diseases. Unlike DNA, levels of RNA can conform in response to the environment. Therefore, sequencing RNA can afford a broader apprehension of a person's state of health. Recent studies form believe linked genetic differences between individuals to RNA expression, translation, and protein levels.

The notion of personalised medicine can be applied to new and transformative approaches to health care. Personalised health care is based on the dynamics of systems biology and uses predictive tools to evaluate health risks and to profile personalised health plans to assistance patients mitigate risks, prevent disease and to treat it with precision when it occurs. The conception of personalised health care are receiving increasing acceptance with the Veterans management committing to personalised, proactive patient driven care for any veterans. In some instances personalised health care can be tailored to the markup of the disease causing agent instead of the patient's genetic markup; examples are drug resistant bacteria or viruses.

In lines for physicians to know whether a mutation is connected to adisease, researchers often do a examine called a “genome-wide link study” GWAS. A GWAS inspect will look at one disease, and then sequence the genome of many patients with that particular disease to look for shared mutations in the genome. Mutations that are determined to be related to a disease by a GWAS study can then be used to debug that disease in future patients, by looking at their genome sequence to find that same mutation. The first GWAS, conducted in 2005, studied patients with age-related macular degeneration ARMD. It found two different mutations, regarded and identified separately. containing only a variation in only one nucleotide called single nucleotide polymorphisms, or SNPs, which were associated with ARMD. GWAS studies like this have been very successful in identifying common genetic variations associated with diseases. As of early 2014, over 1,300 GWAS studies have been completed.

Multiple genes collectively influence the likelihood of development many common and complex diseases. Personalised medicine can also be used to predict a person's risk for a particular disease, based on one or even several genes. This approach uses the same sequencing technology science to focus on the evaluation of disease risk, allowing the physician to initiate preventive treatment before the disease filed itself in their patient. For example, if this is the found that a DNA mutation increases a person's risk of coding Type 2 Diabetes, this individual can begin lifestyle become different that will lessen their chances of developing Type 2 Diabetes later in life.