Welcome to the decade when medicine meets sci-fi fantasy

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Edited from an article in The Times, 17 January 2020.

Thanks to AI and genome editing, age-defying treatment breakthroughs that were just out of our reach should become reality, says Tom Whipple.

In the next ten years medicine will get cleverer, more targeted and personalised. But what is personalised medicine? Experimental genetic therapies find their way into the clinic and once-experimental treatments like immunotherapy become commonplace. There will be a renewed push to change the way we find drugs: to engineer the treatments we need through an understanding of what they have to do at the level of atoms.

This is the decade when so many technologies we have been squinting to see on the horizon will come into view. Bill Gates who best described “Most people overestimate what they can do in one year, and underestimate what they can do in ten years.” The technology of the next ten years will be — because that technology is with us now.

Medical Records

There is a recognition of the power of data.

All records would go electronic, all would be updated in real time and all would be stored in an open format that meant one part of the health service could talk to another. GPs will use apps and consultations will happen online.

Diagnostics

Working out if and why someone is ill can be an art as much as a science, a balance of lifestyle factors, biological tests and GP intuition.

Provided it has the data, AI promises to turn it back into a science — to take what was previously the informed hunch of experienced professionals, and add numbers to it.

Around the world, companies and scientists are working on programs to analyse the thousands of data points that go unanalysed — blood tests, pulse rate, even gait — and integrate them to spot the many subtle changes that together indicate something is amiss. Several studies show that just using cameras to spot subtle changes in skin colouration can give you continuous readings of blood pressure and pulse rate.

Thanks to analysis of this data, in ways no human could hope to achieve, there are projects looking at early cancer detection, at seeing Alzheimer’s years before you start forgetting things, at flagging up sepsis hours before your organs start failing

Genomic profiling

In 2006, Illumina’s first DNA sequencer could sequence a human genome at a cost of $300,000. The 2017 cost is currently $1,000 per genome, including reagents and the amortization of its machines. The machines themselves are still costly: The sequencers cost $1m but will bring down sequencing a genome to $100. The cheaper DNA testing gets, the more data researchers will have and the more it will be integrated into healthcare. But not do so through humans analysing it. Your genome has three billion letters. The patterns and clues it contains are revealed only through massive feats of computation. A GP who uses Google is, like a taxi driver who uses a satnav

DNA. In the last decade science developed ways to edit the genome, in the next decade it will find ways to use it. E.G. Silencing the genes that cause some pain, in the hope of doing away with the need for opiates, with all their side effects.

Illnesses Research methodology

Instead of searching the world to find something to defeat bacteria, it looks at the bacteria to see what its weaknesses are — then its goal is to engineer a treatment to hit them, seeing biology as a branch of physics — looking at physical and structural interactions at an atomic level.

Scientists think that a well-directed injection in the liver could be used to shut off genes related to cholesterol regulation, providing cardiovascular protection for life without the need for statins.

Cancer Treatments

By 2030, genetic sequencing of tumours will be routine, to tell oncologists which of many kinds it is, and in turn the best way to target the structures on the surface of its cells to stop it from reproducing. In the past, chemotherapy would have been used. Instead of poisoning the whole body, it harnesses the body’s own defences to attack malignant cells.

The brain will still remain a mystery. We will not solve the problem of consciousness, or decode the complexities of even a small network of neurons. Slowly we are understanding the brain’s architecture and even ways to communicate in its language. Slowly, too, treatments may be arriving for Alzheimer’s.

Edited from an article in The Times, 17 January 2020

 

 

 


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