Scientific breakthroughs are booming in medicine. We are entering a new era in medicine. From the rediscovery the ‘forgotten’ organ of the body to potential cures of cancers, Alzheimer’s, and HIV, we’re on the cusp of a bold, new era.
There is a consensus on the milestone moments in the history of modern medicine. In 1796, Edward Jenner vaccinated his gardener’s child against smallpox using pus from a cowpox pustule (ushered in an era where vaccination saves five millions lives every year); in 1840, the introduction of anaesthesia; in 1860, the germ theory (which dispelled the fatal belief that diseases are transmitted via’miasmas) and in 1890, the first experiments with X-ray. The discovery of penicillin by Scottish physician Alexander Fleming in 1928, a class of medicines that have extended human life expectancy by 23 years, is notable.
Will the 2020s also be remembered as a watershed moment in history? Bertalan Mesko is a medical doctor who is the director of the Medical Futurist Institute, Budapest. He is one of many voices that claim the world is about to enter a ‘golden age of medicine’. It’s partly thanks to Covid-19.
Mesko explains that breakthroughs in mRNA technologies, first used in Covid vaccines, could soon help eradicate certain cancers. “Then, there’s the enormous potential of AI, 3D printing, and, most importantly, advances in genomics that will unlock the genetic basis of many diseases and lead to new and targeted treatments.” We’re witnessing a pace of advancement that hasn’t been seen in 100 years.
AI is often cited as a threat to white collar jobs, such as those in law and finance. The potential of AI in medicine is a little more positive, according to Chris Stokel-Walker who writes about medical applications for the .
He explains that “AI will accelerate the pace of new drug discoveries, including antibiotics [which are needed] as resistance increases.” “Plus, [the technology] can analyze and identify issues like tumours in scans better than humans.”
AI will also reduce the day-to-day administrative burden on doctors, such as documentation, prescriptions and screenings for common conditions. “This will allow doctors to focus on what they do best: helping patients,” says Stokel Walker.
The rapid extension of life expectancy is a side effect of the advances in medicine made since the late 19th century. The new golden age in medicine will address the downside to these advances: that longer life spans are not necessarily healthier lives. In the coming years, we will see breakthroughs for treating some of the most stubborn conditions of old age. For example, a ‘gene silencing’ treatment for Alzheimer’s, and wearable diagnostics which will give early warnings for metabolic disease, strokes, and heart attacks. This will reduce disablement and improve patient outcomes.
We can also expect to see revolutionary stem cell treatments for infertility, and therapeutics that target the body’s “forgotten organ”, the microbiome. The microbiome is becoming increasingly important in everything from maintaining our immune system to stabilising our mood.
Mesko says, “It is an amazing time. I feel lucky to have lived through it.”
Seven medical innovations to watch out for
1. Cracking Alzheimer’s
Alzheimer’s is a progressive brain disease that affects 620,00 people in the UK. By 2050, this number will rise to 1.2 million Brits. It is the most common form dementia and causes personality changes and memory loss. The disease is believed to be caused by an abnormal protein build-up in the brain that causes nerve cells to die.
Existing drugs remove the proteins after they have already been present, but excitement is growing about a new therapy that prevents the toxic proteins from ever being produced. The treatment, which was tested by a University College London Hospitals team, essentially reduces the gene that produces a protein using RNAi. This is a natural process cells use to silence genes. The drug, ALN-APP has been dubbed a ‘Alzheimer dimmer switch.
The Good News So Far
The interim results of Drug published in July suggest that a single dose can reduce levels of amyloid protein by up to 90%.
2. Harnessing the Microbiome
The human microbiome is a community microorganisms, which includes millions of bacteria and viruses that live on and in our bodies. It’s an undiscovered frontier of medicine. In the last few years, studies have shown that these symbiotic humans helpers protect against a number of diseases including infections, inflammatory bowel diseases, and colorectal carcinoma; that they produce vitamins B12 and thiamine; that they play a profound role on the functioning of our immunity systems; and that they protect against anxiety and depressive disorders.
Microbiome therapy is already being used to treat antibiotic resistant bacterial infections, such as Clostridium difficile, a bacterium that spreads easily within care homes and hospitals, but was difficult to treat until now.
The Good News So Far
Autism spectrum disorder (ASD), which is a lifelong disorder, can be characterized by a narrow range in gut microbes. conducted at Shanghai Jiao Tong University in 2022 used faecal microbial transplants to treat ASD. The results showed significant improvements in the neurobehavioural symptoms of children with ASD.
3. Conquering an child killer
Malaria is estimated to kill 400,000 people every year, mainly children under five years old. According to one estimate, malaria was responsible for 2-5% of deaths in the last century. Despite the high death toll from malaria, vaccines have been difficult to develop due to its complex life cycle, and high mutation rate.
The first ever malaria vaccination – which is currently in phase three clinical trials – trains your immune system to recognise and attack the protein found on the surface sporozoites of the parasite (the infective stage). Later this year, doses should be delivered to African countries (where 90% all deaths occur).
So far, the good news
, the vaccine was 75% efficient in preventing malaria among children aged 5 to 36 months.
4. Cancer vaccines: a powerful weapon against cancer
The traditional vaccines are based on injecting a part of a virus or a weakened version into the human body. This method hasn’t changed much since Jenner’s experiments with cowpox in the 18th century. Initially used during the Covid-19 Pandemic, mRNA vaccinations deliver a genetic code which our bodies can use in order to produce the relevant viral protein themselves.
There is great hope for a universal vaccine for multiple strains (which kill around half a milllion people every year) and for customised cancer treatments. These treatments will use mRNA in order to train the immune system of an individual to recognise and attack cancer cells. Clinical trials are showing promising results for a personalised mRNA pancreatic cancer vaccine, one of the deadliest cancers.
The Good News So Far
Since 2021, the mRNA vaccines developed by Pfizer BioNTech and Moderna for Covid-19 have prevented millions deaths around the world.
5. Printing 3D body Parts
In 2013, Lawrence Bonassar, Cornell University in New York, used 3D scanning of human ears to print a human outer-ear using bovine cartilage suspended in collagen. This was a breakthrough in a technology which could lead to 3D-printed blood vessels and heart valves, as well as allowing surgeons to print bone tissue where needed during surgery.
Orthopaedics is successfully using 3D printing to create patient-customised hip and knee replacements. These implants have fewer negative outcomes than standard implants. They also result in less blood loss during surgery.
The Good News So Far
The charity trained people in India on how to use 3D printers to create amputee-specific limbs and affordable 3D-printed listening aids for kids.
6. Hacking faulty gene
Can our genes ‘cut and sew’ to defeat heritable diseases be achieved? Crispr, the gene-editing technique first discovered in 1980s, has this potential. Scientists discovered that a single-celled organism can splice alien virus DNA into its genome (to mount an immunity response in case of a future infection). A team at the University of California adapted Crispr to edit segments of human gene in 2012.
Scientists can now make precise changes to DNA in living organisms. This includes genes that are implicated in heritable diseases such as sickle-cell anaemia and Cystic Fibrosis. It promises new treatments for heart diseases, targeting genes that control plaques in human arteries. For HIV, it inserts genetic mutations into HIV virus’ genes to make it unable of replication. This could be the final push to the UN’s sustainable-development goal of “ending the HIV pandemic by 2030”. (A target that is, thankfully, on track.
The Good News So Far
In 2020, a Mississippi woman became
7. Stem cells revolutionise fertility
The research on germline stem cells has produced the best news for people who are struggling to start families. With the live birth rates per IVF cycle at as low as 20%, and little improvement in these statistics in the forty years since the birth the first IVF baby, cutting-edge research is producing the most exciting news in a century. Germline stems cells are a special type of stem cell. They are the miracle cells that can develop into anything, from muscle to brain cells.
The research into these stem cells is developing new treatments for diseases such as sickle-cell anaemia, by correcting the genetic defects in the stem cell before they are used to produce eggs or sperm. It is also being developed to improve the results of IVF using germline stem cell to create new ovarian and embryo follicles that are more likely implant and develop normally.
The Good News So Far
Researchers at the University of California San Francisco and University of Pennsylvania have successfully used germline stem cells in trials to repair damage to ovaries of patients who had undergone chemotherapy.
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