Gene editing and drug creation: the medicine that awaits us in 2022

During the pandemic, science and medicine evolved by leaps and bounds in search of answers to deal with the new disease that had the world on edge

During the COVID-19 pandemic, many specialists sounded the alarm about the other pathologies that were neglected or neglected in pursuit of the health emergency.

Many people overlooked their routine check-ups, and even stopped consulting for new ailments that appeared in the midst of the pandemic.

In parallel, science and medicine evolved by leaps and bounds in search of answers to deal with the new disease that had the world on edge.

So now in 2022, medicine can be fully predictive, preventive (based on predictive risk), personalized and participatory. Insights from human genetics, precision and personalized medicine transformed healthcare. Artificial intelligence (AI) has revolutionized healthcare through the mining of medical records, the design of treatment plans, the acceleration of medical imaging, and the creation of drugs.

In this context, for many, this year could be key for some technologies that are revolutionizing medicine, such as the Crispr gene-editing tools or the mRNA technology with which some of the emergency authorized vaccines against COVID-19 were made; the use of genomic information in fields such as immunogenomics or the combination of innovative imaging techniques with genomics; but it will also be the consolidation of telemedicine in patient care and in artificial intelligence applied to health and the use of data.

In the pharmacological field, meanwhile, it is expected that the time lost with the pandemic will be recovered, and there will be important advances in diseases such as cancer, HIV and, of course, the coronavirus itself, which augurs a return to normality.

Alzheimer’s scenario

Great progress has been made in Alzheimer's and there is a good chance that the first affordable and accessible blood test to detect the disease will be approved next year (Getty)
Great progress has been made in Alzheimer’s and there is a good chance that the first affordable and accessible blood test to detect the disease will be approved next year (Getty)

Neurodegenerative diseases such as Alzheimer’s are also awaiting the arrival of a new generation of drugs, after numerous failures in clinical trials. In 2021, the first and controversial aducanumab was already approved in the US, which while for some scientists it was a change of scenery, because it is the “first drug that modifies the course of the disease”, for others the available evidence “generates doubts more than certainties”.

In any case, 2022 may see the arrival of new drugs of this generation.

It is precisely in this field that attention must be paid to its diagnosis. Great progress has been made in this area, and there is a good chance that the first affordable and accessible blood test to detect the disease will be approved next year.

New antivirals and vaccines against COVID-19

For Lluis Montoliu, a researcher at the National Center for Biotechnology (CNB-CSIC), there is no doubt that one of the priorities continues to be COVID-19. “It is necessary to obtain vaccines that are sterilizing and powerful antivirals capable of directly combating the coronavirus in infected people who are hospitalized, so that they can overcome the infection and not run the risk of dying as a result of the coronavirus”he told the newspaper ABC.

But He recognized that in the rest of the pathologies “it is necessary to recover everything that has not been possible to do, investigate or treat the cause, directly or indirectly, of the pandemic.”

In this sense, he considers that mRNA technology is very powerful and “has come to stay”. After decades of development, “thanks to the COVID-19 pandemic, it has found a springboard to express its validity and relevance.”

In addition, for Enriqueta Felip, president of the Spanish Society of Medical Oncology (SEOM), it can also be used to treat other genetic-based pathologies, such as many rare or complex diseases, such as cancer, where there is great interest at the present time for the development of RNA vaccines.

Also, as recently explained by the magazine Nature, mRNA technology could be used to make vaccines against diseases such as HIV or malaria, and other technologies that researchers are working on, such as protein or DNA vaccines, could be cheaper to produce and easier to produce. to stock, so distribution in low-income countries could be much easier.

More immunotherapy for cancer treatment

Experts predict great advances in different types of cancer immunotherapies, as well as in so-called targeted therapies
Experts predict great advances in different types of cancer immunotherapies, as well as in so-called targeted therapies

Felip also predicted for 2022 the advance of different immunotherapy modalities in many tumors, as well as the development of drugs directed against molecular alterations, immunoconjugates, which are therapies that combine antibodies directed against specific alterations of the tumor together with a chemotherapeutic agent.

Y highlighted that because cancer treatment is multidisciplinary, theragnosis or targeted therapy with radioligands should be highlighted, “a treatment that combines a ligand capable of locating tumor cells with a radioisotope, a therapeutic radioactive particle. Once the tumor cell is located, the radioisotope is capable of triggering a mechanism of cell death with less damage to the surrounding healthy tissue”.

The study of genetics

In 2022, genomics, the study of a person’s genes or DNA, will move to center stage, seeing the availability of tools and techniques to treat diseases and disorders based on genetic fingerprint, environment, and lifestyle. of each person’s life.

The use of multimodal data, including genetic information, imaging, digital pathology, and other multimodal information, will allow accurate detection of early disease status and progression, making therapies much more effective while time, it will reduce the cost.

For example, in cancer, according to Felip, it was seen that precision medicine will allow a more precise diagnosis since it incorporates the determination of biomarkers that allow selecting the most effective and safest treatments for each patient.

However, despite the fact that the natural history of certain tumors was changed thanks to the development of precision medicine, “it is not applicable to all cancer patients, although the results are expected to be consolidated.”

The CNB investigator, for his part, believes successes from gene therapy clinical trials with various variants of Crispr gene-editing tools will continue to be seen in 2022, which will gradually become treatments, if they pass the safety and efficacy tests.

In Montoliu’s view, personalized precision medicine has many challenges ahead of it. In the first place, “to be able to determine the genetic cause of a disease, obtaining the genetic diagnosis quickly and conclusively. Once diagnosed, if there are gene therapies, the challenge for 2022 and the following years is to make them available to all patients who may need them, not just those who can afford them.”

In this sense, Valentín Fuster, director of the National Center for Cardiovascular Research (CNIC), warns that when talking about the use of genetics applied to medicine it is necessary to “do it with great precision and, above all, with great caution”. And he considered that it is necessary to be very careful with genetics but that it is very important to “move forward, as with artificial intelligence, but with great caution in interpreting the information.”

Remote medicine is here to stay hand in hand with teleconsultations

The apps provide treatment to 90% of the most common diseases, Remote patient monitoring to measure blood pressure, heart rate is proven to be very useful (Getty)
The apps provide treatment to 90% of the most common diseases, Remote patient monitoring to measure blood pressure, heart rate is proven to be very useful (Getty)

The phenomenon exploded in 2020, out of necessity, and is already becoming the method of choice for millions of people. Remote monitoring devices, says Fuster, can provide the ability to monitor patients from a distance, and the use of predictive analytics is helping to identify at-risk patients before they contract a disease, so preventive measures can be taken. .

Remote patient monitoring to measure blood pressure and heart rate has proven to be very useful, says Fuster, who is clear that all aspects will influence the lives of patients, but also health systems. Therefore, for him, “these systems have to be very well governed for their proper application.”

Advances in data analytics and artificial intelligence are giving healthcare professionals access to many new tools to make their tasks easier to complete.

Animal to human organ transplant?

A team of researchers and cardiovascular surgeons from the University of Maryland School of Medicine in the USA has just announced that they have successfully carried out the first heart transplant from a genetically modified pig to a human. The patient had a severely damaged heart, in addition to other pathologies and comorbidities that made him ineligible to receive a new, compatible heart from another person.

After the risks and novelty of the treatment were explained to him and he freely consented, he agreed to undergo what was the first experimental transplant of a non-human animal heart.

Along the same lines, experts from the University of Alabama at Birmingham, also in the USA, announced the first successful transplant of genetically modified pig kidneys into a brain-dead human individual, replacing the recipient’s native kidneys.

These positive results demonstrate how xenotransplantation, as the transplantation of cells, tissues or organs between animals of different species is called, could address the global organ shortage crisis.

KEEP READING

Advance with two drugs against COVID-19: WHO experts recommended them
Recognition of the international scientific community to an Argentine telemedicine program