Precision medicine (PM) is a medical paradigm that supports the personalization of healthcare by adjusting medical judgments, interventions, procedures, or products to a particular patient population as an alternative to employing a one-drug-fits-all strategy.
The practice of customizing medical care to each patient's unique characteristics is known as "precision medicine." It refers to the capability of grouping people into subpopulations that differ in their susceptibility to a specific disease, in the biology or prognosis of those diseases they may develop, or in their response to a particular treatment, rather than the literal creation of drugs or medical devices that are unique to a patient.
Although the term "personalized medicine" is also used to convey this idea, it is occasionally misunderstood to imply that specific treatments can be created for each individual. [1]
The Development of Personalized Pharmacotherapy
Drug therapy personalization is an evolution, not a revolution in healthcare. For instance, the practice of apothecaries dates back to 2600 BC. More than 800 prescriptions using more than 700 different drugs are mentioned in the well-known Egyptian Papyrus Ebers. Individual patients were given the medications mentioned in the Papyrus Ebers to treat conditions ranging from cancer to asthma.
Apothecaries were referred to as knowledgeable and experienced medical professionals when Shakespeare wrote Romeo and Juliet. People would visit their preferred pharmacy to obtain customized elixirs and treatments that would be helpful (or, as in Romeo's case, poisons that could result in desired effects, even if destructive). The responsibilities of physicians and pharmacists started to shift and split during the Industrial Revolution in the eighteenth and nineteenth centuries, leading to each profession assuming more distinct duties
Throughout the nineteenth and early twentieth centuries, a frequent strategy for individualized treatment was for pharmacists to create custom medicinal products for a specific patient.
In the speech to the New Haven Medical Association on January 6, 1903, Sir William Osler (1849–1919) stated that “Variability is the law of life, and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under abnormal conditions, which we know as disease.”
Physicians like Osler have traditionally treated their patients individually based on science, facts, family history, and symptoms, drawing on their experience and intuition. Hence, Individualization is not a novel concept. [2]
Timeline of precision medicine
- 1892:Sir Archibald Garrod proposes in 1892 that alkaptonuria is brought on by a genetic flaw, laying the groundwork for individualized medicine.
- 1949:The phrase "personalized medicine" is first used in a lecture by Dr. Osler
- 1953: Watson and Crick discover the DNA structure, paving the way for genetic testing and specialized medical care.
- 1985: Kary Mullis creates the polymerase chain reaction (PCR), an amplifying method for DNA sequences that transforms genetic testing.
- 1990:The Human Genome Project, which aims to sequence the entire human genome, is started in 1990.
- 1998:The first targeted treatment for breast cancer, Herceptin, receives FDA approval in 1998.
- 2001: The FDA approves Gleevec, the first personalized cancer treatment.
- 2003: The Human Genome Project is finished, producing a thorough map of the human genome.
- 2016: President Obama announces the launch of the Precision Medicine Initiative, which aims to advance personalized medicine.
- 2017: the FDA's approval of Luxturna, the first gene therapy for an inherited illness.
- 2018:Vitrakvi, a medication that targets a particular genetic abnormality in a variety of tumor types, receives FDA approval in 2018.
- 2019: The FDA grants approval to the first spinal muscular atrophy treatment that is based on the patient's unique genetic mutation.
- 2020: As researchers investigate the use of genetic data to predict disease severity and create individualized treatments for COVID-19, the COVID-19 pandemic raises interest in precision medicine.
- 2021: Precision medicine is still being developed in a number of fields, such as cancer, rare diseases, and neurological disorders.
- 2022: A novel gene therapy for sickle cell anemia receives FDA approval, representing a significant advance in the management of this inherited blood condition.
With ongoing efforts to increase its accessibility and effectiveness for patients, personalized medicine remains a significant area of research and development
Classification
Depending on the method used, precision medicine can be divided into several categories. Here are some typical divisions:
- Precision medicine based on genomics aims to find genetic mutations or alterations that may be the cause of a patient's disease. The DNA of a patient is frequently sequenced as part of precision medicine, and the resulting data is then examined to find potential therapeutic targets.
- Precision medicine based on proteomics involves examining the proteins found in a patient's cells or tissues to find potential therapeutic targets. The identification of targets for cancer therapy can be a particular benefit of this kind of precision medicine.
- Precision medicine based on metabolomics involves examining the metabolites found in a patient's tissues or cells to find potential targets for treatment. Changes in the levels of metabolites, which are small molecules involved in numerous cellular processes, can point to the presence of disease.
- Precision medicine based on imaging: This strategy involves identifying potential treatment targets using medical imaging technologies like MRI, CT, or PET scans. Imaging can be particularly helpful in identifying targets for cancer therapy because it can make the location and size of tumors more visible.
- Precision medicine based on digital health involves monitoring a patient's health and locating potential therapeutic targets by using digital health technologies like wearables, mobile apps, or sensors. For the management of chronic illnesses like diabetes or heart disease, digital health can be especially helpful.
Summing up Precision medicine is a cutting-edge method of providing healthcare that may enhance patient outcomes. The real advantages of precision medicine in treating complex diseases, such as cancer, have been evident through the recent FDA approval of numerous precision medicine medications. Precision medicine is an indispensable tool in the fight against disease as our understanding of genetics and disease continues to grow.
We can make sure that patients receive the most individualized and effective therapy by adjusting medicines based on each patient's unique genetic profile. By removing the need for inefficient therapies and lowering the likelihood of adverse events, this not only improves patient outcomes but also has the potential to save healthcare expenditures.
References
1. Personalized medicine - Wikipedia
2.LJ Lesko1 and S Schmidt , doi:10.1038/clpt.2012.113