Precision Medicine: A new opportunity for disease diagnosis and treatment will benefit patients directly

Release date: 2015-06-08

Worldwide, “precise medical care” has long been the focus of the industry. With the development of gene sequencing technology and the progress of major projects such as the Cancer Genome Atlas program, especially in January this year, after President Obama proposed the concept of “precise medical care”, people’s attention to “precise medical care” reached An unprecedented degree.

As the ability of genetic testing becomes stronger and the cost is gradually reduced, the accumulated personal medical health data will be more abundant. Through the accumulation and mining of big data and the integration of personal information, “gene detection” as a new detection method has brought new opportunities for the diagnosis and treatment of complex diseases such as cancer.

However, is genetic testing equivalent to personalized medicine? In the era of precision medicine, what kind of changes can genetic testing bring to individualized medicine? In this regard, the Science and Technology Daily reporter interviewed Dr. Cheng Jing, the chairman of the first “Precision Medical and Gene Sequencing Conference”, academician of the Chinese Academy of Engineering, and President of Boao Bio-Group.

Precision medicine, genetic testing

"The core of precision medicine is individualized medicine, and genetic testing is only a means to achieve personalized medicine. If genetic testing or gene sequencing is equivalent to precision medicine, it is very narrow, and it is impossible to simply describe individualized medicine as Genetic testing or gene sequencing." Cheng Jing told reporters that "diagnosis and personalized treatment of diseases do not rely solely on genetic testing. Some diseases can be reflected at the genetic level, but some diseases do not necessarily show Genetic changes. Therefore, in the process of diagnosis and treatment of diseases, other methods are often used, such as proteomics, glycomics, etc. Therefore, genetic testing or gene sequencing is only to achieve precision medicine and individuals. One of the technical means of medical treatment."

Cheng Jing believes that when a new thing or technical means emerges, people tend to be over-expected and overwhelmed. But this does not mean that other technical means are not needed. For the diagnosis and treatment of diseases, many technical means are interdependent and mutually compensated, in order to get the most accurate results.

If genetic sequencing is simply equated with individualized medicine or precision medicine, it not only exaggerates the function of gene sequencing, but also misleads consumers.

Accurate medical treatment should focus on "treatment is not sick"

Cheng Jing believes that precision medicine should include precision detection, precision conditioning, precision diagnosis and precision treatment. Chinese medicine has developed to the present day, and has accumulated many useful and successful experiences in medicine and technology. Chinese medicine is one of them. We should have confidence and determination. In the face of new things and technologies emerging in the world, we cannot simply follow the trend and copy the foreign medical model. After all, China is only a developing country and needs to consider its comprehensive national conditions. In his view, accurate detection and precise conditioning are particularly important, fully embodying the prevention concept of "treating the disease" in Chinese medicine.

Cheng Jing believes that over the past 30 years of reform and opening up, the incidence of chronic diseases in China has risen sharply, which is closely related to the weak concept of people's self-health management and the lack of attention of the government, society and industry to “treating the disease”.

"Precise medicine can help us understand the susceptibility genes of our diseases, and take corresponding countermeasures." In the interview, Cheng Jing picked up a chip on the table and told reporters, "This gene chip can detect nearly 3,000 human bodies." Gene loci predict the risk of disease in 13 categories and 150 diseases."

"Understanding your own 'genetic constitution', you can combine the physical fitness of TCM and adjust the diet structure through scientific health. If a child is born, he will combine his family history with genetic testing to know that he will have a high risk of developing hypertension in the future. Parents can pay attention to less salt during the meal, develop a light taste, and reduce the risk of high blood pressure in children. Cheng Jing told reporters that Japan has reduced the risk of cardiovascular disease in the whole country through this simple method.

"China has a very good advantage resource - Chinese medicine, the classification of Chinese medicine reflects the concept of precision conditioning." Cheng Jing revealed that at present, Boao Bio has developed according to the nine constitutional standards of the master of Chinese medicine, Professor Wang Qi. There are nine functional drinks that are homologous to different body medicines and medicines, and eight types of biased quality are transferred to the level of quality.

Precision medicine will benefit patients directly

The "SARS" in 2003 has been remembered so far, and the failure to clear the pathogens in time has caused the unfortunate death of many patients and medical workers. If we face the sudden outbreak in the future, can precision medical care save us?

In this regard, Cheng Jing believes that precision medicine will have a lot to offer in the field of infectious diseases. "Like SARS, as long as the correct virus strain is isolated, the virus species can be detected by gene sequencing, and corresponding preventive and therapeutic measures can be taken."

Cheng Jing believes that the world is facing a common problem. In clinical practice, there are still many things that have not been clarified. There are quite a few cases that cannot be diagnosed by current technical means. Therefore, blind treatment is inevitable during the treatment. Not only does it cause waste of medical resources, but it may also cause harm to patients and even cause "super-resistant bacteria". Therefore, the word "precision" is very meaningful. He believes that if the word "precision" can be implemented, it will be of great benefit to clinical treatment.

Cheng Jing gave reporters an example: tuberculosis is one of the most important infectious diseases in the world. About 550 million people in China have been infected with M. tuberculosis, and it is one of the 22 countries with high burden of tuberculosis. However, due to defects in diagnostic techniques, a large number of patients were misdiagnosed and missed. Not only that, China's tuberculosis drug resistance situation is also extremely severe, and it is the world's largest tuberculosis drug-resistant country. However, for various reasons, patients do not generally have appropriate drug resistance tests when they are being treated.

On the one hand, the harm of drug-resistant tuberculosis has become increasingly prominent, and the prevalence of tuberculosis dominated by drug-resistant bacteria may occur in the next few years; on the other hand, the drug resistance of tuberculosis patients shows dynamic changes, and traditional diagnostic techniques cannot Real-time monitoring.

In order to solve this problem, Cheng Jing led Boao Bio to develop a “Tumor Disease Rapid Molecular Diagnostic System”. Through the detection of M. tuberculosis drug resistance genes, it is possible to quickly detect whether clinical TB patients are on the first and second line within 6 hours. Drug resistance. The hospital can customize the treatment plan according to the test results, so that the therapeutic effect of the targeted treatment is more guaranteed.

Ms. Zhao, a 40-year-old female tuberculosis patient at the Third Military Medical University Southwest Hospital, is one of the direct beneficiaries of this diagnostic system.

In the case of being diagnosed as "vertebral tuberculosis with abscess and sinus formation", the attending doctor gave Ms. Zhao regular medication for 20 days, and then performed surgical debridement. After the operation, Ms. Zhao still found the wound pus after 2 months of routine medication. The attending doctor suspected that Ms. Zhao might be a drug-resistant tuberculosis, and immediately tested it with Boao's M. tuberculosis drug resistance gene chip. After 6 hours, the test results showed that the patient had previously used the "rifampicin / isoniazid" All are resistant. After the attending doctor made adjustments to the treatment plan in time, Ms. Zhao’s condition improved significantly and she was discharged from hospital soon.

"In the future, with the advancement of technology, we will introduce a fast workstation system that integrates everything from sample to result. After the sample is taken into the system, the diagnosis results can be automatically and quickly released." Cheng Jing is full of confidence in the future development of precision medicine.

Source: China Science and Technology Network - Technology Daily

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