Photo by Melany @ tuinfosalud.com on Unsplash

The A to Z of Precision Medicine

A brief overview of the different branches of precision medicine

As soon as you walk into a clothes store, all of the clothing pieces only have 3–5 sizes. Extra small, small, medium, large, and extra large. However once you try it on, you never know if one of these 5 sizes will work for you.

Taking into account how all people have different body shapes, arm lengths, weights, and muscle masses; these clothes look very different from person to person.

What if we replace these clothes with medicine and treatment? Then this isn’t such a good idea, is it?

The current biggest problem in medicine is that it is modeled just like this clothes store— everything is in a sized approach not taking into account how individuals have different nuances and needs.

Every year, 1.9 million hospitalizations are caused by properly prescribed drugs.

Let that sink in.

People into the hospital — not for the disease itself — but for receiving the correct drug for a disease only because of how the health care system with a few sizes fits all approach.

The solution: Precision medicine

Well, there is a solution to this problem; introducing precision medicine!

Precision is a relatively new-ish field of medicine that takes into account how we are all different as individuals and aims to give specific and targeted treatments.

The way that precision medicine does this is by putting us all into groups, then developing treatment for the groups we fall under.

Think of it in these three steps:

1. People are tested
2. They are put into a group of people with similar characteristics + reactions
3. They are given the treatment of that specific group.

By giving more specific and targeted treatment, precision medicine helps prevent these tragedies and deaths from happening.

This article will be providing some of the basic technologies + components of precision medicine.

Here is what will be covered:

1. Biomarkers
2. Biosensors
3. Pharmacogenomics

1. Biomarkers

Biomarkers are one of the most used and very important tools in healthcare today. In a nutshell, biomarkers are measurable indicators used to monitor, diagnose and treat diseases in the body. These can range from simple blood and urine tests to blood pressure tests, and glucose tests.

By monitoring biomarkers, doctors and researchers can get a better understanding of a patient’s health status and track changes over time, aiding in the precision medicine process.

Here are the 5 main ways biomarkers are used:

1. Diagnosis by providing measurable evidence of a patient’s condition.
2. Prognosis to predict the progression of a disease or condition and provide insight
3. Monitoring by checking the patient’s response to treatment and adjusting treatment plans accordingly.
4. Clinical trials to identify patients who are most likely to benefit from a new treatment and to monitor treatment response. This can help researchers develop new therapies that are more effective and have fewer side effects.
5. Personalized medicine develops personalized treatment plans that target specific molecular or genetic characteristics of a patient’s disease.

Biomarkers are also used along with the other fields that are talked about later on. This field is one of the most prominent and promising to continue to rise as researchers are finding new biomarkers to base drugs and treatments. This field will continue to grow as time goes on.

There are many processes in which biomarkers are detected; for example proteomics, genomics, and metabolomics.

Here is an example of a project I did for biomarker identification using proteomics:

Biomarker Identification of Glioma in the CSF

Biomarkers provide a baseline diagnosis, and once we have the diagnosis we can move on to more specialized treatment.

2. Biosensors

In this day and age, we use biosensors more than ever. From things like managing diabetes through glucose monitoring systems and blood pressure machines, biosensors are the future of healthcare.

Biosensors are devices that measure the body’s biological or chemical reactions by generating signals. These signals need to be proportional to the sample and have features that connect to the substance that you want to measure.

There are two main types of biosensors used in healthcare:

1. Wearable biosensors
2. Implantable biosensors

Wearable biosensors are small, compact devices that measure signals from out of the body. These usually have a limited range of what they can measure (other than implantable biosensors) and focus on things like heart rate, blood pressure, and body temperature.

However, with implantable biosensors, scientists are able to study many more things than wearable ones.

Here is roughly how implantable biosensors work:

1. Surgically placed in a specific area
2. The biosensor connects to the indicator needed to be tested (ex. pathogen, virus, cancerous cells) and sends a signal
3. This signal would be picked up by healthcare professionals and they would understand what is happening
4. Further treatment could be done.

In cases where doctors want to understand how cancer is growing and affecting the body, nano-scale biosensors can be implanted and understand the biological processes. This can aid in the treatment of the disease as well, linking to precision medicine.

3. Pharmacogenomics

Pharmacogenomics is basically a way to measure how the body is reacting and adjusting to pharmaceutical drugs. The pharmaceutical industry is a huge one — and one where a lot of money is put into it. It is no wonder that pharmacogenomics comes into the picture to help professionals understand and make sense of the drugs that they are making.

In pharmacogenomics, there are two main subfields;

1. Pharmacokinetics: the study of what the drug goes under while it is interacting with the body's systems.
2. Pharmacodynamics: understanding how the body reacts to drugs ingested

I talk more about the study of pharmacogenomics in this article:

The Solution to Extreme Side Effects is in Your Genes

Ways these can be developed

Under these three branches, there are also many ways for researchers to figure out how to do them. Here are Genomics, Metabolomics, and Proteomics; three of the many studies that focus on developing these technologies.

4. Genomics

By definition, genomics is the study of the complete set of DNA (including all of its genes) in a person or other organism. Essentially, not all genes expressed in an area of a body are linked together and genomics aims to further understand this and the phenotypes expressed from it.

From the Human Genome Project that ran a long 13 years, we have learned that not all genes expressed in the human body are linked directly and can vary in the places where they are placed. Genomics aims to further understand our human genome and provide a basis for treatments.

Further, many diseases deal with the genes and mutations in them themselves. Genomics allows us to study rare diseases and cancer, including those that are exclusively genetic, common diseases with a Mendelian subset, polygenic complex conditions, and somatic mosaic conditions.

There are many implications of this technology and it can be used in a variety of ways.

5. Metabolomics

Metabolomics is the study of the set of metabolites present within an organism, cell, or tissue. In the human body, there are a total of 19,000 small molecules of metabolites.

The reason this is such a great technology to use is that only a small number of metabolites are used to diagnose complex metabolic diseases and, monogenic disorders. Current metabolomic technologies go well beyond the scope of standard clinical chemistry techniques and are capable of precise analyses of hundreds to thousands of metabolites.

Consequently, metabolomics affords detailed characterization of metabolic phenotypes and can enable precision medicine processes.

6. Proteomics

Proteomics is defined as the analysis of proteins in the human body. Rather than just relying on the genes — which do not contain the ‘code’ for all proteins that are produced in the body — proteomics focuses on the outcome of these genes for analysis. Further, proteomics allows for a larger-scale analysis of human proteins and allows researchers to analyze multiple proteins rather than only just one individually.

In contrast to genomics which would only study the gene itself and its relation to a disease, proteomics works on the relationship between diseases and protein expression.

Along with pharmaceutical creation, this works on the link between drug and protein expression to develop drugs.

Here I talk more about this:

This study can also help identify biomarkers and understand the progression of drug and body system development.

These are only a few of the many ways that precision medicine can be developed.

Key Takeaways

1. Precision medicine aims to provide more tailored made treatment to individuals by taking into account their differences in drug and treatment intake. This is done by grouping individuals with other people who are similar to them and giving them the treatment that relates to them.
2. There are many subfields, but the ones that are developing the most right now are the fields of biomarkers, biosensors, and pharmacogenomics
3. These subfields are developed through the studies of genomics, metabolomics, and proteomics.

However, there are many things in medicine that are still needed to be further developed and worked on. Precision medicine is a promising field and I don’t think it will stop any time soon!

Hey! Thanks for reading my article! It means a lot to me!!

My name is Anya Ishani Sharma, and I am a grade 11 student passionate about personalized medicine and tech! If you found this review interesting and would like to discuss it with me please feel free to reach out. You can contact me through my email (anya.ishani.sharma@gmail.com), and my Linkedin (click here).