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:: Volume 29, Issue 1 (spring 2019) ::
MEDICAL SCIENCES 2019, 29(1): 1-17 Back to browse issues page
The personalized medicine: today and tomorrow
Mohammad Reza Noori-Daloii * 1, Narges Zafari2
1- PhD of Medical Molecular Genetics, Department of Medical Genetics, School of Medicine, Tehran University of Medical Science, Tehran, Iran , nooridaloii@sina.tums.ac.ir
2- MSc Student of Medical Genetics, Department of Medical Genetics, School of Medicine, Tehran University of Medical Science, Tehran, Iran
Abstract:   (173 Views)
Recent genetic findings and correlated developments in genomic techniques have led to the commercialization of novel diagnostic platforms for studying disease or evaluating therapeutic results in patients. This field is known as ‘‘personalized medicine,’’ and uses the patient’s genetic structure to tailor approaches for patient specific disease detection, treatment, or prevention. Personalized medicine is embedded in the belief that since individuals have unique features at the molecular, physiological, environmental exposure, and behavioral levels, they may need to have mediations provided to them for diseases they have that are tailored to these unique characteristics. Personalized diagnostic tests are used to identify patient-to-patient differences in gene or protein expression levels, which performance as indicators for drug treatments or disease prognosis. In order, medical experts be able to better answer questions such as: ‘‘who must be treated with which drug?’’ and ‘‘How should the treatment be ordered?’’ Clinical genetic testing began over 30 years ago with the accessibility of mutation detection. Since then, the field has intensely altered to include genome sequencing and genome-wide analyses using microarrays and next-generation sequencing. The identification of deoxyribonucleic acid (DNA) sequence variants related with common diseases stimulated the availability of testing for personal disease risk estimation, and created commercial opportunities for direct-to-consumer genetic testing companies that examine these variants. This genetic risks, are the key components of the personalized medicine, which aims to apply personal genomic and other relevant data into a patient’s clinical valuation to more accurately guide medical management. Direct-to-consumer (DTC) DNA testing, by providing a wide range of personal genomic information directly to its consumers. These companies, illustrated by the well-established 23andMe, usually carry out an analysis of single nucleotide polymorphisms (SNPs) using DNA extracted from a saliva sample. These genetic data are then assimilated and provided direct to the customer, with different interpretation.
Keywords: Personalized medicine, Pharmacogenomics, Precision
Full-Text [PDF 380 kb]   (102 Downloads)    
Semi-pilot: Review | Subject: Genetic
Received: 2018/12/15 | Accepted: 2019/02/18 | Published: 2019/03/10
References
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39. Ward RL, Hicks S, Hawkins NJ. Population-based molecular screening for Lynch syndrome: implications for personalized medicine. J Clin Oncol 2013;31:2554-62. [DOI:10.1200/JCO.2012.46.8454] [PMID]
40. Morrison P, Harding‐Lester S, Bradley A. Uptake of Huntington disease predictive testing in a complete population. Clin Genet 2011;80:281-6. [DOI:10.1111/j.1399-0004.2010.01538.x] [PMID]
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73. Hunt S. Pharmacogenetics, personalized medicine, and race. Nature Educat 2008;1:12.
74. Ortega VE, Meyers DA. Pharmacogenetics: implications of race and ethnicity on defining genetic profiles for personalized medicine. J Allergy Clin Immunol 2014;133:16-26. [DOI:10.1016/j.jaci.2013.10.040] [PMID] [PMCID]
75. Zanger UM, Raimundo S, Eichelbaum M. Cytochrome P450 2D6: overview and update on pharmacology, genetics, biochemistry. Naunyn-Schmiedeberg's Arch Pharmacol 2004;369:23-37. [DOI:10.1007/s00210-003-0832-2] [PMID]
76. Ashley-Koch A, Yang Q, Olney RS. Sickle hemoglobin (Hb S) allele and sickle cell disease: a HuGE review. Am J Epidemiol 2000;151:839-45. [DOI:10.1093/oxfordjournals.aje.a010288] [PMID]
77. Aidoo M, Terlouw DJ, Kolczak MS, McElroy PD, ter Kuile FO, Kariuki S, et al. Protective effects of the sickle cell gene against malaria morbidity and mortality. Lancet 2002;359:1311-2. [DOI:10.1016/S0140-6736(02)08273-9]
78. Slatkin MA. Population-genetic test of founder effects and implications for Ashkenazi Jewish diseases. Am J Hum Genet 2004;75:282-93. [DOI:10.1086/423146] [PMID] [PMCID]
79. Ostrer H. Skorecki K. The population genetics of the Jewish people. Hum Genet 2013;132:119-27. [DOI:10.1007/s00439-012-1235-6] [PMID] [PMCID]
80. Ge D, Fellay J, Thompson AJ, Simon JS, Shianna KV, Urban TJ, et al. Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance. Nature 2009;461:399-401. [DOI:10.1038/nature08309] [PMID]
81. Raby BA. Personalized medicine. UpToDate:2017.
82. Noori-Daloii MR, Eshaghkhani Y. lncRNAs: significance and function mechanisms. Med Sci J Islamic Azad Univ Tehran Med Branch 2015:79-94.
83. Noori-Daloii MR, Fazilaty H, Tabrizi M. Cancer metastasis, genetic and microenvironmental factors of distant tissue: a review article. Tehran Univ Med Sci 2013:70.
84. Ng PC, Murray SS, Levy S, Venter JC. An agenda for personalized medicine. Nature 2009;461:724-6. [DOI:10.1038/461724a] [PMID]
85. Kalf RR, Mihaescu R, Kundu S, de Knijff P, Green RC, Janssens AC.Variations in predicted risks in personal genome testing for common complex diseases. Genet Med 2014;16:85-91. [DOI:10.1038/gim.2013.80] [PMID] [PMCID]
86. Imai K, Kricka LJ, Fortina P. Concordance study of 3 direct-to-consumer genetic-testing services. Clin Chem 2011;57:518-21. [DOI:10.1373/clinchem.2010.158220] [PMID]
87. Noori-Daloii MR, Nikpour B. Gene therapy in cancer and its development. Journal of Razi 1999;10:9-28. [In Persian]
88. Noori-Daloii MR, Tabarestani S. Molecular Genetics and gene therapy in breast cancer. The Journal of Faculty of Medicine. J Sabzevar Univ Med Sci 2010;17:74-87. [In Persian]
89. Chua EW, Kennedy MA. Current state and future prospects of direct-to-consumer pharmacogenetics. Front Pharmacol 2012;3:152. [DOI:10.3389/fphar.2012.00152] [PMID] [PMCID]
90. Middleton A, Mendes A, Benjamin CM, Howard HC. Direct-to-consumer genetic testing: where and how does genetic counseling fit? Per Med 2017;14:249-57. [DOI:10.2217/pme-2017-0001] [PMID]
91. Adams JU. Pharmacogenomics and personalized medicine. Nature Educat 2008;1:194.
92. Goldstein DB, Tate SK, Sisodiya SM. Pharmacogenetics goes genomi. Nature Rev Genet 2003;4:937. [DOI:10.1038/nrg1229] [PMID]
93. Ingelman-Sundberg M, Oscarson M, McLellan RA. Polymorphic human cytochrome P450 enzymes: an opportunity for individualized drug treatment. Trends Pharmacol Sci 1999;20:342-9. [DOI:10.1016/S0165-6147(99)01363-2]
94. Analysis P. More Than 20 Percent of FDA's 2014 Novel New Drug Approvals are Personalized Medicines. 2015.
95. Lerman C, Croyle RT, Tercyak KP, Hamann H. Genetic testing: psychological aspects and implications. J Consult Clin Psychol 2002;70:784-97. [DOI:10.1037/0022-006X.70.3.784] [PMID]
96. Ward RL, Hicks S, Hawkins NJ. Population-based molecular screening for Lynch syndrome: implications for personalized medicine. J Clin Oncol 2013;31:2554-62. [DOI:10.1200/JCO.2012.46.8454] [PMID]
97. Morrison P, Harding‐Lester S, Bradley A. Uptake of Huntington disease predictive testing in a complete population. Clin Genet 2011;80:281-6. [DOI:10.1111/j.1399-0004.2010.01538.x] [PMID]
98. Roberts JS, Barber M, Brown TM, Cupples LA, Farrer LA, LaRusse SA, et al. Who seeks genetic susceptibility testing for Alzheimer's disease? Findings from a multisite, randomized clinical trial. Genet Med 2004;6:197-203. [DOI:10.1097/01.GIM.0000132688.55591.77] [PMID]
99. Foster MW, Mulvihill JJ, Sharp RR. Evaluating the utility of personal genomic information. Genet Med 2009;11:570-4. [DOI:10.1097/GIM.0b013e3181a2743e] [PMID]
100. Sanderson SC, Wardle J. Associations between anticipated reactions to genetic test results and interest in genetic testing: will self-selection reduce the potential for harm? Genet Test 2008;12:59-66. [DOI:10.1089/gte.2007.0047] [PMID]
101. Bloss CS, Schork NJ, Topol EJ. Effect of direct-to-consumer genomewide profiling to assess disease risk. N Engl J Med 2011;364:524-34. [DOI:10.1056/NEJMoa1011893] [PMID] [PMCID]
102. Haga SB, Tindall G, O'Daniel JM. Public perspectives about pharmacogenetic testing and managing ancillary findings. Genet Test Mol Biomarkers 2012;16:193-7. [DOI:10.1089/gtmb.2011.0118] [PMID] [PMCID]
103. Sanderson SC, Humphries SE, Hubbart C, Hughes E, Jarvis MJ, Wardle J. Psychological and behavioural impact of genetic testing smokers for lung cancer risk: a phase II exploratory trial. J Health Psychol 2008;13:481-94. [DOI:10.1177/1359105308088519] [PMID]
104. Roberts JS, Ostergren J. Direct-to-consumer genetic testing and personal genomics services: a review of recent empirical studies. Curr Genet Med Rep 2013;1:182-200. [DOI:10.1007/s40142-013-0018-2] [PMCID]
105. Vernarelli JA, Roberts JS, Hiraki S, Chen CA, Cupples LA, Green RC. Effect of Alzheimer disease genetic risk disclosure on dietary supplement use. Am J Clin Nutr 2010;91:1402-7. [DOI:10.3945/ajcn.2009.28981] [PMID] [PMCID]
106. Haga SB, LaPointe NMA. The potential impact of pharmacogenetic testing on medication adherence. Pharmacogenomics J 2013;13:481-83. [DOI:10.1038/tpj.2013.33] [PMID] [PMCID]
107. Stratton MR, Campbell PJ, Futreal PA. The cancer genome. Nature 2009;458:719. [DOI:10.1038/nature07943] [PMID] [PMCID]
108. Garrett M, Dancikand DT. Bladder Cancer. 1ed. Mica Haley, 2018:724.
109. Druker BJ, Guilhot F, Brien SG, Gathmann I, Kantar jian H, Silver RT, et al. Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. N Engl J Med 2006;355:2408-17. [DOI:10.1056/NEJMoa062867] [PMID]
110. Noori-Daloii MR. Shahriar H. Telomerase and its inhibition in cancer. Tehran Uni Med J 2009;67:599-607. [In Persian].
111. Allison M. Is personalized medicine finally arriving? Nature Biotechnol 2008;26:509. [DOI:10.1038/nbt0508-509] [PMID]
112. Takata R, Katagiri T, Kanehira M, Tsunoda T, Shuin T, Miki T, et al. Predicting response to methotrexate, vinblastine, doxorubicin, and cisplatin neoadjuvant chemotherapy for bladder cancers through genome-wide gene expression profiling. Clin Cancer Res 2005;11:2625-36. [DOI:10.1158/1078-0432.CCR-04-1988] [PMID]
113. Hayes DF, Markus HS, Leslie RD, Topol EJ. Personalized medicine: risk prediction, targeted therapies and mobile health technology. BMC Med 2014;12:37. [DOI:10.1186/1741-7015-12-37] [PMID] [PMCID]
114. Mirnezami R, Nicholson J, Darzi A. Preparing for precision medicine. N Engl J Med 2012;366:489-91. [DOI:10.1056/NEJMp1114866] [PMID]
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Noori-Daloii M R, Zafari N. The personalized medicine: today and tomorrow . MEDICAL SCIENCES. 2019; 29 (1) :1-17
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فصلنامه علوم پزشکی دانشگاه آزاد اسلامی واحد پزشکی تهران Medical Science Journal of Islamic Azad Univesity - Tehran Medical Branch
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