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Abstract

The availability of the human genome sequence together with major advances in biological technologies have an enormous potential to usher in a new era of medicine. We can imagine a situation in which a physician uses advanced molecular and imaging techniques—individually or collectively—to diagnose an illness and determine the exact molecular ‘fingerprint’ of the disease, be it cancer, cardiovascular disease or an infection. The physician will not only know what has gone awry in the patient's body but also have access to a wide range of new, highly effective therapeutics that directly tackle molecular defects or invading pathogens without causing side effects. Such drugs could be, for example, peptides that specifically instruct cancer cells to initiate apoptosis, or molecules that repair a defect in the DNA of the cell. Many biomedical researchers are optimistic that such a scenario will be realized through the current advances in genomics, proteomics, systems biology and advanced diagnostic and imaging techniques, in conjunction with new methods of drug development. This scenario challenges our current concept of treatment, whereby physicians identify a disease and prescribe a drug to treat it. Quite probably, the concept of a drug targeted against a single illness will no longer be accurate. Many diseases induce changes to cells and tissue, such as those that occur in tumour development, which involve numerous genes and proteins. Even a simple infection triggers a complex cascade of gene and protein actions both in the infected cells and in the cells of the immune system. Instead of using a therapeutic that tackles rapidly dividing cells to kill tumour cells—which in the course of treatment affects normal body cells—or an antibiotic that kills beneficial bacteria as well, it would be much safer and more efficient to use therapeutics that target only the molecules that are involved in …