Thinking about the future is always inspiring. The reason is simple: the history of past events cannot be changed, as they are written; the future, on the other hand, is neither constrained nor delimited by our understanding. Hence, many imaginative thinkers of past centuries dreamed of "impossible things" such as flying cars or holograms. Interestingly enough, many of these crazy premonitions have come true, be it instant communication, geolocation, or cloning. Two decades ago, this topic might have been futuristic, whereas today it is almost a reality. Personalized medicine is not only a very good marketing strategy but also a giant step forward for human healthcare.
The application of discoveries in the field of synthetic biology has made it possible to bring to the table different approaches that were previously unthinkable. That is, any chemical or molecular tool that allows genome editing and gene disruption coupled with computational studies to predict protein structures and functions, metagenomic evaluation of the microbiome, and next-generation sequencing. The exciting side is that it doesn't stop here, there are thousands of related technologies emerging every day.
Biologically speaking, the disease is a homeostatic alteration of the physiology determined by the genome. Taking into account that aging itself can be considered a pathology under this premise, it is not unreasonable to think that by altering the genes of an individual we could increase the longevity of the human being. However, the genetic background plays a very important role in pharmacokinetics, in the occurrence of diseases, and in their evolution. That is, the individual genome differs significantly from the population average, making it impossible to design a drug or treatment with maximum efficacy for a group of people. These divergences are precisely what enriches a population at the species level but to the detriment of individuals with the worst genes for survival in a given set of circumstances. This is where the idea of individual medicine takes over the niche: it is possible to know the genome, epigenome, and metagenome of each person in the blink of an eye. Obtaining this information is essential since mechanisms capable of intervening in metabolic pathways specific to each individual should be designed.
There has always been an attempt to personalize medical care, a clear example being a patient's medical history or allergy-related questions. However, now we are about to pass a critical juncture and we are standing in front of one of the most profound innovations that will change human society in the coming years.
3D – BioPrinting
One of the most brilliant ideas is to address the problem of biological diversity of physiognomy with bioprinting technologies. And this is not a trivial problem, since thousands of postural/locomotion anomalies cause a wide range of ailments. Moreover, not only genetic variability is an important factor, the physiognomy and three-dimensional structure also depend on the patient's lifestyle and injuries. With this approach, complete organs or tissues can be replaced without fear of implant rejection, since the patient's own stem cells are used to create the 3D-culture, and his or her physiognomy to create the impression mold with biomaterials for the external cellular matrix. Of course, it could not only fix problems of a structural nature, but also organ malfunctions, skin burns, transplants... a great example in this field is represented by the start-up Axial3D. They use a large variety of scanners to resolve each patient’s puzzle to deliver health solutions.
The possibility of reading the genome of each individual brings the incredible potential to medicine. Not only could it treat virtually any disease, but it could also prevent them with close to 100% efficiency. That is, of course, if we can interpret all the information we read. At present, this is not possible. However, deep learning (a branch of artificial intelligence) is proving very useful for learning all intergenic interactions. It is also possible to determine the right amount of medication for each patient in specific circumstances using this technology. A more mundane approach is to detect known mutations in certain regions of the genome (known as SNPs), which with analytical treatment could discern genetic diseases. Platomics is a start-up specializing in this area. In Evelo Biosciences are trying to achieve a holistic approach to treat diseases derived from the microbial genome associated with our organism, as we each have a different diversity of species, with different functions.
A branch of synthetic biology requires a reductionist approach to see its objectives fulfilled. I am referring to nano-biotechnology, another “science fiction idea” that has become reality. Many engineers are have dreamed of devices that travel through our bodies to target the delivery of a drug. But if we add to that a biosensor, capable of measuring various concentrations of molecules (such as glucose), we are talking about eliminating annoying needle pricks for diabetics. And with diabetes being the new disease of the near future, there's nothing better than news like this. The start-up Encellin is developing this idea apparently at a good pace.
In the coming years, we will see all these initiatives implemented in society. However, this may create even deeper imbalances in human welfare between first and third world nations. On the other hand, it is undeniable that humanity will have at its disposal very powerful tools to change this and many other facts since progress is reaching all areas of knowledge very promptly.
Now, let's think: What is the limit of medicine? The therapeutic effect of any substance is based on spatial-temporality and its chemical-physical action. Synthetic biology is already developing platforms to control gene products (proteins and mRNA) spatiotemporally within mammalian cells. This, together with the gene-editing mentioned above, would bring us a little closer to the virtual immortality that humans have always longed for. If this is not futuristic, I can't tell you anything else.