The University of Texas Health Science Center, Department of Nanomedicine and Biomedical Engineering, Houston, TX 77030, USA.
Pharmacol Res. 2010 Aug;62(2):57-89. doi: 10.1016/j.phrs.2009.12.011. Epub 2010 Jan 5.
Individualized medicine is the healthcare strategy that rebukes the idiomatic dogma of 'losing sight of the forest for the trees'. We are entering a new era of healthcare where it is no longer acceptable to develop and market a drug that is effective for only 80% of the patient population. The emergence of "-omic" technologies (e.g. genomics, transcriptomics, proteomics, metabolomics) and advances in systems biology are magnifying the deficiencies of standardized therapy, which often provide little treatment latitude for accommodating patient physiologic idiosyncrasies. A personalized approach to medicine is not a novel concept. Ever since the scientific community began unraveling the mysteries of the genome, the promise of discarding generic treatment regimens in favor of patient-specific therapies became more feasible and realistic. One of the major scientific impediments of this movement towards personalized medicine has been the need for technological enablement. Nanotechnology is projected to play a critical role in patient-specific therapy; however, this transition will depend heavily upon the evolutionary development of a systems biology approach to clinical medicine based upon "-omic" technology analysis and integration. This manuscript provides a forward looking assessment of the promise of nanomedicine as it pertains to individualized medicine and establishes a technology "snapshot" of the current state of nano-based products over a vast array of clinical indications and range of patient specificity. Other issues such as market driven hurdles and regulatory compliance reform are anticipated to "self-correct" in accordance to scientific advancement and healthcare demand. These peripheral, non-scientific concerns are not addressed at length in this manuscript; however they do exist, and their impact to the paradigm shifting healthcare transformation towards individualized medicine will be critical for its success.
个体化医学是一种医疗保健策略,它驳斥了“只见树木,不见森林”的陈词滥调。我们正进入一个新的医疗保健时代,开发和销售一种仅对 80%的患者群体有效的药物已经不再被接受。“组学”技术(如基因组学、转录组学、蛋白质组学、代谢组学)的出现和系统生物学的进步放大了标准化治疗的缺陷,这种治疗方法通常为适应患者生理差异提供的治疗空间很小。个体化医学并不是一个新概念。自从科学界开始揭开基因组的奥秘以来,放弃通用治疗方案转而采用针对患者的治疗方法的承诺变得更加可行和现实。个体化医学运动的主要科学障碍之一是需要技术支持。纳米技术预计将在患者特异性治疗中发挥关键作用;然而,这种转变将在很大程度上取决于基于“组学”技术分析和整合的系统生物学方法向临床医学的演进发展。本文前瞻性地评估了纳米医学在个体化医学中的应用前景,并建立了基于“组学”技术分析和整合的系统生物学方法的当前基于纳米的产品在广泛的临床适应症和患者特异性范围内的技术“快照”。预计其他问题,如市场驱动的障碍和监管改革,将根据科学进步和医疗保健需求“自我纠正”。这些外围的、非科学的问题在本文中没有详细讨论;然而,它们确实存在,它们对朝着个体化医学范式转变的医疗保健的影响将是其成功的关键。