Scripps Clinic Medical Group, La Jolla, California.
The Translational Genomics Research Institute, Phoenix, Arizona; The City of Hope/TGen IMPACT Center, Duarte, California; J. Craig Venter Institute, La Jolla, California; The University of California, San Diego, La Jolla, California.
Fertil Steril. 2018 Jun;109(6):952-963. doi: 10.1016/j.fertnstert.2018.05.006.
There is a great deal of hype surrounding the concept of personalized medicine. Personalized medicine is rooted in the belief that since individuals possess nuanced and unique characteristics at the molecular, physiological, environmental exposure, and behavioral levels, they may need to have interventions provided to them for diseases they possess that are tailored to these nuanced and unique characteristics. This belief has been verified to some degree through the application of emerging technologies such as DNA sequencing, proteomics, imaging protocols, and wireless health monitoring devices, which have revealed great inter-individual variation in disease processes. In this review, we consider the motivation for personalized medicine, its historical precedents, the emerging technologies that are enabling it, some recent experiences including successes and setbacks, ways of vetting and deploying personalized medicines, and future directions, including potential ways of treating individuals with fertility and sterility issues. We also consider current limitations of personalized medicine. We ultimately argue that since aspects of personalized medicine are rooted in biological realities, personalized medicine practices in certain contexts are likely to be inevitable, especially as relevant assays and deployment strategies become more efficient and cost-effective.
个性化医疗的概念引起了广泛关注。个性化医疗的理念源于这样一种信念,即由于个体在分子、生理、环境暴露和行为等方面具有细微而独特的特征,他们可能需要针对其具有的疾病进行个性化的干预,这些干预措施需要根据这些细微而独特的特征来制定。通过应用新兴技术,如 DNA 测序、蛋白质组学、成像方案和无线健康监测设备,在一定程度上验证了这一信念,这些技术揭示了疾病过程中存在着巨大的个体间差异。在这篇综述中,我们考虑了个性化医疗的动机、其历史先例、推动其发展的新兴技术、一些最近的经验(包括成功和挫折)、个性化医疗的验证和应用方法,以及未来的发展方向,包括治疗生育和不育问题的潜在方法。我们还考虑了个性化医疗的当前局限性。我们最终认为,由于个性化医疗的某些方面植根于生物学现实,因此在某些情况下,个性化医疗实践可能是不可避免的,尤其是随着相关检测和部署策略变得更加高效和具有成本效益。