Department of Preclinical Research, Angion Biomedica Corporation, Nassau, NY 11553, USA.
Department of Chemistry and Biochemistry, The University of Texas, El Paso, TX 79968, USA.
Molecules. 2018 Sep 18;23(9):2384. doi: 10.3390/molecules23092384.
The practice of medicine is ever evolving. Diagnosing disease, which is often the first step in a cure, has seen a sea change from the discerning hands of the neighborhood physician to the use of sophisticated machines to use of information gleaned from biomarkers obtained by the most minimally invasive of means. The last 100 or so years have borne witness to the enormous success story of allopathy, a practice that found favor over earlier practices of medical purgatory and homeopathy. Nevertheless, failures of this approach coupled with the omics and bioinformatics revolution spurred precision medicine, a platform wherein the molecular profile of an individual patient drives the selection of therapy. Indeed, precision medicine-based therapies that first found their place in oncology are rapidly finding uses in autoimmune, renal and other diseases. More recently a new renaissance that is shaping everyday life is making its way into healthcare. Drug discovery and medicine that started with Ayurveda in India are now benefiting from an altogether different artificial intelligence (AI)-one which is automating the invention of new chemical entities and the mining of large databases in health-privacy-protected vaults. Indeed, disciplines as diverse as language, neurophysiology, chemistry, toxicology, biostatistics, medicine and computing have come together to harness algorithms based on transfer learning and recurrent neural networks to design novel drug candidates, a priori inform on their safety, metabolism and clearance, and engineer their delivery but only on demand, all the while cataloging and comparing omics signatures across traditionally classified diseases to enable basket treatment strategies. This review highlights inroads made and being made in directed-drug design and molecular therapy.
医学实践在不断发展。诊断疾病通常是治疗的第一步,从社区医生的敏锐诊断到使用复杂的机器,再到使用通过最小侵入性手段获得的生物标志物获取的信息,这一过程发生了翻天覆地的变化。在过去的大约 100 年里,对抗疗法取得了巨大的成功,这种疗法比早期的医疗炼狱和顺势疗法更受欢迎。然而,这种方法的失败,加上组学和生物信息学革命,促使了精准医学的发展,在这个平台上,个体患者的分子特征驱动着治疗方案的选择。事实上,最初在肿瘤学中找到应用的基于精准医学的疗法正在迅速应用于自身免疫、肾脏和其他疾病。最近,一种正在塑造日常生活的新文艺复兴正在进入医疗保健领域。药物发现和医学从印度的阿育吠陀开始,现在正受益于一种完全不同的人工智能——它可以自动化新化学实体的发明和在健康隐私保护的保险库中挖掘大型数据库。事实上,语言、神经生理学、化学、毒理学、生物统计学、医学和计算机等不同学科已经联合起来,利用基于迁移学习和递归神经网络的算法来设计新的药物候选物,预先了解它们的安全性、代谢和清除情况,并按需设计它们的传递方式,同时对传统分类疾病的组学特征进行编目和比较,以实现篮子治疗策略。这篇综述强调了在定向药物设计和分子治疗方面取得的进展和正在取得的进展。