Analyzing how the healthcare and clinical sectors can take steps to deliver tangible progress in the field of personalized medicine.
The rise of personalized medicine comes with great opportunity to create clinical models aligned with precision, unique patient experiences, and better overall patient and care outcomes.
However, although the field has seen great promise in recent years, there has been a systemic lack of focus on innovation, problem-solving, and creation in the field. Personalized medicine has remained an idealistic version of what the future holds.
What is Personalized Medicine?
The following definition is taken from my previous article in the area of personalized medicine, The Application of Personalized Medicine Techniques in Drug Development and Delivery.
Personalized Medicine is yet another buzz word that has become a phenomena and gained wide-spread attention in recent years. It has propelled forward further research in top health agencies at the federal government level — from the National Institutes of Health (NIH) to Health and Human Services (HHS) — and it has also posed a profound opportunity for improvement in healthcare delivery and population health sciences.
Personalized Medicine, also widely known as precision medicine, is a unique, multidisciplinary field which emphasizes a modern approach to understanding health.
The field promotes innovative interventions and strategies including specialized treatment that address diverse and unique patient concerns, environments, circumstances, and realities while trying to break the often-unbreakable cycle of one-size-fits-all approaches in healthcare.
Research includes collecting and analyzing different types of critical patient, medical, and health information; organizing proactive and predictive data and information systems; and processing information to allow for specific treatments and/or diagnoses.
Why is the Field Important?
Personalized Medicine is — simply put — the future of healthcare. This is not a cliché.
The further development of precision medicine is moving the healthcare and clinical sectors closer to more precise, predictable and powerful care that is customized for the individual patient.
Our profound progress in better understanding genetics and genomics — and how they drive health, disease and drug responses in each person — is enabling doctors to provide better disease prevention, more accurate diagnoses, safer drug prescriptions, and more effective, public health-centered treatments.
Tailoring health care to each person’s unique experience is revolutionary, and can dramatically transition healthcare providers and insurance companies towards a more proactive — rather than reactive — framework for care.
Here are some select key opportunities for healthcare providers to embrace as a result of advances in the field:
- Shift the emphasis in medicine from reaction to prevention
- Improve disease detection and predictive modeling
- Prevent disease progression
- Customize disease-prevention strategies
- Prescribe more effective, tailored drugs
- Avoid prescribing drugs with predictable side effects
- Reduce the time, cost, and failure rate of pharmaceutical clinical trials
eliminate trial-and-error inefficiencies that inflate health care costs and undermine patient care.
How to Engineer the Next Generation of Personalized Medicine
While there has been substantial progress in the development of personalized medicine techniques centered around sequencing one’s genome and integrating genetic information, very minimal attention has been focused on engineering innovative solutions beyond the surface level — and with emphasis on harnessing other aspects of personal health‐related information.
The following consists of some critical engineering approaches that consider both genetic and nongenetic factors to provide higher precision in care.
1 — Stem Cell Engineering
Stem cells are cells with the potential to develop into many different types of cells in the body. They serve as a repair system for the body, with applications in personalized regenerative medicine — which focused on repairing certain organs, tissue, and biological systems using these cross-functional cells.
In recent decades, a great amount of research has been focused on using embryonic stem cells, but due to the ethical and availability issues associated with using these cells, induced pluripotent stem cells (iPSCs) have been used as an alternative.
iPSCs can be extracted directly from somatic cells (non-reproductive cells), thereby providing a more accessible source of stem cells for regenerative medicine.
There are a few valuable techniques that can utilize stem cells to move precision medicine forward:
- Cell replacement/regeneration therapies — for example, scientists have been able to develop scaffolds (“materials that have been engineered to cause desirable cellular interactions to contribute to the formation of new functional tissues for medical purposes”), which can then be provided to the body through various injection systems.
- Disease modeling or drug screening — since the iPSCs can be produced and obtained from patient‐derived cells — such as skin or blood — they provide opportunity for personalized therapies or disease models with exactly the same genomic background as the patient.
2 — Biomaterials for Tissue Engineering and Drug Delivery
Personalized Tissue Engineering
Specialized biomaterials are engineered with focused and niche mechanical and biochemical properties to enable the design of personalized implants or organ replacements for select individuals.
Biomaterials often have special properties that allow them to be in contact with human cells, tissue, and organs without being rejected by the body.
With advances in both polymerization and manipulation of natural materials — ranging from proteins to polysaccharides — there has been substantial progress in the development of biocompatible materials which can be inserted into the body to replace or repair damaged organs or tissues.
Personalized Drug Delivery
In addition to helping replace or repair damaged tissue, biomaterials are becoming key in the design of smart drug delivery systems.
This approach is centered around creating a customized drug delivery systems which can deliver the optimal dose of the drug to the intended organs at the specific time.
These smart biomaterials would be able to sense the needs of an individual’s physiological state and adjust their drug release profile accordingly to best serve the individual.
3— Proactive Diagnostic Devices
Advances in smart sensors, biomarker technologies, wearables, and monitoring devices, enable “point‐of‐care” (POC) innovation that allows analysis of patients’ health status at any time and place.
Recent advances in the area encompass developments in flexible electronics, bioelectronics, and biosensors, which offer the unique application of POC devices toward testing of biomarkers in sweat, tear, saliva, and interstitial fluid using a variety of sensors.
Here are some revolutionary applications of this technology currently on the rise:
- Minimally invasive surgical tools — Signals present in internal tissue could enhance the precision of surgical operations.
→ For example, a sensor on a biopsy needle has been employed to help surgeons monitor the mechanical and biochemical properties of the tissues around the needle in real time. Through this approach, surgery precision has improved by distinguishing between the properties of normal tissues from diseased ones, such as tumors.
- Elderly care and at-home proactive healthcare — Sensors and wearables are becoming increasingly useful in monitoring populations within homes, particularly the elderly.
→ For example, personal health data can be compiled through numerous sensing devices, with focus on parameters including psychological ailments, such as anxiety, stress, or depression in real‐time, as well as skin and fluids.
- Disease prevention — With the integration of electrochemical sensors, wearable devices could detect health‐related biomarkers critical to disease prevention processes.
→ For example, key biomarkers such as temperature, pH, protein presence, and/or saliva concentration, can serve as critical reflections of diseases such as autism, Alzheimer’s disease, Parkinson’s disease, atherosclerosis, heart failure, and cancer. Proactive treatment can then be applied.
Ultimately, personal health data can be collected by these previously-mentioned sensors continuously. Personalized healthcare advice or intervention could then be generated based on this information.
With these advances in diagnostic devices, research and innovation must continue to be focused on meaningfully analyzing data using artificial intelligence and machine learning techniques while providing tailored and personalized recommendations and interventions to the user.
These diagnostic devices can then be paired with already-stored personal medical data to enable a holistic approach to health.
4–3D‐Printing in Precision Tissue Engineering
3D printing advancements offer incredible potential to the field of personalized medicine. Engineering medical implants, artificial tissue, and artificial organs are becoming increasingly viable possibilities.
With patient‐derived anatomy information and clinically-centered biomaterials, interventions with patient‐specific shape and size could be precisely manufactured by 3D printing.
Some examples of precision 3D printing solutions include:
- Soft tissue implants, such as for lung and heart therapy — With the precise use of medical scanning and computer-aided design techniques, complex, personalized soft tissue structures can be implanted into humans.
Examples of interventions in this area include the printing of artificial splints and regenerative tissue for organs and biological systems.
- Hard material implants — Unlike the soft tissue implants mentioned above, hard material implants require materials such as calcium phosphate, bioactive glasses, and metals. These are commonly used as “ink” in 3D printing of orthopedic implants, for example.
Many additive manufacturing methods central to this process include material jetting, binder jetting, material extrusion, vat photopolymerization, sheet lamination, and powder bed fusion — key to the production of medical implants.
Key Takeaways and Conclusion:
To sum up, personalized medicine is changing how healthcare will be delivered in the coming decades:
- The field promotes innovative interventions and strategies centered around personalized treatment which addresses diverse and unique patient concerns, environments, circumstances, and realities.
- Stem cells can help deliver tailored regenerative solutions and drug delivery models.
- Tissue engineering and drug delivery are becoming exponentially more significant with the rise of innovative biomaterials which can provide personalized treatment while enabling precise drug delivery when needed and in the right dosage.
- Wearables and smart monitoring technology will enable a holistic approach to personal health — with integration of vast amounts of data and proactive solutions leading the way.
- 3D printing offers a tangible engineering framework to deliver on critical clinical aspirations.
Ultimately, precision medicine is an ambitious approach that needs multidisciplinary efforts from physicians, patients, insurance companies, information technology developers, bioengineers, and related professions and industries.
It requires knowledge and technologies from various fields, such as medicine, genetics, chemical engineering, materials engineering, bioengineering, and pharmaceuticals.
In order to successfully transition to a personalized medicine-centered healthcare system, we have to collectively remove barriers and work to integrate information, data, and systems like never before.
About the Author
Hamid is a student based in Long Beach, CA. His interests lie in medicine, healthcare, biomedical engineering, and business. He strives to make a meaningful impact in the areas of clinical practice, healthcare delivery, and public health by leveraging technology and innovation.
P.S. → If you’d like to learn more about the role of personalized medicine specifically focused in drug development and delivery, feel free to check out my previous article: The Application of Personalized Medicine Techniques in Drug Development and Delivery.