The Future of Medicine

1

• The Future of Medicine

Danny Belkin
2

• Our generation may be the last to have to accept
  death and taxes as inevitable."
• - Commander Shaun Jones ,US Navy, DARPA

3
Contents

• Challenges to traditional big pharma, their
  future
• Pharmacogenomics
• Current and Future Biotechnology
• Stem Cell Therapy
• Microtechnology and nanotechnology

4
Challenges to Pharmaceutical Companies

• Aging and informed population
• Increased focus on preventive care / wellness
• Demand for safety and efficacy
• Serious drug side effects (Vioxx, Hormone
  replacement therapy)
• Prescription drugs that dont always work
• Progress in science and technology providing
  other therapeutic paradigms
• Keeping up with advances in information
  technology
• Lack of RD productivity increase despite
  sustained investments
• Increased regulatory demands
• Unacceptable failure rates of RD projects

5
challenges which lead to changes in healthcare

• Better understanding of nutrition and its effects
• Initially specified for diseases/population
  groups(problems with clinical trials for
  unpatentable nutrition compounds)
• Later - per individual genetic makeup
• Pharmacogenomics and Proteomics
• Many major diseases understood at molecular level
  advanced drug design
• Smart Drugs for Cancer and Autoimmune Diseases
  (arthritis, psoriasis, diabetes).
• Development of diagnostics combined with targeted
  therapeutics
• in silico simulations of biological systems

6
The 5 Ps of Future Medicine

• Predictive - Pharmacogenomics and
  Pharmacoproteomics
• Preventive - Acting proactively with
  preventive medicine
• Point of care - Mobile communications
  ubiquitous computing
• Parametric - Multiple parameters, over time,
  referenced to patients own baseline and genetic
  profile, compared to standard model
• Personalized - Individual treatment for each
  patient

7
Pharmacogenomics - Personalized Medicine

• Both preventative and therapeutic
• Single nucleotide polymorphisms (SNPs) - Only a
  fraction of these, probably 300,000, determine
  everything from hair colour to disease
  susceptibility and drug response.
• 100,000 people die each year in the US from
  adverse reactions to prescription drugs, stemming
  from specific gene loci. Millions more suffer
  painful side effects from drugs.
• Knowledge of patients genetic profile will allow
  significantly improved preventative measures as
  well as improved drug safety and effectiveness
  (tailor made).

8
Pharmacogenomics - Personalized Medicine
Risk prediction
Pharmacogenomics
New Therapies

• Drug dose of antidepressant determined by drug
  metabolism genetic profile

• Begin colonoscopy at age 40
• Avoid high fat in diet

• Gene-based drug therapy for cancer
• Gene Cell therapy for heart disease

9
Current and Future Biotechnology

• RNAi (RNA Interference) and micro RNA to
  disable/weaken expression of genes
• Ageing-promoting
• Pathogens
• Cancer
• Autoimmune
• Gene Chips
• Cell Therapy
• Gene Therapy
• Combined Cell and Gene Therapy
• Human Cellular Engineering and Tissue Engineering

10
Stem Cells Therapy - Regenerative Medicine

• Multipotent Cells that can develop into any organ
  or tissue
• Embryonic stem cells controversial and
  technically difficult to manipulate
• Ideally - patients own stem cells, rejuvenated
  and then delivered into desired tissue
• Stem cell transplants have been effective in
  treating cancers
• Stem cell therapy now being used for degenerative
  diseases

11
Future of Stem Cell Therapy

• Multipotent Blood-derived cells are available now
  
• Developing further depth additional cell types
• Developing further width treatment of additional
  diseases treatable by a certain cell type
• Automation of manufacturing processes for
• Faster, more efficient production (e.g. improved,
  closed-system culture systems)
• RD Rapid improvement of manufacturing process
  manufacturing of more effective products
• Improved transplantation techniques
  microcapsules targeted systemic infustion slow
  release in vivo growth by mimicry of BM
• Integration of gene therapy to form a synergetic
  product exhibiting the benefits of both
  technologies

12
Microtechnology and Nanotechnology
Bring the ability to detect, prevent and treat
disease down to the molecular level
13
First Microtechnology Pioneers

• BioMEMs Microelectronic Mechanical Systems
  microsensors, drug delivery, disposable chips for
  diagnostics
• Dendrimers synthetic polymer for disease
  detection and drug delivery
• Artificial microbes - producing beneficial
  materials or breaking down harmful ones

14
First Microtechnology Pioneers
From Wired 14.12
15
The Potential of Nanotechnology

• Nanodevices can potentially
• Be much more therapeutically effective than
  current drugs
• Be much more efficient than current diagnostic
  tests
• First generation nanoparticles are already in
  development
• Magnetic particles for in vivo diagnostics are in
  use in the clinic
• Lipid-based nanoparticles capable of delivering
  drugs or genes in advanced preclinical testing.

16
Nanotechnology Information Meets the Physical
World

• A technology ripening 10-20 years from now
• Massive parallel diagnostics
• Paradigm first augmenting, then replacing
• Highly expensive, moderately efficient, then
  ultimately cheap and efficient
• Upgrading the cell nucleus with a nanocomputer
  and nanobots

17
Nanotechnology Information Meets the Physical
World

• The Biological assembler

18
Nanotechnology Information Meets the Physical
World

• Surveillance and monitoring nanobots
• Hormone delivering nanobots
• Oxygen-extracting nanobots no need for lungs
• Microbivores (artificial phagocytes)
• Tumor-destroying nanoparticles
• Surgical Nanorobotics vascular maintenance,
  gene or chromosome replacement
• Metabolic nanobots introducing nutrients
  directly into bloodstream no need for digestive
  system
• Augmentation of all thats left skeleton, skin,
  sensory organs, brain.

19
Nanobots in the bloodstream

• http//www.foresight.org/Nanomedicine/Gallery/inde
  x.htm

20
Nanobots
Nanobots in the bloodstream

• http//www.foresight.org/Nanomedicine/Gallery/inde
  x.htm

21
Nanobots
Clottocytes
Housekeeping Nanobots

• http//www.foresight.org/Nanomedicine/Gallery/inde
  x.htm

22
Nanobots
Neural Augmentation/replacement
Respirocytes (mechanical RBC)

• http//www.foresight.org/Nanomedicine/Gallery/inde
  x.htm

23
Nanobots
Surveillance and monitoring nanobots

• http//www.foresight.org/Nanomedicine/Gallery/inde
  x.htm

24
Timeline
1990
2000
2010
2020
2030
Gene Therapy I
Gene Therapy II
Cell Therapy II
Cell Therapy I
Combined Gene Cell Therapy
Advanced Tissue Engineering
Advanced drug design based on proteomics
genomics
Nanomedicine - diagnostics
Nanomedicine - interventional
25

• Whatever happens, it will be an interesting place
  to be

26

• To Whoever is still awake

Thank you for your attention.