Just because a pair of x you can’t be someone’s ‘x’ or ‘ex’.

The total number of coronavirus positive cases in India rose to 1071 (including 942 active cases, 99 cured/discharged cases and 29 deaths){as per today’s (30.03.2020)report in TOI}.

We all know change is the only constant but people across the country are now indifferent to this change. It is high time for us to modify our lifestyle. Get into the bower of positivity and do something constructive in your own way.

Today we have no other option except isolation. Let’s raise from the dozed doom. Let’s take the isolation as boon and fight against the COVID-19 demon. Be aware, be free and hope for the good to happen.

Personalized medicines are becoming a glib approach of pharmacogenomics nowadays. The term ‘personalized medicine’ was first appeared in 1999 unveiling an individual’s molecular and clinical profiles. These are prescribed on the basis of a person’s specific genetic factor, lifestyle and environment. It is nothing but the modern tool for providing favorable treatment for certain disease of a group of persons. However, the principle of the model does not support the idea of ‘unity among diversity’ rather supports ‘diversity among unity’. We all know like the diversities of phenotype, diversities of genotype also exist and these variations in genome among individuals have made the scientists to muse for exploring a new descent prospect of treatment but unfortunately the model of personalized medicine may confer a major threat to public health also. As we know everything in the world is agathokakological, the model in the field of pharmacogenetics uncannily carries the same agathokakological nature. Sometimes prescribed medications deceive people by causing death. In fact it is holding the third most common cause of death globally after heart disease and cancer.
Precision medicines are very similar to personalized medicines and they are used interchangeably sometimes. The true and contrary fact is that the precision medicines provide unique treatment to diseases in an individualistic manner. Personalized medicine is the pioneer medical model to beckon the new precision medicine approach.
The genotype of an individual is similar to a mirror, providing the scope of developing an impeccable picture of the individual but definitely on the gene level. The farrago of DNA, RNA and protein plays striking role in biological science. Even a minute change in the genome may cause fatal diseases. So the molecular basis of a person’s genome is a very crucial point. Single Nucleotide Polymorphisms (SNPs), the alteration of a single nucleotide base in one of the DNA strands during replication may lead to formation of variation at an average frequency of 1/1000bp. Genome-wide association study (GWAS) is a major tool for studying genome-wide set of genetic variants in different individuals to detect the particular variant which is associated with a trait or disease. GWAS detects the SNPs across the genome by comparing it with the reference Human genome project and helps in the implementation of the personalized medicine model. In everyday life we always come across some changes which makes us worry and then we try to solve them with our own. The GWAS is following the same rule also.
Besides this insertions, deletions, translocations, duplications, repeats of chromosomal segment are also responsible for variations. In human beings 99.9% bases are same and the remaining 0.1% make a person unique. So if this much rife variations are present among the individuals there should be different approaches to treat the corresponding variants. Thus personalized medicines can be considered a breakthrough in molecular genetics.
Environment is a pivotal factor for determining the consequence of a person’s genotype. Environment dependent acquired mutations are the most common causes for developing cancerous cells in human body. Nevertheless the study of genome creates ramifications of genomic analysis indeed. Gene sequencing, next gen sequencing etc. are the effulgent techniques required for leading the personalized medicine treatment ahead. As the sequencing techniques are fruitful for detecting mutations they are highly recommended for diagnosing particular disease of individuals.
Several factors of individuals like height, weight, age, food habit, gender etc. are among the primary concerns for the treatment of the individuals. The changing lifestyle for example, changes in food habit may alter metabolic pathway of people and hence they have to rely on the personalized medicines if any disease corresponding to metabolic activities is found to be detected. These medicines are applied to a group of persons having a particular disease on the basis of their age and disease-stage resemblance.
The particular response exhibited by the body in presence of the treated drug can procure the required dose or dosage regimen of it. This phenomenon of response to the drug is known as Pharmacokinetics which depicts the drug fate. Whereas Pharmacodynamics relates to the action of drug to the body implying the concentration of drug needed. Pharmacokinetics and Pharmacodynamics are thus key tool to assess the drug efficacy.
The patients carrying genotype like CYP2C9 and VKORC1 are susceptible to blood clots such as deep vein thrombosis and pulmonary embolism. These may cause stroke and therefore to prevent it a drug named Warfarin acting as an anticoagulant can be used. Similarly the females exhibiting higher levels of HER2 and having breast cancers can be treated with Herceptin. So the treatment technique does not unleash futility if properly done. Patients with chronic myeloid leukemias (CMLs) are treated using Gleevec to inhibit the elevated levels of tyrosine kinase enzyme. Several therapies are identified to provide the patients maximal safety and it also includes the study of risk factor when the particular drug or therapy is applied. The diseases like diabetes, cancer, stroke are finding their ambit in the exodus just because of the success of personalized and precision medicines. As per the report of FDA (Food and Drug administration) personalized medicines beholds 42% of all drug approvals in 2018. This model provides the opportunity for not clinging to multiple tests of a patient as the whole genome sequence analysis can facilitate the doctors to go for only one test to treat. So there is precision in the fact that clinical personalization may personalize the demands of the health sector.
Modern medicine is gaining on enrichment but at the same time we should be a little fastidious to look into the actual facts and observations. Surmises of personalized medicines need to be evolved as there are a lot of examples of failure of therapeutic drugs in treating diseases like AIDS. The HIV virus possesses the ability to become resistant to personalized medicines and therapies and overpower the patient by stealing the spirit of immune system. Hence much more researches and clinical investigations must be done to extend the success rate.
These medicines may increase the cost of treatment as every subgroup would require individualized drug production. Leakage of genetic information of patient is correlated with the model. So ethical issue is drawing attention against information-leakge of a person. Patient privacy is very crucial in every aspect of a human being. The use of the medicines can bring psychological issues and therefore ethical points are in questions. A growing private industry is selling genetic tests to consumers, sidestepping the traditional relationship between a doctor and a patient. This is also a drawback of PM.
The drawbacks can be overlooked because this concept of Personalized Medicine can behold a new era of treatment against life threatening diseases. The efficiency is much more important than the limitations. Life threatening adverse reactions can be reduced or eliminated with the use of customized pharmaceuticals. Besides this, improved efficacy of drugs reveals plethora of hopes. Proper drugs can be designed for patients instead of ‘trial and error. It may also reduce costs of clinical trials which facilitate the patients with financial benefit. The minimal side effects offer a good future of the particular medical model.
Regulation laws should be reassessed to make Personalized Medicines more convenient. If any incorrect findings are peeping through then the finding must be recorded and should be resolved to ensure proper steps in the treatment. Advancement of knowledge for the proper diagnosis is to be assured. Doctors should also ensure that there is no over prescription of medicines as they confront major side effects. Several bio-banks should take the initiative to protect the genetic information of patients, so that ethical aspect of a patient is maintained.
“Personalized medicines act as a boon for the modern era of treatment if we can rein in the limitations and use it ethically and legally.’’