Per sonalized medicine in a multidisciplinary specialized hospital. Implementation in clinical practice
Abstract
Introduction. The strategy of personalized medicine is currently expanding in various fields, transforming medical practice on a new level. This review aims to examine the impact of personalized medicine on clinical practice by discussing key areas of interest, presenting current findings, and exploring future prospects. This review aims to summarize the existing data on the implementation of personalized medicine approaches in healthcare practice. Materials and methods. A literature search was conducted using PubMed, Web of Science, UpToDate, and relevant genetic databases with the specified keywords “personalized medicine”, “molecular genetic testing”, “DNA”. Additionally, expert opinions from a multidisciplinary team of healthcare professionals were consulted. The data from 39 relevant articles was analyzed. Results. The article discusses the practical applications of personalized approach and provides examples of laboratory methods and the potential for pharmacogenetic research. It emphasizes the significance of adopting an individualized approach to diagnosis, treatment, and monitoring, including the utilization of modern technologies and traditional methods, drawing on experience gained through work with patients in a specialized multidisciplinary hospital. Conclusion. Personification allows the improvement of medical care by preventing and early diagnosis of diseases, and it also increases the effectiveness of medicine therapy and significantly reduces the material costs of treatment. It is essential to emphasize the significance and necessity of a mutual understanding and constructive dialogue between doctors and patients, as the focus of this approach should be on the patient rather than the disease. The personalized approach to patient care is now a promising trend in medicine that requires not only scientific resources but also organizational efforts, as it represents a new paradigm in modern healthcare.
References
Goetz L.H., Schork N.J. Personalized medicine: motivation, challenges, and progress. Fertil Steril. 2018;109(6):952–963. DOI: 10.1016/j.fertnstert.
05.006.
Scholz N. Personalised medicine: The right treatment for the right person at the right time. Briefing Oct 2015 European Parliamentary Research Service. Available at: http://www.europarl.europa.eu/RegData/etudes/BRIE/
/569009/EPRS_BRI(2015)569009_EN.pdf (accessed:
07.2016).
National Cancer Institute. Definition of personalized medicine. Available at: http://www.cancer.gov/publications/dictionaries/cancer-terms (in USA) Cdrid=561717 (accessed: 23.07.2024).
Hood L., Friend S.H. Predictive, personalized, preventive, participatory (P4) cancer medicine. Nat Rev Clin Oncol. 2011;8(3):184–187. DOI: 10.1038/nrclinonc.2010.227.
Савельева М.И. Персонализированная медицина с точки зрения медицинской этики. Медицинская этика. 2022;2:4–11. DOI: 10.24075/medet.2022.047.
Приказ Министерства здравоохранения РФ от 24 апреля 2018 г. № 186 «Об утверждении Концепции предиктивной, превентивной и персонализированной медицины». Доступен по: https://www.garant.ru/products/ipo/prime/doc/71847662/ (дата обращения: 23.07.2024).
Мокрышева Н.Г., Мельниченко Г.А. Персонализированная медицина — этапы формирования концепции и пути практической ее реализации. Российский журнал персонализированной медицины. 2021;1(1):43–58. EDN: FMLQUG.
Conti R., Veenstra D.L., Armstrong K., Lesko L.J., Grosse S.D. Personalized medicine and genomics: challenges and opportunities in assessing effectiveness, cost-effectiveness, and future research priorities. Med Decis Making. 2010;30(3):328–340. DOI: 10.1177/0272989X09347014.
Tremblay J., Hamet P. Role of genomics on the path to personalized medicine. Metabolism. 2013;62(Suppl 1):S2–S5. DOI: 10.1016/j.metabol.2012.08.023.
Özdoğan M., Papadopoulou E., Tsoulos N. et al. Comprehensive tumor molecular profile analysis in clinical practice. BMC Medical Genomics. 2021;14(1):1–21. DOI: 10.1186/s12920-021-00952-9.
Sartore-Bianchi A., Pietrantonio F., Amatu A. et al. Digital PCR assessment of MGMT promoter methylation coupled with reduced protein expression optimises prediction of response to alkylating agents in metastatic colorectal cancer patients. European Journal of Cancer. 2017;71:43–50. DOI: 10.1016/j.ejca.2016.10.032.
Peixoto P., Cartron P.F., Serandour A.A., Hervouet E. From 1957 to Nowadays: A Brief History of Epigenetics. Int J Mol Sci. 2020;21(20):7571. DOI: 10.3390/ijms21207571.
Matai I., Kaur G., Seyedsalehi A., McClinton A., Laurencin C.T. Progress in 3D bioprinting technology for tissue/organ regenerative engineering. Biomaterials. 2020;226:119536. DOI: 10.1016/j.biomaterials.2019.119536.
De Vita Т., Hellman S., Rosenberg T. Cancer. Principles & Practice of Oncology. 11th edition. Philadelphia: Wolters Kluwer; 2019.
Canzoneri R., Lacunza E., Abba M.C. Genomics and bioinformatics as pillars of precision medicine in oncology. Medicina (B Aires). 2019;79:587–592.
Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001;69(3):89–95. DOI: 10.1067/mcp.2001.113989.
Данишевич А.М., Жукова Л.Г., Воронцова М.В., Лисица Т.С., Литвинова М.М., Бодунова Н.А., Хатьков И.Е. Персонализированное ведение больных BRCA1/2-ассоциированным раком молочной железы: от диагностики к лечению. Медицинский вестник Северного Кавказа. 2022;17(3):328–335. DOI: 10.14300/mnnc.2022.17081.
Garber J.E., Offit K. Hereditary Cancer Predisposition Syndromes. J Clin Oncol. 2005;23:276–292. DOI: 10.1200/JCO.2005.10.042.
Garutti M., Foffano L., Mazzeo R. et al. Hereditary Cancer Syndromes: A Comprehensive Review with a Visual Tool. Genes. 2023;14(5):1025. DOI: 10.3390/genes14051025.
Шелыгин Ю.А., Имянитов Е.Н., Куцев С.И., Ачкасов С.И., Васильев С.В., Фролов С.А., Кашников В.Н., Кузьминов А.М., Рыбаков Е.Г., Стрельников В.В., Вышегородцев Д.В., Цуканов А.С., Москалев А.И., Пикунов Д.Ю. Клинические рекомендации: Аденоматозный полипозный синдром. Доступен по: https://akr-online.ru/upload/iblock/2ec/%D0%9A%D0%A0_%D0%90%D0%9F%D0%A1.pdf (дата обращения: 23.07.2024).
Lynch A.I., Boerwinkle E., Davis B.R. et al. Pharmacogenetic association of the NPPA T2238C genetic variant with cardiovascular disease outcomes in patients with hypertension. JAMA. 2008;299(3):296–307. DOI: 10.1001/jama.299.3.296.
Giudicessi J.R., Kullo I.J., Ackerman M.J. Precision Cardiovascular Medicine: State of Genetic Testing. Mayo Clin Proc. 2017;92(4):642–662. DOI: 10.1016/j.mayocp.2017.01.015.
Teekakirikul P., Cox S., Funke B., Rehm H.L. Targeted sequencing using Affymetrix CustomSeq Arrays. Curr Protoc Hum Genet. 2011;7(7.18). DOI: 10.1002/0471142905.hg0718s69.
Lee M.S., Flammer A.J., Lerman L.O., Lerman A. Personalized medicine in cardiovascular diseases. Korean Circ J. 2012;42(9):583–591. DOI: 10.4070/kcj.2012.42.9.583.
Braig Z.V. Personalized medicine: From diagnostic to adaptive. Biomed J. 2022;45(1):132–142. DOI: 10.1016/j.bj.2019.05.004.
Polyakova V.V., Bodunova N.A., Rumyantsev K. et al. Genetic Determinants of Autoimmune Gastritis. BioNanoScience. 2023;13:322–329. DOI: 10.1007/s12668-023-01068-3.
Cassano A., Conidi C., Ruby-Figueroa R., Castro-Muñoz R. Nanofiltration and Tight Ultrafiltration Membranes for the Recovery of Polyphenols from Agro-Food By-Products. Int J Mol Sci. 2018;19:351. DOI: 10.3390/ijms19020351. (In USA).
Nehme F., Rowe K., Palko W. et al. Autoimmune metaplastic atrophic gastritis and association with neuroendocrine tumors of the stomach. Clin J Gastroenterol. 2020;13(3):299–307. DOI: 10.1007/s12328-019-01074-7.
Mentella M.C., Scaldaferri F., Pizzoferrato M. et al. Nutrition, IBD and Gut Microbiota: A Review. Nutrients. 2020;12(4):944. DOI: 10.3390/nu12040944.
Zheng H.B., de la Morena M.T., Suskind D.L. The Growing Need to Understand Very Early Onset Inflammatory Bowel Disease. Front Immunol. 2021;26(12):675186. DOI: 10.3389/fimmu.2021.675186.
Fadeeva N., Khatkov I.E., Bodunova N.A. et al. Personalized Medicine for IBD Patients. BioNanoSci. 2023;13:30–337.
Graham D.B., Xavier R.J. Pathway paradigms revealed from the genetics of inflammatory bowel disease. Nature. 2020;578(7796):527–539. DOI: 10.1038/s41586-020-2025-2.
Mansour H.H., Seddek S.S., Meguid M.E. et al. Very-early-onset inflammatory bowel disease versus late-onset inflammatory bowel disease in relation to clinical phenotype: a cross-sectional study. Indian J Gastroenterol. 2023;42(2):185–191. DOI: 10.1007/s12664-022-01318-4.
Shribman S., Poujois A., Bandmann O. et al. Wilson’s disease: update on pathogenesis, biomarkers and treatments. J Neurol Neurosurg Psychiatry. 2021;92(10):1053–1061. DOI: 10.1136/jnnp-2021-326123.
Litvinova M.M., Khafizov K.F., Speranskaya A.S. et al. Spectrum of PRSS1, SPINK1, CTRC, CFTR, and CPA1 gene variants in chronic pancreatitis patients in Russia. Sovrem Tekhnologii Med. 2023;15(2):60-70. DOI: 10.17691/stm2023.15.2.06.
Malfertheiner P., Megraud F., Rokkas T. et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. 2022;71:1724–1762.
Medakina I., Tsapkova L.A., Polyakova V.V. et al. Helicobacter pylori Antibiotic Resistance: Molecular Basis and Diagnostic Methods. Int J Mol Sci. 2023;24:9433. DOI: 10.3390/ijms24119433.
Сычев Д.А., Мошетова Л.К. Проблемы интеграции медицинской науки, образования и практического здравоохранения: фокус на персонализированную медицину. Фармакогенетика и фармакогеномика. 2020;1:3–10.
Bindu S., Mazumder S., Bandyopadhyay U. Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: a current perspective. Biochem pharmacol. 2020;180:114147. DOI: 10.1016/j.bcp.2020.114147.