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Precision medicine or personalized medicine is increasingly popular in the medical and surgical fields. However, this concept has not yet been introduced in regenerative medicine. Read the article below to understand the importance of personalized or personalized regenerative medicine in personalized medicine and healthcare.1. The definition and importance of personalized regenerative medicine
1.1. Personalized regenerative medicine definition
Personalized regenerative medicine, also known as personalized medicine (or personalized medicine) is a way for doctors to learn about a patient's genetics and tumor growth in the body. their bodies. With this information, doctors hope to be able to find ways to prevent, screen and provide more effective treatment regimens for each patient. Personalization in medicine can also help find new treatments that are effective, with fewer side effects than traditional treatments. Using genetic tests on cancer and normal cells, your doctor can tailor your treatment to your individual health care needs.A personalized reconstruction-based cancer screening and treatment plan consists of 3 basic steps:
Figure out a person's cancer risk and select the most appropriate screening methods to reduce risk. Provide appropriate, effective and minimally invasive treatment regimens for patients. Predict the risk of cancer recurrence for each specific patient.
2.2. The importance of personalized regenerative medicine
Personalized screening guided by artificial intelligence (AI) and biomarkers could maximize the transformative potential of medicine, according to a study published in the Mayo Clinic journal. regenerative. Studies on this topic have also shown similar results.Another paper, published in the journal Biomarkers in Medicine, asserts that using new scientific tools to tailor a biological treatment to the right patient ushers in a new era of treatment. care after cancer treatment. In contrast, without the intervention of personalized regenerative medicine, biological and genetic differences lead to different outcomes from regenerative procedures. However, there are still some patients with poor outcomes or care when personalized medicine is applied
Professor Andre Terzic, cardiologist and senior author of the study The factors that determine the separation of success and failure in curative treatment have not yet been clearly identified by humans, the study said. Biodiversity among recipients, unpredictable biotherapeutic efficacy, and inconsistent care delivery all underline recognized challenges in rehabilitative care.
This concept of personalized treatment has revolutionized cancer therapy and is gaining momentum in cardiovascular medicine, but has yet to be studied extensively in medicine regeneration and cell therapy. In advanced colorectal cancer, KRAS mutation is an independent prognostic factor in treatment with cetuximab and broad-spectrum KRAS is required to achieve the efficacy of panitumumab. In breast cancer, the understanding of novel HER2 overexpression has radically changed the therapeutic approach with monoclonal antibodies against HER2. And recently, the treatment of melanoma has changed with immunotherapy and the understanding of mutations associated with acquired resistance to PD-1 blockade. Similarly, cardiovascular medicine is becoming personalized. Patients with an inactivating mutation in the gene encoding the trafficking protein PCSK9 have a much lower risk of myocardial infarction, and their response to warfarin and clopidogrel is influenced by gene polymorphisms in VKORC1 and CYP2C19, respectively. response.
Regenerative medicine has lagged behind the concept of personalized medicine, where genetic polymorphisms and individual responses to therapies remain largely untested in the context of innovation. improve outcomes with cell and regenerative cell therapies. This is an area with enormous potential to advance regenerative medicine and surgery in two powerful ways. First, it is important to understand the potential for donor-to-donor change of any autologous regenerative product - realizing that one person's cells are not the same type of cell from another. Other donors suggest that donor screening can be an important first step in tailoring treatment for a given disease. The second is the ability to design “smart” cell or cell therapies to target the disease being treated – a type of cell that is not suitable for all disease states.
The Whole Genome Project eloquently demonstrates that each individual is unique based on our basic genetic makeup. This means embryonic stem cells, induced pluripotent stem cells (iPS) and mesenchymal stem cells (MSCs) from any particular individual other than the cell right next to them. Therefore, when investigating the effectiveness of cell-based therapy, it is important to consider donor variation and how this may affect cellular function as a treatment. For example, if Crohn's disease is to be treated, understanding that autologous mesenchymal stem cells from Crohn's patients are indeed causing inflammation may prompt an alternative co-product. When searching for optimal allogeneic mesenchymal stem cells, finding a donor whose mesenchymal stem cells increase T-regulatory cells and polarize M2 macrophages in vitro and in vivo can be beneficial. best for Crohn's.
However, the same donor mesenchymal stem cells may not have the optimal antimicrobial properties required for a cystic fibrosis therapy or the desirable neovascular and regenerative properties. want for a heart attack therapy. Similarly, each person receiving cell therapy is unique, and so their response to cell therapy is individualized. Genomic studies before and after cell delivery using sc-RNA and tissue RNA before and after cell therapy can shed light on how cell therapy works and who is optimal responders.
An exciting potential of cell therapy is the ability to engineer cells or alter their function in the laboratory prior to use in clinical trials; With regard to scalability, this would likely be a more viable approach using allogeneic cells. For example, mesenchymal stem cells have emerged as a promising treatment for inflammatory and immune-mediated disease due to their remarkable anti-inflammatory, immunosuppressive, and immunomodulatory properties. performed in both endocrine signaling and cell-to-cell contact mechanisms. However, of the more than 900 preclinical and clinical trials in the past 10 years, many have resulted in treatment failure or failure to achieve the desired effect. One possible explanation for these treatment failures is the expectation that a cell type, harvested from a specific site (i.e. mesenchymal stem cells from bone marrow, adipose tissue, and umbilical tissue), from a specific donor, is expected to be effective in the treatment of many diseases with different pathophysiologies.
Instead of expecting a specific mesenchymal stem cell product to be equally effective across many diseases, mesenchymal stem cells can be optimized to treat any particular disease in a particular patient body. Mesenchymal stem cells can be initiated by cytokines and growth factors, hypoxic conditions, pharmacological drugs, biomaterials, different culture conditions and diverse molecules to influence to immunoregulatory, regenerative, angiogenic, anti-apse and anti-scarring properties. In addition, mesenchymal stem cells can also be engineered through heterogeneous delivery of DNA and RNA to alter gene expression, thereby improving in vivo th eradication function. By up- or down-regulating gene expression in mesenchymal stem cells or iPS, there is great potential to target tumor growth in malignancies or specific immunosuppressive effects. essential for immune-mediated disease.
2. Strategies for applying regenerative medicine in personal health care
Restorative medicine is poised to shift its focus from fighting disease to protecting human health before disease occurs, a strategy that is a top priority in developed countries. With a focus on restoring form and function, restorative care aims to provide new cures to needy patients who really need it.Success can be predicted from identifying the right patients for regenerative therapies. New insights into the underlying causes of disease, along with emerging technologies such as genetic testing and artificial intelligence (AI), are helping to pinpoint candidates who are likely to be or treatment will not be achieved.
For example, research from the clinical trial “Cardiovascular Regenerative Therapy Against Congestive Heart Failure” called CHART-1, shows that cardiac comparative stem cell therapy is safe and beneficial for patients, especially those with severe left ventricular hypertrophy. However, mixed responses have slowed the integration of this new biologic therapy into daily clinical care. Pre-screening for patients in high-risk groups can identify which heart patients are most likely to undergo a cure. "Personalized regenerative therapy is increasingly supported by prescreening the genetic makeup of individual therapy recipients. Notably, carriers of cardiomyopathy variants appear to benefit less from the therapy. stem cells, encourage pre-intervention screening to identify the best responders in the management of heart failure," added Professor Terzic. The study also demonstrates the need to better understand personalized biomarkers to further select suitable candidates for regenerative interventions and guide informed decisions about care.
Dr Satsuki Yamada, one of the lead members of the study, said: “The development of personalized biomarker-guided diagnosis, targeted repair, and artificial intelligence-driven decision-making has the potential to transform clinical practice and contribute to optimizing patient outcomes. Structural parameters of cardiac remodeling, specifically left ventricular size, appear to predict stem cell efficiency. Therefore, disease severity stratification could help determine which heart patients are most likely to benefit from stem cell therapy."
The researchers also suggest that adopting a biological treatment approach Patient-ready learning, combined with cutting-edge new guidance technologies (such as artificial intelligence), and optimized clinical care planning, can help increase consistency in follow-up outcomes. This could spur the development of a new era in which primary health care is valued and put first.
Although a very promising medical science, medicine In fact, it is not possible to apply to all cancers individually.Some new methods are only in the clinical trial stage and have not yet been included in standard treatment guidelines. and their tumors can be time consuming and expensive, and usually won't be covered by insurance.In addition, some individual medical therapies, such as Targeting methods can be very expensive. Personalized medicine is a new approach to cancer treatment. Scientists still don't fully understand the genetic changes that occur in cancer cells. They also don't know the exact mechanism of action of these treatments. Therefore, in case there is a need to use personalized regenerative medicine, patients need to choose the right treatment place to ensure the right expertise as well as discuss with the doctor before proceeding with the application.
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References: advancethescience.mayo.edu, sciencedirect.com