The term translational medicine was coined in the 1990s, but it was not widely used until the early 2000’s. Transitional medical research arose out of the concept of “from the laboratory to the patient’s bed”And the As a type of medical research that sought to remove barriers between the laboratory And clinical research.
German Quintana, Doctor of Veterinary Medicine, MSc in Behavioral Medicine and Animal Welfare and MSc in Genomics and Genomics, Biology Beatrice AguiarThe MSc in Clinical Genetics and Assisted Reproduction, has published an article for GRETCA (AVEPA Clinical Ethology Specialty Group) explaining the applications of this approach in the veterinary clinic.
The authors define translational medicine as A rapidly advancing discipline in biomedical research that aims to accelerate the discovery of new diagnostic tools And new therapies using a highly multidisciplinary collaborative approach.
Thus, translational medicine translates the latest discoveries at the laboratory level into clinical studies, and tries to answer questions through the use of various laboratory techniques. “It is intended to improve forecastingAnd the blockAnd the Diagnose and treat diseases. In other words, translational medicine transforms the basic achievements of research into practical and technical theory and methods for reconciling laboratory and clinical practice, “they point out.
Translational medicine is a two-way flow concept, thus, it will enhance the flow of information from lab to clinic, and in the same way, it needs to be promoted from clinic to lab.
Experts comment that translational medicine’s ultimate goal is to help patients by allowing new diagnostic methods to be developedSpeculation and gaining new knowledge are useful in treating diseases. In this way, both people and animals can receive health care of the highest standard at an affordable cost.
“Knowledge of the various basic biological aspects that affect health and disease is still insufficient.. For this reason, current results cannot yet be fully and reliably translated into new, more effective preventive methods and treatments. ”The goals of transformational medicine can only be achieved through continuous investment and advancement in fundamental discoveries in biomedicine and behavioral along with effective translational science.
Precision Personalized Medicine or MPP
The risks of suffering from disease and the way the patient responds to drug treatments It is conditioned by both the genes and the environment the patient is exposed to. This environment is the result of environment and lifestyle. In the text, they indicate that Integration of genomic and other scientific data with the patient’s clinical data set and environmentAnd the It makes it possible to adapt clinical practice to the individual characteristics of each patientAnd the In what is called MPP.
PPM is an essential tool for applying criteria for dividing a population, making it possible to adapt preventive, diagnostic and treatment strategies to patient characteristics. So it is assumed that Prof. A powerful tool for improving treatment choiceAnd the Avoid unnecessary side effects and rationalize healthcare spending. This is achieved by segmenting treatment measures based on different variables (age, gender, ethnicity, other diseases, genetic markers, etc.), they comment.
Biomarkers in diagnosing disease
The continuous and recent discoveries that have been made in recent years in the field of molecular biology and genetics, Thanks to the use of huge sequencing platformsAnd the It has enabled unprecedented advances in biomedical research.
to text He concluded that thanks to this, the knowledge of the molecular and genetic basis of various diseases was greatly expanded and made possible Identification of a large number of biomarkers that allow the creation of more accurate and precise patient protocolsAnd the Improve both diagnosisDiagnosis as treatment.
Quintana and Aguiar stated that the introduction of these new analysis techniques, as well as the processing of associated data, pose A paradigm shift in research and models of careAnd the Enabling the development of new approaches in multiple diseases. However, the general application of approaches that have demonstrated efficacy, efficacy, safety and cost-effectiveness, pose important challenges in clinical practice.
OMIC Science, Present of Veterinary Medicine
Development of high-throughput omics technologies, such as genome sequencing and whole exome sequencing, along with advances in other omics technologies, such as ProteinsAnd the MetabolismAnd the PharmacogenomicaAnd the epigenómicaAnd the Transcriptology or MicrobiologyAnd the And the possibility of integrating this information with the patient’s clinical data, Accelerating the effective incorporation of PPM into clinical practice.
Although there have been many publications in the field of omics in veterinary medicine, the authors assert that these constitute isolated studies without generalized clinical application at present outside the scope of research or the academic field.
“ In the past 20 years, 129 articles have been published dealing with personalized precision medicine in veterinary medicine and many more regarding diseases or diagnostic techniques related to PPM. 108 has been published in the past five years, which shows that PPM is not the future of veterinary medicine but the immediate present“.
Psychiatry and Precision Clinical Ethics
PPM in areas of knowledge such as oncology has yielded important results in recent years andToday, it is really important to know the genetic lineage of tumors more than their locationIn contrast, in psychiatry, diagnoses still meet subjective criteria and trial-and-error prescription continues to be executed.
“Knowledge of the aetiology of mental illness continues, although remarkable progress has been made, from “top to bottom”, Rather than “bottom-up,” which is generally known as “starting home from the roof.” “Most psychiatric drugs currently available are not the result of discovering the pathophysiological basis of mental disorders, but rather the result of careful but fortunate clinical observations,” they say. From how it works we concluded that there is something wrong in the brain with dopamine, serotonin or glutamate“.
In the opinion of the authors, Precision PsychiatryAnd the Hence the exact science of clinical behavior is here to stay, Even though they are still in the embryonic stage; Soon the rhetoric will become clear and articulate, and it will not be possible to act to deny the biological basis of mental illness.
Although the aim is to achieve personalized medicine, it will be possible at first to divide the population into strata without reaching individual overdefinition, but it will allow the identification of subgroups within the diagnostic categories. “It happened in oncologyAnd the It occurs in neuroscience (only 10 years ago the diagnosis of multiple sclerosis was exclusively clinical) It will happen in the field of mental illness. “
Drug development based on biomarkers
In clinical psychiatry and behavioral science, there is a series of ideological and economic barriers that determine the development of these disciplines. The stigma of mental illness will last for a long time, But evidence on the biological basis of mental illness and reducing costs for biomarkers and mass sequencing techniques will open the door to PPM In both disciplines, in addition to neuroimaging techniques (CT and MRI), they made their way in the past decade in veterinary medicine, to routinely use the techniques today.
On the other hand, as a transversal advancement in all medical specialties, pharmacogenetics enables tests to improve the prediction of tolerance and response to different therapies. “Using therapies that focus on controlling symptoms will be a thing of the past The industry is already accepting that to discover new molecules with real added value, it will be necessary to rely on PPMTherefore, many drugs already have information on their efficacy and tolerability in patients with specific biological markers. ” Although it is true today that the sensitivity and specificity of biomarkers are available (geneticAnd the BiochemicalsAnd the Electrophysiology, imaging, or simply clinical) not sufficient, more and more information is available.
In conclusion, at the moment, “we are seeing real emergence of small entrepreneurs (startups)” Investigate methods to validate the diagnosis and predict best treatment for mentally ill peopleAnd the Also in veterinary medicine“, is over.