Title : Personalized and Precision Medicine (PPM): A unique healthcare model via pathology-related modelling and bi-odesign-inspired translational applications for the next gen-eration of human healthcare and biosafety
Abstract:
A principally new and upgraded systems approach to subclinical and/or diseased states and wellness resulted in a new trend in the healthcare services, is called as Personalized and Precision Medicine (PPM. PPM has progressed into fields such as gene therapy and surgical treatment/design. The targeted gene-based therapies today represent an important stake for the clinical community, patients, persons-at-risk and biopharma, in terms of market access, of return on investment and of image among the prescribers.
Meanwhile, most disease, including regeneration-related pathologies are consequences of cellular damage at differing levels. And the key to the mitigating cell and/or tissue damage repair needs cell therapy which, in turn, is becoming a promising treatment that can be tai-lored not only to an illness but also to an individual patient and even for a person-at-risk. So, simultaneously, regenerative medicine and cellular therapy use cell-rooted products in order to develop PPM-based treatments being based on different sources of stem cells (SCs) which are being used in targeted therapies whilst providing a personalized approach and could give many advantages as well, including a possibility for SC-based individualized therapy be ad-justed according to the patient-specific profile. Some strategic fields for SC applications as part of the micro-ecosystem!
Due to the latest results, regulatory network models of gene interactions have provided in-sights into the gene networks regulating pluripotency in embryonic and epiblast SCs, as well as cell-lineage determination in vivo. To facilitate this field and to promote more efficient development of novel therapies, biobanking of hiPSCs has bloomed with participation of several academic groups and commercial institutions which are typically funded in partner-ship with government entities. And improving the ability to generate? For instance, specific cardiac subtypes from hiPSCs will also enable more precise modeling of diseases that prefer-entially affect either the ventricles (e.g., dilated cardiomyopathy), or atria (e.g., atrial ar-rhythmias), in addition to opening new prospects for creating patient-specific bioengineered pacemakers.
The breakthrough development of iPSC technology is also spurring efforts to reprogram with-in the frame of the individualized micro-ecosystem one somatic cell type directly into anoth-er, whilst providing the research and clinical communities with a self-renewing and, thus, unlimited, source of pluripotent SCs for targeted differentiation, in principle, into the entire range of cell types found in the body. Therefore, iPSC technology and the increasingly refined abilities to differentiate in the micro-ecosystem iPSCs into disease-relevant mature cells has far reaching implications for understanding disease etiology and promoting drug discovery and other advances in PPM-based regenerative medicine.
Of particular interest are SC-based therapies to strengthen the heart muscle and treat is-chemic attacks and post-infarction conditions. The phenomenal achievement in this area is the identification of resident cardiac SCs (CSCs), supposed to be a crucial source to initiate and prompt myocardial self-renewal and regeneration but can be developed inside immature cardiac cells by formation of “cell-in-cell structures” (CICSs). The latter, in turn, being encap-sulated are involved into cardiac myogenesis and thus opening up a green light to secure the targeted management of post-infarction regeneration.
PPM incorporates genetic variability, lifestyle, and environmental factor to select or develop the most effective treatments (uniting preventive, prophylactic, therapeutic and rehabilita-tive types) for a patient. In this sense, SC-based therapy and drug discovery have lagged be-hind other fields such as oncology: cancer cells contain a subpopulation of SC-like or cancer SCs (CSC) which are thought to cause treatment resistance, recurrence, and metastasis. Thus, understanding and targeting CSC holds significant promise to advance PPM as a strate-gy to improve outcome of cancer patients. And thus CSCs represent the main target of the current efforts to eradicate cancer, because of their ability to promote metastatic dissemi-nation and survive cytotoxic therapies, including therapeutic strategies aiming at specifically targeting the CSC population, particularly focusing on cancer immunotherapy.
The micro-ecosystem and microenvironment as a whole play an active role in supporting tumor progression whilst securing the effective crosstalk between CSCs and the host immune system. The latter today is an object of intensive study, with the aim to develop effective therapeutic strategies targeting the ability of CSCs to escape immune-surveillance through immune-editing. So, PPM in oncology is centered on identifying which therapies are most effective for individual patients.
The transdisciplinary work could inform how best to achieve efficient and predictable SC mi-gration to sites of tissue damage, thereby facilitating tissue repair whilst securing individual-ized therapy with SC interventions across a broad scope of micro-ecosystems. The above-mentioned would illustrate a unique Micro-Ecosystem for SC treatment in the near future. This ecosystem would provide a unique platform for collaboration among thought leaders and stakeholders in government, academia, biopharma, foundations, disease and patient advocacy with an interest in improving the system of healthcare delivery on one hand and drug discovery, development, and translation, on the other one, whilst educating the policy community about issues where biomedical science and policy intersect.
