فهرست مطالب

Acta Medica Iranica - Volume:55 Issue: 3, 2017
  • Volume:55 Issue: 3, 2017
  • تاریخ انتشار: 1396/01/06
  • تعداد عناوین: 8
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  • Babak Arjmand, Bagher Larijani Pages 142-143
  • Babak Arjmand, Parisa Goodarzi, Fereshteh Mohamadi Jahani, Khadijeh Falahzadeh, Bagher Larijani Pages 144-149
    Personalized medicine as a novel field of medicine refers to the prescription of specific therapeutics procedure for an individual. This approach has established based on pharmacogenetic and pharmacogenomic information and data. The terms precision and personalized medicines are sometimes applied interchangeably. However, there has been a shift from “personalized medicine” towards “precision medicine”. Although personalized medicine emerged from pharmacogenetics, nowadays it covers many fields of healthcare. Accordingly, regenerative medicine and cellular therapy as the new fields of medicine use cell-based products in order to develop personalized treatments. Different sources of stem cells including mesenchymal stem cells, embryonic stem cells and induced pluripotent stem cells (iPSCs) have been considered in targeted therapies which could give many advantages. iPSCs as the novel and individual pluripotent stem cells have been introduced as the appropriate candidates for personalized cell therapies. Cellular therapies can provide a personalized approach. Because of person-to-person and population differences in the result of stem cell therapy, individualized cellular therapy must be adjusted according to the patient specific profile, in order to achieve best therapeutic results and outcomes. Several factors should be considered to achieve personalized stem cells therapy such as, recipient factors, donor factors, and the overall body environment in which the stem cells could be active and functional. In addition to these factors, the source of stem cells must be carefully chosen based on functional and physical criteria that lead to optimal outcomes.
    Keywords: Personalized medicine, Precision medicine, Stem cell therapy, Induced pluripotent stem cells, Regenerative medicine
  • Somayeh Mirsadeghi, Bagher Larijani Pages 150-165
    Personalized medicine aims is to supply the proper drug to the proper patient within the right dose. Pharmacogenomics (PGx) is to recognize genetic variants that may influence drug efficacy and toxicity. All things considered, the fields cover a wide area, including basic drug discovery researches, the genetic origin of pharmacokinetics and pharmacodynamics, novel drug improvement, patient genetic assessment and clinical patient administration. At last, the objective of Pharmacogenomics is to anticipate a patient’s genetic response to a particular drug as a way of presenting the best possible medical treatment. By predicting the drug response of an individual, it will be possible to increase the success of therapies and decrease the incidence of adverse side effect.
    Keywords: Personalized medicine, Pharmacogenetics, Drug discovery, Drug safety
  • Hamid Reza Aghaei Meybodi, Mandana Hasanzad, Bagher Larijani Pages 166-174
    Type 2 diabetes mellitus (T2DM) is recognized as a public health problem and increasingly prevalent illness. Key elements of the guideline for diabetes care are based on evidence-based medicine approach and apply for population, not individuals. However, individualized care can improve diabetes management. Personalized medicine is otherwise called precision medicine tries to find better prediction, prevention, and intervention for T2DM individuals. Precision medicine in diabetes refers to the utility of genomics data of a patient with diabetes to provide the most effective diagnosis strategies and treatment plans. Over 100 genetic loci influence susceptibility to T2DM. Genomics data together with the potential of other “Omics” and clinical evidence-based data will lead to diabetes care improvement in the context of personalized medicine in the near future. Breakthrough of technologies enables much greater improvements in the understanding of individual variations that may alter the T2DM outcome. This article represents a comprehensive review of current knowledge on the impact of personalized medicine in T2DM.
    Keywords: Type 2 diabetes mellitus_Personalized medicine_Omics_Diabetes care
  • Fatemeh Khatami, Hamid Reza Aghayan, Maryam Sanaei, Ramin Heshmat, Seyed Mohammad Tavangar, Bagher Larijani Pages 175-193
    Circulating tumor cells (CTCs) recognition and characterization in the peripheral blood of patients with breast cancer have proven practical and predictive value in different studies. However, the clinical significance of CTCs enumeration and molecular characterization in thepersonalization of breast cancer diagnosis and treatment remains under the debate. A literature search in PubMed, Web of Science and Scopus was performed from October 1990 to June 2016 for studies which evaluating CTCs and its association with clinical and pathological characteristics and medical outcome in the field of breast cancer personalization for both diagnosis and treatment categories. The treatment outcomes were progression-free survival (PFS) and overall survival (OS) or relapse in different patients. Sixty-nine studies met the inclusion criteria. The sample size varies from 1 to 2026. Median follow-up was 15 months (range 3-27). Different molecular techniques have been applied toresearch, but they mostly are based on CTCs enrichment and then detection by using FDA-approved Cell SearchTM. By far the most studies define CTCs as cytokeratins (CK) positive and CD45 negative cells. Despite the differences in methodology, twenty-eight studies for breast cancer diagnosis and prognosis were mainly focused on CTCs isolation and enumeration.Forty-threeresearches were about CTCs count and exact molecular characterization. In the way of precision treatment, CTCs detection before starting the first-line of therapy or during therapy in breast cancer patients is extremely valuable, but in the way of precision medicine it should be supported with some molecular characteristics of CTCs like CTCs phenotypic changes, gene expression analysis of CTCs and molecular characteristics of CTCs.
    Keywords: Circulating tumor cells, Breast cancer, Personalized medicine
  • Ali Hosseini Bereshneh, Fatemeh Morshedi, Mahsa Hematyar, Arastoo Kaki, Masoud Garshasbi Pages 194-199
    Pancreatic cancer (PC) is a progressive, fatal disease with a high degree of malignancy. More than 40000 peoplediefrom this cancer annually in the United States. As a multifactorial condition, PC has a complex nature, and there are several genes and signalingpathwaysimplicated in PC pathogenesis and progression. There are diffèrent mutations in master genesincludingtumorsuppressors and oncogenesthat lead to Pancreaticintraepithelialneoplasia (PanIN) whichis the mostcommon non-invasive precursorlesion of pancreatic cancer. These mutations influence directly or indirectly the cycle of Pharmacodynamics profile. Interactions between genetics and drug metabolism could be considered as one of the most important insights in the personalized medicine and targeted therapy based on the genetic profile of each affected person. In this literature, we will discuss pathogenesis and susceptibility to PC, pharmacogenetics and personalized medicine in pancreatic cancer and scrutinized the most important genes, variations and signaling pathways that influence individualized therapy of PC.
    Keywords: Pancreatic cancer, Pharmacogenetics, Personalized medicine
  • Hilda Samimi, Parviz Fallah, Alireza Naderi Sohi, Rezvan Tavakoli, Mahmood Naderi, Masoud Soleimani, Bagher Larijani, Vahid Haghpanah Pages 200-208
    Personalized medicine is a set of diagnostic, prognostic and therapeutic approaches in which medical interventions are carried out based on individual patient characteristics. As life expectancy increases in developed and developing countries, the incidence of diseases such as cancer goes up among people in the community. Cancer is a disease that the response to treatment varies from one person to another and also it is costly for individuals, families, and society. Among thyroid cancers, anaplastic thyroid carcinoma (ATC) is the most aggressive, lethal and unresponsive form of the disease. Unfortunately, current drugs are not targetable, and therefore they have restricted role in ATC treatment. Consequently, mortality of this cancer, despite advances in the field of diagnosis and treatment, is one of the most important challenges in medicine. Cellular, molecular and genetic evidences play an important role in finding more effective diagnostic and therapeutic approaches. Review of these evidences confirms the application of personalized medicine in cancer treatment including ATC. A growing body of evidence has elucidated that cellular and molecular mechanisms of cancer would pave the way for defining new biomarkers for targeted therapy, taking into account individual differences. It should be noted that this approach requires further progress in the fields of basic sciences, pharmacogenetics and drug design. An overview of the most important aspects in individualized anaplastic thyroid cancer treatment will be discussed in this review.
    Keywords: Precision medicine, Anaplastic thyroid cancer, Signal pathways, Pharmacogenetics, Therapy
  • Pooneh Salari, Bagher Larijani Pages 209-217
    More than a decade ago, personalized medicine was presented in modern medicine. Personalized medicine means that the right drug should be prescribed for the right patient based on genetic data. No doubt is developing medical sciences, and its shift into personalized medicine complicates ethical challenges more than before. In this review, we categorized all probable ethical considerations of personalized medicine in research and development and service provision. Based on our review, extensive changes in healthcare system including ethical changes are needed to overcome the ethical obstacles including knowledge gap and informed consent, privacy and confidentiality and availability of healthcare services. Furthermore social benefit versus science development and individual benefit should be balanced. Therefore guidelines and regulations should be compiled to represent the ethical framework; also ethical decision making should be day-to-day and individualized.
    Keywords: Ethics, Personalized medicine, Pharmacogenetics studies, Genetic data