2005.
Awaiting revision 2008
MEDICINE IN THE NEXT 100 YEARS
APPLYING
LEECHES TO THE SKIN TO SUCK BLOOD, now considered
perverse and archaic, was once a common medical practice.
In a hundred years' time, many contemporary medical practices will
be looked on in a similar light.
Two such abuses, for example, are the dangerous overuse of
antibiotics; and the removal of healthy appendices 'just in case'
of a later inflammation - a common contemporary practice.
We will be looked back on as rather quaint to permit doctors to
foist such 'cures' on us.
Of course, practices such as these seem quite usual today. And as
for leeches - I expect that having a leech doctor was the height of
chic in the 18th century Western world. The poor must have looked
on and thought, 'If only we could afford leeches...'.
So - open your mind - cast your prejudices to the wind... while I
touch on some of the exciting medical discoveries now being made.
They will revolutionise your view of healthcare over the coming
decades.
Some of the questions I will answer over the next few issues of the
HealthZine, are:
Will there soon be a cure for cancer or Alzheimer's disease?
The answer may surprise you.
Will old age become just another symptom to be treated?
Will the promised advances simply turn out to be another "band aid"
in the way that drug medicine is?
Are scientists simply uncovering sinister dangers for the
human race?
Should we use the scientific secrets we discover? Or should we
try to stop some of them becoming public knowledge? We will
certainly have the ability to replace more broken body parts - with
bits of animals or tissue 'grown' in scientific labs; and, yes, we
will be able to replace unwanted genes. But what should we do with
this information?
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WILL OUR
DISCOVERIES give us more
free choice about our health
OR are we inevitably destined for a
FRANKENSTEIN
FUTURE? | |
MODIFYING DNA
First, let's look at DNA, which is
where much of the exciting research of the moment is being
done.
WHAT IS DNA?
De-oxy-ribo-Nucleic Acid. It is the key to
reproduction. Without it - there would be no children. (Stop that
cheering!)
WHAT DOES IT DO?
Following egg fertilisation, DNA splits
in half, and then uses raw materials within the cell (nucleic
acids, actually) to re-complete itself. And there you have - as if
by magic - a new strand of DNA in a cell. The cell divides in two
again and again, duplicating the new DNA in each cell. Eventually,
a new individual is formed.
WHAT ARE GENES? AND HOW ABOUT CHROMOSOMES?
About 3% of
the DNA tissue comprises the genes. These are located on pairs of
chromosomes - 23 pairs in the human being. The genes provide the
blueprint of the human body, deciding such things as colour of
eyes, type of skin, height, and also the likelihood of our
developing certain diseases. About 5,000 diseases can be inherited
through the genes.
There are around 100,000 genes in a human being. This is
repeated in every cell of the body. Each gene consists of long
chains of BASE PAIRS of four kinds of nucleic acids called, for
short, A, C, T and G. Think of it as a long, thin jigsaw of 4
interlocking pieces, repeated over and over in differing orders.
The precise order decides the genetic make-up of a person. If we
can learn the order of nucleic acids, and what the nucleic acids in
a particular position relate to, we can understand the genetic
code.
Are you following this?
TO SUMMARISE
- BASE PAIRS, each one containing two of the four
nucleic acids (labelled A, C, T and G - remember?) make up a
type of 'jigsaw' which is called a GENE. These are of various
lengths, depending how complex the function is that a
particular gene controls.
- Each GENE is located on one of 46 CHROMOSOMES
arranged as 23 pairs, which appear in every single cell
of
the body;
- The CHROMOSOMES make up 3% of the DNA - albeit a
very important 3%. The other 97% is little understood at
present, but it obviously has a lot to do with co-ordinating
the activity of the
genes.
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Think of the DNA as a huge zip, or zipper. Imagin it twisted along
its length, and this is the shape of our DNA.
ONE OF MY PROOF READERS has had to wander off for a stiff drink
after reading the previous 'simple' summary - and I think he's
taking the rest of the day off... so if I have gone too fast for
you - I'm sorry. Rest assured you're not alone!
Just remember... Base Pairs .. Genes .. Chromosomes .. DNA.
See?
Simple!
I think I'd better lighten up a bit with some...
FACTS AND FIGURES
Here are the number of BASE PAIRS in
various organisms:
- E coli bacterium - 5 million base pairs
- Fruit fly - 180 million
- Tomato - 700 million
- Human being - wait for it - 3,000 million base
pairs
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And here are the number of genes - out of the total of 100,000
-
which define and regulate some of the major parts of the human
body:
- Brain - 3,195
- Liver - 2,091
- Lung - 1,887
- Placenta -1,290
- Bone - 904
- Colon - 879
- Kidney - 712
- Skin - 620
- Eye -
547
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Each of these genes govern a particular function of the part of the
body in question. For example, a specific gene in the Lung or Liver
may give a tendency to develop cancer of that organ. Gene therapy
is about replacing a gene which produces disease with one which
doesn't.
A MAJOR PIECE OF THE PUZZLE - THE MAP OF THE
HUMAN GENOME
With a total of 3,000 million base pairs,
it would be a big help to have a map of all of the genes,
showing exactly which gene on which chromosome
controlled which function of a part of the body.
Creating this map was the aim of the US Government-sponsored
Human Genome Project.
THE HUMAN GENOME PROJECT
The American government decided
to fund a project to identify and label every gene in the
human genome. (The 'genome' is the collective name for all the
genes of an organism. As mentioned previously, this is the same in
every cell in the body of that organism.)
Supported by some UK researchers, the US proposed to complete this
huge task over fifteen years.
POLITICS REARS ITS UGLY HEAD!
Francis Collins - head of
the Project once said: "There is only one Human Genome
Project..." Wrong!
'Gene hunter' Craig Venter thought he could cut the time taken to
map the human genome in half. His approach used a 'shotgun' method
of splattering the DNA to pieces, and mapping it as part of the
re-assembly process. This was too messy for the government people.
They said their method was superior. (So was the Beta max video
format...)
So Venter got together with Tony White of the company Celera, who
was as committed as Venter to sequencing the genome.
Automatic sequencing machines ran day and night analysing DNA.
Celera's electricity bill was around $1m a year!
US GOVERNMENT EAT YOUR HEART OUT
Venter - a great
self-publicist - was able to boast that the job would be finished
in 3 years - and at a tenth of the cost of the government
effort.
Maybe it wouldn't be so thorough an approach - but Venter would
iron out the errors in his findings by repeating it several times,
and cross checking.
WHOOPS!
The government suddenly had second thoughts
themselves - and decided they could speed up considerably. Not
enough to beat Celera though - who crossed the finishing line in
April 2000. They had sequenced the entire human genome several
months earlier than even their own estimates.
LINKS
Celera:
www.celera.com/celerascience/index.cfm
Human Genome News - official newsletter of the Human Genome
Project
www.ornl.gov/hgmis/publicat/hgn/hgn.html
A LOT OF WORK REMAINS
A mammoth task has been completed -
but that is just the beginning.
Now the hard work starts; making sense of the data, and
extracting more.
Researchers can start to look more carefully at which genes are
involved in diseases, which proteins those genes create, and what
each of the proteins do.
And there is still the job of identifying the role of the other 97%
of the DNA - the bit apart from the genes. Celera themselves say:
'Nothing will be absolutely understood anytime in this (21st)
century.' But the basics are there.
Whose method was better - the US government, or Venter/Celera? Hard
to say - but one thing is certain - Venter sped up the whole
process by between five and ten years.
FRANKENSTEIN LIVES?
The big question is: where do you
draw the line between 'sensible
manipulation' of genes, or 'unacceptable meddling'?
Some people don't like the idea of messing around with genes. But
if you - or your child - had a 50% chance of
developing a killer disease, and you had the opportunity of
changing a gene which would avoid the disease - would you take
it?
If the chances of side-effects were slim, you probably would -
unless you had contrary religious or moral beliefs.
HOW SOON WILL THERE BE EASY ACCESS TO GENE THERAPY?
This
type of choice will definitely be available to you in the fairly
near future - in the next 10-20 years. Not for everything - but the
therapy will cease to be a novelty.
HAS ANYONE HAD IT YET?
In fact, genes have already been
swapped over in humans.
Was it successful?
We've run out of space - but we'll tell you next issue!
NEXT MONTH:
- THE SUCCESSES AND FAILURES OF GENE THERAPY TO
DATE
- KNOW YOUR OWN GENETIC CODE - FOR A FEW POUNDS (or
dollars!)
- WHAT WILL YOU DO WITH THAT CODE?
- A CURE FOR SCHIZOPHRENIA, DIABETES, CANCER AND HIGH
BLOOD PRESSURE?
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______________________
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