Advances in precision medicine in 2021 involved more than just genetics: a year in review
While there were many exciting advances in precision medicine in 2021, some of the most important developments that hospital leaders should be aware of include advances in personalized medicine that went beyond simple genomics. From research into chronobiomes, to proteomics, to cell states, many advances over the past year have developed precision medicine beyond genetic-specific approaches.
The term “chronobiome” is relatively new, only existing since 2017. While it is well known in medical science that everyone has a cyclical biological rhythm, called a circadian rhythm, the chronobiome takes this knowledge a step further and describes the concepts of personalized circadian rhythms. See Hospital Administrators Will Need to Understand How the Chronobiome Could Impact Precision Medicine.
Personalized chronobiome approaches have the potential to impact precision medicine treatments because they are designed from how individuals respond to treatments based on the time of day they are administered. While genetics impact the chronobiome, research shows that multiple other factors also play a role in chronobiome variations.
Chronobiome research is still quite nascent. However, it took a significant step forward in 2021 with advances in chronobiome testing. In one effort led by Christopher Depner, PhD, researchers at Colorado University (CU) Boulder found that the rather laborious process of drawing multiple blood levels throughout a period of time could be replaced by a single blood test to characterize an individual’s chronobiome. See New Research Reveals Potential Precision Medicine Blood Test for Determining an Individual’s Chronobiome.
“If we can understand each individual person’s circadian clock, we can potentially prescribe the optimal time of day for them to be eating or exercising or taking medication. From a personalized medicine perspective, it could be groundbreaking,” Depner said at the time.
Another important advancement Precision Medicine Institute notes from 2021 is progress in the field of proteomics. Like the genome describes the genetic makeup of an individual, the proteome describes the makeup of the proteins of an individual.
While the proteome and the genome are closely related, there are some differences in how each can be used for research and how each can be applied in clinical settings. Another distinction to remember is that unlike genomes, which do not change, proteomes change constantly. That is one of the main reasons why studying the human salivary proteome could lead to valuable diagnostic tools.
To this end, research in proteomics was meaningfully advanced in May 2021 with launch of a landmark public platform for cataloging and curating proteins found in saliva. The Human Salivary Proteome Wiki was designed to provide a public database that can be used to recognize differences in individuals’ salivary proteins, and develop individualized treatments based on their unique salivary profiles. See New Saliva Protein Database Pairs With Human Disease Studies to Advance Precision Medicine Possibilities.
“This community-based data and knowledge base will pave the way to harness the full potential of the salivary proteome for diagnosis, risk prediction, and therapy for oral and systemic diseases, and increase preparedness for future emerging diseases and pandemics,” stated the study’s lead investigator Stefan Ruhl, DDS, PhD, at the time.
Notable in the field of proteomics must also include the 2021 announcement of Google-associated AI network, DeepMind. This move has been described as the successful development of a predictive algorithm that accurately predicts the 3D structure of proteins based solely on their underlying genetic sequences. See Precision Medicine Research Advances as AI Technology Provides Researchers With Accurate Representation of the Human Proteome. Additionally, this proteomic discovery is already being used to discover new medications and treatments.
As 2021 drew to a close, researchers made another significant discovery affecting precision medicine. While precision medicine typically relies heavily on genetic differences between individuals, Harvard and MIT researchers took personalized treatment a step further.
When studying precision medicine treatments for pancreatic cancer, the Harvard and MIT researchers found that cancer cells existed in different states, in which different sets of genes are expressed. The discovery impacts how cancer cells with the same underlying genes will respond to treatment. It also indicates that different treatments could be necessary for the same cells based on their specific states.
“There are plenty of situations where the genetics are incredibly important, where you can develop these very precise drugs that target mutations or translocations,” said Andrew Navia, an MIT Chemistry PhD candidate and co-lead author of the pancreatic cancer study. “But in many instances mutations alone don’t give you an effective way to target cancer cells relative to healthy ones.”
Differing cell states also impact precision medicine research, as individual-specific cancer cells grown outside of the body were shown to be in a different cell state than the cancer cells actually living inside the individuals being tested. Growing 3D cancer cultures, called organoids, from cancer cells belonging to a specific individual is an increasingly popular method of precision medicine research. Finding variations in cells’ states for cancer organoids has the potential to significantly impact how research in this area is performed in 2022 and beyond.
As we enter the new year, innovative hospital leaders following precision medicine developments will benefit from understanding how precision medicine is developing in areas beyond genetics and how these new breakthroughs will ultimately affect the patients they serve.