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10 Medical Breakthroughs to Watch for in the Next 10 Years
Daniel Welch Medill News Service
Chicago Daily Herald
29 March 2006
From lasers to nanotechnology to stem cells, rapidly advancing technology is driving the medical breakthroughs that might one day save our lives.
In the last decade, scientists have mapped the human genome, begun to unlock the secrets of stem cells and made strides in battling diseases with treatments that were the stuff of science fiction not long ago.
What about the decade to come?
"The current state of medicine is too 'one-size-fits-all,' " said William Moffitt, chief executive officer of the Northbrook- based biotechnology company Nanosphere Inc. "The future of medicine is to treat diseases on an individualized level, to personalize the treatment," Moffitt said.
That's the sphere of nanotechnology, the science of engineering applications at the molecular level. "Nanotechnology will start from the other end of the spectrum, because if you want to treat a disease on the genetic or molecular level, you need tools that are small and precise enough to do that for you."
Here's a look at some of the breakthroughs that technology is poised to deliver in the not-so-distant future.
Cancer
Future cancer treatment will be geared at fighting smarter, not necessarily harder. Precisely targeting cancer cells and preventing them from growing will be less clumsy than traditional chemotherapy, in which normal cells are killed along with tumor cells.
The biotechnology firm Kereos, based in St. Louis, is developing a computer program using nanotechnology probes to diagnose and treat cancer. The company says its technology can detect tumors 1 to 2 millimeters in size - less than a tenth of an inch. Then the procedure delivers targeted treatment carrying 20 times the concentration of traditional chemotherapy, using only 1 percent of the standard dose overall.
The company plans to begin human clinical trials this year.
Starving the tumors by cutting off the blood and oxygen supplies they need to grow will also have a big impact in cancer treatment, scientists say.
Australian researchers recently announced a drug called PI-88 that showed early success in preventing tumor growth by cutting off its blood supply.
"There's great optimism for this area among a lot of people in the medical community," said Dr. Steven Rosen of Northwestern University's Feinberg School of Medicine. "The drugs have shown some success in animals, but the key is whether they'll work in humans."
Obesity
Exercise and diet remain the best way to lose weight. Unfortunately, it's not the easiest way for many people, which explains why a weight-loss pill that hasn't even received Food and Drug Administration approval is making such waves.
A study published in February by the Journal of the American Medical Association found that half of the patients who took Acomplia were able to lose 5 to 10 percent of their body weight - and keep it off. The study tracked patients for two years. Those who stopped taking the pill immediately gained the weight back, however, meaning people would have to stay on the medication.
The pill, which some experts expect will be approved within the next year, works by blocking food cravings. Drugmaker Sanofi- Aventis says Acomplia has only minimal side effects, in contrast to Xenical and Meridia, two weight-loss drugs currently on the market that can cause increased blood pressure or diarrhea.
Heart disease
Stem cells might help fend off heart attacks by stimulating the growth of new blood vessels around the heart.
The FDA recently approved a study to test this, which will be performed by a team of researchers in Cleveland. The scientists will take adult stem cells from the bone marrow of patients and inject them into their clogged arteries, hoping that new vessels will grow and increase the flow of blood to the heart.
The study will be performed by researchers at Case Western Reserve University School of Medicine. Deerfield-based Baxter International Inc. is initiating a clinical trial this month for a similar treatment.
"This is a cutting-edge idea," said John Solaro, a professor of physiology and biophysics at the University of Illinois at Chicago. "It's one of the more exciting arenas of activity for treatment, and it carries a low risk for the patient."
A similar treatment uses stem cells to replace damaged tissue after a heart attack but has had mixed results in a recent study in Germany.
Avian flu
Researchers at the University of Pittsburgh have engineered a promising vaccine for the deadly H5N1 virus.
Unlike other vaccines being tested to thwart the disease, the Pittsburgh vaccine is thought to create a stronger immunity because it's made from a live virus. It also can be made quickly.
The vaccine, expected to begin testing in humans in the next six months, protected all mice and chicken exposed to the virus that has killed an estimated 150 million birds and almost 100 people. It also could prove useful in vaccinating U.S. livestock to curtail spread of the virus.
Meanwhile, scientists around the world are trying to determine if the avian flu virus will be transmitted from person to person, which could lead to a pandemic. Some prominent researchers say the H5 family of viruses might be incapable of human-to-human transmission. But public health officials aren't taking any chances and are asking pharmaceutical companies to ramp up the production of flu drugs that might help combat the virus.
Mental health
To know if we're susceptible to depression, soon we'll have to look no further than our genes. In a study published in the British Journal of Psychiatry, researchers found that people who carry a particular gene - a short version of a serotonin transporter gene - are more likely to suffer depression.
"It doesn't mean that if you have this gene, you will be depressed," said Dr. Pedro Dago, a psychiatry professor at Northwestern's Feinberg Medical School. "But this measures the vulnerability to depression, and the sensitivity to stress."
Some experts think knowing that someone is susceptible to depression might help with early diagnosis and improved treatment.
"Down the line this may have an impact on prevention with psychotherapy, or to encourage people to seek help sooner," Dago said.
Alzheimer's disease
Two Chicago science companies are working together to design a test for the early detection of Alzheimer's disease, which could open the door to more effective treatment.
To date, Alzheimer's can only be definitively diagnosed by studying the patient's brain after death.
An early diagnosis of Alzheimer's means there's a better chance to see if the disease can be treated with experimental therapies.
Researchers at Applied NeuroSolutions Inc. in Vernon Hills found a protein called p-tau that they say is linked to the disease. Nanosphere Inc. scientists designed a test to isolate the protein.
Nanosphere's president, William Moffitt, said he hopes the collaboration will lead to a "sensitive and specific test" to identify the disease.
Paralysis
Using controversial embryonic stem cell technology, a California scientist has given paralyzed rats the ability to walk again.
Recently featured on 60 Minutes, Dr. Hans Keirstad said "truly remarkable" results can be achieved if the same technique works on humans.
In his experiment, the stem cells wrapped themselves around the damaged area of the rats' spinal cords, reconnecting neural pathways to enable brain signals to travel throughout their bodies.
The breakthrough is one of the latest applications using embryonic stem cells, a controversial technology that has been restricted by a Bush administration-backed funding ban because the process involves destroying human embryos.
Keirstad is waiting for FDA approval to begin tests with human patients.
Laser technology
Scientists have developed lasers sharp enough to cut diamonds and precise enough to be used in detailed surgical procedures. Researchers have aimed lasers at cancer, destroying tumors by cutting them away from body tissue or by directing extreme heat at them.
Lasers will also help our ability to diagnose disease, said Dr. Rox Anderson, a professor of dermatology at Harvard Medical School.
Anderson predicted that some imaging that requires an MRI machine today will soon be done at the bedside, using laser-based techniques.
The techniques can pinpoint trouble spots with precision at a microscopic level.
In terms of diagnostics advances, "this is a really big deal," Anderson said.
Pregnancy screening
The most accurate way to screen for a problem pregnancy might be to make a "protein profile" of the mother's amniotic fluid. Researchers at Yale University found that certain protein markers present in the fluid could point to a premature delivery or dangerous infection.
It's crucial to detect signs of inflammation or infection in the amniotic fluid because these conditions could lead to the death of the fetus or other serious problems, including brain damage.
The researchers said the results could be available in just 30 minutes, saving crucial time in emergencies.
"For these women, knowing their risk and managing it may lead to dramatic improvement in the health of their babies," said Dr. Nancy Green, medical director of the March of Dimes, which earlier this year recognized the researchers with its annual award.
Public health
The life expectancy for Americans is 78 years and it continues to climb. Yet skyrocketing obesity rates will have profound effects on health problems, such as heart disease, that require long-term treatment, experts say.
The national health-care system is bracing for the arrival of the baby boomers, a generation now becoming eligible for Social Security and Medicare.
Health care expenditures already account for 15 percent of the U.S. economy, compared to just 10 percent in 1987.
Meanwhile, the number of uninsured Americans continues to soar. Some 45 million people - almost one in six Americans - lack adequate coverage.
The Institute of Medicine, a private organization affiliated with the National Academy of Sciences, estimates more than 18,000 people die unnecessarily each year because they lack health coverage.
The solution to this health problem, however, will be debated by politicians, not just by doctors.
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