The World entered the 21st century with expectations of continued progress in medical advances. The 20th century witnessed remarkable discoveries. Some argue that the progress has slowed down and others that medical advances progress is not slowing down.
For the past 17 years we have heard about extraordinary medical advances such as gene therapy, cloned replacement organs, stem cell therapy and tailored/precision medicine. The possibility that stem cells will one day be able to cure conditions such as spinal cord injury, Parkinson’s Disease, Multiple Sclerosis and many other conditions has given hope to many suffering from these conditions. However, none of these new treatments are routinely available at the current time.
We are living longer but not necessary healthier. Some argue that most recent advances in longevity are the result of getting people to give up smoking, eat better and exercise more rather than result of medical advances.
Some medical experts argue that there are too many controversial media stories inflating the hopes of millions patients, especially cancer patients. While research is progressing for those seeking cures the wait to deliver on the promise can be frustrating.
So, let us take a look back at some of emerging medical advances that could transfer healthcare in the coming year. Some of them could have significant implications for the Life Insurance industry.
Using the human gut Microbiome to prevent, diagnose and treat disease
The last Cleveland Clinic’s Medical Innovation Summit unveiled the list of top 10 medical innovations for 2017. The microbiome was listed number one in order of anticipated importance. This is an exciting new area of health research.
The microbiome has been a catchword for years because of its association with a number of diseases, from obesity to Crohn’s disease, diabetes, allergies, asthma, multiple sclerosis and even autism. Now researchers around the world are increasingly interested in the potential links between cancer and the microorganisms that call our body home – which would open up a host of new opportunities to understand and tackle the disease.
The term “microbiome” refers to trillions of bacteria (and viruses and fungi) making up communities in the human body. The human microbiome has an estimated 100 trillion microbes, the bulk of which live in our gut (99%). They have a greater complexity than the human genome itself. The European Metagenomics of the Human Intestinal Tract and the Human Microbiome Project, have reported 3.3 million unique protein-encoding genes as compared with the entire human genome, which has around 23 000 genes.
The human microbiome is sometimes considered our “forgotten organ” or “second genome”, weighing around 2 kg.
Yes, there are many bad microbes that make us sick, but there are also some that have a beneficial role that we would not be able to live without. What scientists have learned about them plays a role in preventing, diagnosing and treating disease, including the discovery that chemicals they emit influence how diseases progress and the way the body digests food and uses medicine.
The relationship between changes in microbiome composition and disease pathogenesis is still uncertain. The challenge is to identify whether microbial imbalance is related to disease, sometimes termed ‘dysbiosis’, and to be able to distinguish between cause and effect. However, there is an abundance of data suggesting treatments capable of reversing dysbiosis are effective in managing certain human diseases.
Many developed countries have initiated ambitious Governmental microbiome funding programs in the last five years. The USA, UK and Ireland, for example, have spent or announced $1.6 billion, £100 million and €50 million, respectively, for microbiome research and development programs. In May of last year, the White House launched the National Microbiome Initiative, which would invest $121 million from federal agencies, with another $400 million invested from outside sources, to accelerate the research, development, and the economic and health benefits of the microbiome.
Recent attention on cancer and the microbiome is coming from several directions. Firstly, from the research community – clearly demonstrated by the fact that between 2005 and 2015 the number of published articles on the topic increased by nearly 2,000 percent. The media have also leapt on the bandwagon, capturing the public’s imagination with reports of the potential for preventing and treating various diseases by targeting and ‘rebalancing’ our microbiomes.
It is not surprising, taking into consideration the long and intimate relationship between the (biotech and pharmaceutical) industry and the medical profession that the industry has seen the opportunity for the further growth. The microbiome industry is an evolving and rapidly developing field. There are no marketed microbiome based drugs currently on the market, but the first crop of drugs and diagnostics could launch by 2018.
There are already a new group of companies similar to “23andMe” starting to offer personal microbiome sequencing testing. Microba is among the first in Australia to bring the test to market.
Predictive value of “microbiome sequencing testing” could create a new challenge for the Life Insurance industry similar to predictive genetic testing. Beyond human DNA, scientists now investigate the DNA of micro-organisms inhabiting the human body. Recent work shows that an individual’s collection of microbial DNA consistently identifies that person and could be used to link a real-world identity to a sensitive attribute in a research dataset.
The current FSC Privacy and Genetic Testing Policies need to be reviewed from time to time to take into account new medical advances and technologies. They do not specifically cover issues in relation to the risk-rated life insurance and “microbiome sequencing studies”.
Increasing availability of “microbiome sequencing testing” and their predictive value also highlights the importance of continuing education and training in the Life Insurance industry.
Here are few more emerging medical advances:
• Alzheimer’s disease linked to low levels of memory protein
New research on Alzheimer’s, a disease that affects over 100,000 Australians, has linked the cognitive decline associated with Alzheimer’s to low levels of protein NPTX2. The discovery will lead to important research and may one day help experts develop new and better therapies for Alzheimer’s and other forms of cognitive decline.
• New game changing drug for treating Amyotrophic Lateral Sclerosis (ALS)
Motor Neurone Disease (MND) is the name given to a group closely related disorders affecting the nerve cells (neurons) controlling voluntary muscle movement. ALS, Progressive Muscular Atrophy (PMA), Progressive Bulbar Palsy (PBP) and Primary Lateral Sclerosis (PLS) are all subtypes of MND. There is considerable overlap between these clinical categories. ALS is the most common type and in the USA the name “ALS” is generally used to cover all subtypes of MND. But in Australia the term MND is more commonly used.
The U.S. Food and Drug Administration (FDA) approved a new drug for ALS for the first time in over 22 years. Radicava, also referred to as edaravone, is the second drug in treating ALS. The first drug for treatment of ALS is the riluzole that was approved by the FDA in 1995. The new drug may slow down the decline of function in ALS patients by around one-third.
The drug edaravone (Radicava) was developed by Mitsubishi Tanabe (MT) Pharma Corporation in Japan. Edaravone was originally marketed for use in stroke patients. Later, the company decided to test edaravone in people with ALS (MND).
Currently, edaravone is not available to Australians living with ALS (MND) in Australia. Mitsubishi Tanabe Japan is responsible for making an application to the Therapeutic Goods Administration (TGA) to approve edaravone for the treatment of MND in Australia. As yet no application has been made.
• A breath test for lung cancer
Scientist at the Max Planck Institute for Heart and Lung Research in Bad Nauheim were able to correctly diagnose lung cancer through the presence of traces of RNA molecules altered by cancer growth in a breath test. This could change the way we approach cancer diagnosis and help save lives through early diagnosis.
• The HIV virus was removed in animals
Scientists are finally closer to finding a permanent cure for HIV infection. According to a recently published study in Molecular Therapy, researchers at Temple University successfully removed the HIV-1 infection in mice through genetic modification. The strategy was up to 96% effective at removing the virus in mice, which had been modified to have human immune cells.
And the list goes on. I am, by nature, an optimistic person and I am more optimistic than ever about the future. Thanks to impressive technological advances, fast Internet and smartphones the pace of medical advances will continue and very soon we could live in a world where Alzheimer’s are treatable. 2017 and 2018 could be years in which medical advances experience a few huge leaps.
1. Cleveland Clinic – Top 10 for 2017
2. RACGP – The gut microbiome
3. The British Gut Project
4. Map my gut
5. Cancer Research UK – The microbiome and cancer: what’s all the fuss about?
6. The White House – FACT SHEET: Announcing the National Microbiome Initiative
8. ScienceDaily – Low levels of ‘memory protein’ linked to cognitive decline in Alzheimer’s disease
9. Science World Report – ALS Breakthrough: FDA Approves New Drug For ALS Treatment
10. Bioscience – Lung Cancer Diagnosis With a Breath Test
11. Medical News today – HIV breakthrough: Scientist remove virus in animals using gene editing
Dr Goran Lazic
AIA Medical Consultant