Ciechanover talks future of medicine

The idea that most medical schools across the nation will one day shut down because all diseases will be cured is entirely possible, said Nobel Laureate of Chemistry Dr. Aaron Ciechanover in his lecture to Tech faculty and students on Tuesday, Oct. 4.

“In only one single century, which is the 20th century, we expanded our lifespan by thirty more years,” Ciechanover said.  Before the 1900s, “it took 4000 years for people to extend their lifespan by only 20 or so years,” attributing the rise of human’s life span in this century to advances in medicine.

Ciechanover, who was awarded the Nobel Prize in Chemistry in 2004 for his discovery of how cells reduce unwanted proteins, went on to discuss the currently expanding life-span and the cure for malignant diseases, such as cancer.

“We are entering a personalized medicine revolution,” Ciechanover said, one that began in the 1930s with an era of incidental discoveries such as penicillin and aspirin, expanded to experimental methods of finding chemical cures in the 1960s, and is now localizing medicine to a personal level.

This personalized medicine revolution that began in the early 2000s will last until the four P’s are established: primarily the personalized medicine and the derived predictive medicine, preventive medicine and participatory medicine traits therein.

“Personalized medicine is medicine that will be directed to each and every one of us in person,” Ciechanover said. “The idea is that the severity and cause of each disease will be determined on each and every one of us individually.”

The current, “one-size-fits-all” type of medicine is much like a pajama, uniform and supposedly applicable to everyone. However, personalized medicine will be more like a tailored suit, “sitting right on the shoulders, button down, and look like it’s tailored for us.”

Until now, Ciechanover suggested, doctors had misdiagnosed all patients by grouping them under one pajama when each needed a tailored suit, meaning that individual patients responded differently to treatments because their diseases were molecularly different.

“We are going to profile patients initially based on their DNA,” Ciechanover said. He reasoned that the investment in the Human Genome Project, which was the sequencing of all the 13 billion combinations of bases in one human, could be lowered for individuals.

In other words, people in this era of personalized medicine will be able to sequence their DNA in one day for about $1000, as opposed to the seven years and $700 million it took for the Human Genome Project.

Plans are underway to understand DNA sequences, primarily through a comparative method in which 500 cancer patients will undergo a sequencing of their DNAs from both the cancer tissue and a nearby healthy tissue. Comparisons made between the two tissues,  reasoned Ciechanover, will show what genes cause the disease.

Bioethical problems, however, may arise from this solution.

“The issue of ethics is really going to blow up,” Ciechanover said during his speech. “Diseases are going to lose their definition. For now, a disease is something that inactivates us, a social definition. In the future, diseases will have more quantitative qualities.” IQ, obesity, and susceptibility to diseases will be known from DNA, and may become the “diseases” of the future.

The impact of this will be widespread, even affecting spouse selection between human beings.

“Before we marry, let’s have a CAT scan or MRI, or in the future, a DNA scan,” Ciechanover said, imitating a possible criteria for choosing a mate. “DNA will penetrate into our lives.”

“It was inspiring in some sense, but also brought to attention the problematic point he was trying to bring out,” said Sepura Dosetareh, a third-year BME major. “What I found interesting is that technology is coming to a point where it conflicts with philosophy and morality. How much do you prevent, when do you stop.”

Ciechanover referred to a Jewish adage to sum up the risks arising from finding this solution. “The one who increases his knowledge increases his troubles,” he said.

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