未来医学的演变- WE医学-满足未满足的医疗需求

Yung‐chi Cheng, Peikwen Cheng, Shwu-Huey Liu, W. Lam, Fulan Guan, Rong Hu, William Cheng
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摘要

目前,许多制药和生物技术公司主要侧重于疾病的治疗而不是预防,除了开发针对传染性病原体的疫苗作为预防措施。开发小分子药物在很大程度上仍然采用一种简化的方法,专注于一个特定的目标,并针对它开发选择性和强效的化学物质。知识和现代技术的进步促进了还原论的方法,并导致了一些有趣的靶向药物的发现,取得了不同程度的成功,然而,这种方法对于治疗更复杂的、异质性的疾病并不令人满意,这些疾病通常与衰老过程有关。人们认识到,在大多数情况下,选择的靶点不仅对疾病的发病机制重要,而且对机体的正常功能也起着重要作用。由于长期使用强效化学物质,正常组织中的毒性往往会演变。此外,由于营养物质(包括氧气)的程度以及组织中细胞之间的相互作用,组织靶表型存在异质性。药物可能对细胞产生不同的影响,这取决于其目标表型或其他细胞成分。靶细胞对药物的反应可能不一样。这在癌组织中非常明显(图1)。
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The Evolution of Future Medicine - WE Medicine - To Meet Unmet Medical Needs
Currently many pharmaceutical and biotech companies are focusing primarily on the treatment versus the prevention of disease, with the exception of developing vaccines against infectious agents as preventative measurement. Developing small molecule medicines still largely applies a reductionist approach focused on a particular target and developing selective and potent chemicals aimed at it. The advancement of knowledge and modern technologies has facilitated the reductionist approach and led to the discovery of a few interesting targetoriented drugs with varying degrees of success, however this approach has not been satisfactory for the treatment of more complex, heterogeneous diseases which are often associated with the aging process [1]. It is recognized that the selected target in most cases is not only important for the pathogenesis of disease, but also plays an important role in the normal functions of the body. With highly potent chemicals used on long term basis, toxicity in normal tissues will often evolve. Furthermore, there is heterogeneity of the tissue target phenotype due to the degree of nutrients, including oxygen, and interaction among cells in the tissue [2]. Drugs could have a different impact on cells depending on its target phenotype or other cellular components. The response of targeted cells to drugs could `be different. This is clearly evident in cancer tissue (Figure 1).
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