Personalised Medicine for Brain Disorders
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1
European Brain Council, Belgium
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2
Imperial College London, Centre for Neuropsychopharmacology, United Kingdom
Personalised medicine holds the promise for prediction, prevention and treatment of illness that is tailored to individuals’ needs. The vision is that the therapeutic paradigm will shift from ‘one-fits all’ and ‘trial-and-error’ prescription to a personalised concept of prevention and treatment targeted to the unique characteristics of an individual. In recent years, the advent of new technologies for detailed biological profiling of individuals at the molecular level have been crucial in opening the way toward personalised medicine and in many contexts, we have already started to move from treating diseases to treating individuals.
In the context of brain disorders, which comprise a variety of complex diseases of the nervous system, including psychiatric, neurological, and neurosurgical conditions, the availability of more detailed information, obtained from ‘omics’ data has offered the possibility of dissecting the genetic or epigenetic components of these disorders and opened the door to personalised medicine. For instance, in the area of neurological disorders such as Huntington’s disease, new interventions are being developed targeted to lower the levels of the abnormal huntingtin protein, which causes the disease. In the field of neuro-oncology, the identification of a number of mutations allows an elaborated genetic analysis of brain tumours and opens the door to individualised therapies. Finally, in psychiatry, new approaches are being developed to leverage genetic information to predict patients’ responses to treatment for psychiatric disorders.
Despite these exciting developments, the discipline is facing some formidable scientific, policy, and ethical challenges that need to be addressed in order to translate the scientific discoveries responsibly into clinical applications for the benefit of patients [1]. Personalised neuro-medicine, with its promise of better and more precise treatment for individuals, calls for increased support for curiosity-driven research into the mechanisms of normal brain functioning as well as challenging adaptations of health care and research infrastructures, encompassing legal frameworks for analysing large amounts of personal data, a flexible regulatory framework for correlating big data analyses in cooperative networks between academia and the drug development industry, and finally new strategies for brain banking in order to increase access to brain tissue samples.
Résumé en Français:
La médecine personnalisée, également appelée médecine de précision, a pour but d’améliorer la performance des soins, d’éviter des traitements inutiles et d’améliorer la qualité de vie des patients. La mise en place d’une telle médecine dépend de l’accès à des données de type génétique comme le séquencage du génome de chaque patient mais aussi de données sur l’environnement et le mode de vie.
En neuro-médecine, qui couvre un large spectre de maladies du système nerveux, incluant les maladies mentales, neurodégénératives et neurologiques, les progrès sont plus lents qu’en oncologie. Néanmoins, le challenge est relevé et l’espoir de voir de meilleurs traitements s’appliquer permettra d’affronter avec flexibilité les obstacles éthiques, ceux de la coopération entre le monde académique et industriel et le difficile passage de la recherche vers la clinique.
Samenvatting in het Nederlands:
Gepersonaliseerde geneeskunde, ook precisiegeneeskunde genoemd, heeft tot doel de zorg te verbeteren, onnodige behandelingen te vermijden en de levenskwaliteit van de patiënt ten goede te komen. Het invoeren van dergelijke geneeskunde is afhankelijk van het beschikbaar zijn van genetische informatie (het genoom van elke patiënt) maar ook gegevens uit de omgeving en betreffende de levensstijl. In de neurogeneeskunde, die een breed spectrum aan ziektes van het zenuwstelsel, inclusief geestelijke, neurodegeneratieve en neurologische ziektebeelden, verloopt deze evolutie trager dan bij de oncologie. De handschoen wordt echter opgenomen en het vooruitzicht betere behandeling te kunnen bieden moet ons in staat stellen op een flexibele manier de ethische bezwaren aan te pakken, evenals obstakels tot samenwerking tussen de academische wereld en de industrie uit de weg te ruimen om te komen tot een vlotte doorstroming van onderzoek naar klinische praktijk.
References
1. Esposito G, Burgunder JM, Dunlop J, Gorwood P, Inamdar A, Pfister SM, et al.: Gene-Tailored Treatments for Brain Disorders: Challenges and Opportunities. Public Health Genomics 2016;19:170–177.
Keywords:
Brain Disorders,
neuro-medicine,
individualized therapy,
Brain banking,
Genetic Markers
Conference:
6th Belgian Brain Congress, MONS, Belgium, 8 Oct - 8 Oct, 2016.
Presentation Type:
Poster Presentation
Topic:
Brain and brain diseases: between heredity and environment
Citation:
Esposito
G and
Nutt
D
(2016). Personalised Medicine for Brain Disorders.
Conference Abstract:
6th Belgian Brain Congress.
doi: 10.3389/conf.fnagi.2016.03.00072
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Received:
14 Jul 2016;
Published Online:
14 Jul 2016.
*
Correspondence:
PhD. Giovanni Esposito, European Brain Council, Brussels, 1000, Belgium, gies@braincouncil.eu