Tuesday, February 12, 2008

Personalised medicine

Genes determine the color of our eyes and shape of our bodies. Genes also determine our susceptibility to disease and how we respond to medicine.

Researchers believe that each person has about 35,000 genes. The complete set of genes together is known as the human genome, commonly referred to as "the instruction manual" for how the body works. Each gene carries instructions for making proteins, which direct the body's cells and functions.

Most cells have 46 chromosomes--23 from each parent. Chromosomes contain thousands of genes, which are made up of deoxyribonucleic acid (DNA), the chemical material that is inherited.

Genomics is the study of an individual's gene structure, including how the genes interact with each other and with the environment. Experts say genomics has the potential to revolutionize the practice of medicine. That revolution, called "personalized medicine," includes the use of genomic information to improve the diagnosis of disease, as well as the prevention and treatment of disease.

An example of a preventive approach is when a genetic test predicts which diseases an individual is likely to develop. For instance, people who have certain mutations in the BRCA1 gene have a high risk of developing breast, ovarian, and possibly prostate, and colon cancers, according to the National Cancer Institute (NCI). Alterations in the BRCA2 gene have been associated with breast, pancreatic, gallbladder, and stomach cancers. An example of a treatment approach is when a genetic test determines whether a person is among the 10 percent of those for whom a particular drug is likely to work.

Felix Frueh, Ph.D., associate director for genomics in the Food and Drug Administration's Office of Clinical Pharmacology and Biopharmaceutics, says, "Personalized medicine tries to answer questions like: Why do some people get cancer and others don't? Why is cancer more aggressive in this person compared to that one? Why does this drug work for you and not me? Why does someone need twice the standard dose to be effective? And why do others need only half of the standard dose?"

"The goal of personalized medicine is to get the best medical outcomes by choosing treatments that work well with a person's genomic profile, or with certain characteristics in the person's blood proteins or cell surface proteins," Frueh says. Genetic information isn't usually meant to be used alone to make treatment decisions, but rather is used with other factors such as the patient's family history, medical history, clinical exam, and other non-genomic diagnostic tests.


Friday, February 01, 2008

Banker's Paradox? Reciprocal Altruism?

--Thus, Tooby and Cosmides conclude, the Banker’s Paradox* leads us to an evolved psychology where “if you are unusually or uniquely valuable to someone else — for whatever reason — then that person has an uncommonly strong interest in your survival during times of difficulty. The interest they have in your survival makes them, therefore, highly valuable to you. The fact that they have a stake in you means…that you have a stake in them. Moreover, to the extent they recognize this, the initial stake they have in you may be augmented.”8 Through such augmentation can the poor become rich through the evolved foundation of friendship**.--

*The Banker's Paradox is that people who need the credit the most are the ones with the highest risk to lenders so they can't get the credit.

**Too bad there is no real concrete means to all of this - too subjective and arguments can and do occur.

This is all from Michael Shermer's book called "The Mind of the Market" and you can view the prologue where I got this from here.