Personalized medicine
In personalized medicine (English: Personalised medicine, also: individualized medicine) to every patient be under large scale to individual circumstances, beyond the mere diagnosis of the disease also treated.
The term is used especially for a tailor-made pharmacotherapy, which in addition to the clinical picture individual molecular configurations taken into account, which can be determined with modern biomarkers and under which the genetic makeup ( genome ) of the patient plays a special role. The influence of the genome on the effect of drugs is subject of research in pharmacogenomics.
This use of the term " personalized / individualized medicine " in this limited biological significance, however, is seen controversially. The Federal Centre for Health Education ( BZgA) emphasizes in its key concepts that the term " personalized medicine " in its context of meaning is misleading, " as the personal side of the man, so his capacity for reflection and self-determination, is first not meant but is lifted on fundamental biological structures and processes " the Chairman of the Central Ethics Commission of the German Medical Association Urban Wiesing criticized ". Personale characteristics do not manifest themselves at the molecular, but on personal level, " Heiner Raspe from the Centre for population Medicine and Health Services Research (CUA ) of the University. Lübeck accuses the use of the term " personalized medicine " in the sense of pharmakogenomisch based therapy one-sidedness; so there is next to the " biomarkers " and "Psycho marker " and " Socio- marker ", which also earned attention in the choice of medical therapy, such as selected examples showed. The Committee on Education, Research and Technology Assessment ( TAB) of the Bundestag suggests that the term " stratified medicine" before that ( " stratified medicine" ) is increasingly used in the international literature.
About the stratified medicine also can be described with the concept of " personalized medicine " also therapies with individual prostheses and implants, as well as therapies with autologous ( autologous ) cells ( " therapeutic unique ").
Practical Application
The Biomarkerdiagnostik includes not only the reading of the genetic code, but all possibilities for characterizing individual particularities. At the molecular level, these are the diagnostic analysis of the genomic DNA, mRNA and proteins.
Therapeutically significant is the " personalized medicine " currently mainly in oncology. One example is the treatment of metastatic melanoma. In more than half of melanoma patients results in an over- activity of the BRAF protein for cell growth ( tumors). By introducing a corresponding mutation tests can be detected in advance whether the patients respond to appropriate therapy. In addition, functional analyzes can identify the activities of enzymes to responses of cells.
Criticism
The methodological approach to research and practice focuses on the precision-fit cut as possible to the physiological relationships of the patient. This is the core of a solution approach. On the other hand is completely negated that already today the organization of inpatient and outpatient treatment and care is filled with methods of control, without giving the executors for the consistent implementation and tracking an optimal sequence appropriate support.
According to current research calls this requirement remains without special budgeting. It is expected that the theoretical results improved personalized medicine for serious organizational shortcomings in the context-sensitive flow control can not be achieved. Improvements in the retrospective medical documentation alone will not solve this increasingly emerging problem.