What is molecular medicine?

"Molecular medicine is designed to predict the development of diseases"

Irina Reznik, MedNovosti

Molecular medicine, which is called the medicine of the future, is both a radically different approach to finding the causes of the disease and its prevention, and a new look at the old methods of treatment. The director of the Institute of Molecular Medicine told Mednovosti about the possibilities of molecular medicine The First Moscow State Medical University named after I.M. Sechenov, Professor Andrey Zamyatnin.

Photo: press service of the First MGMU

– What is molecular medicine?

– Molecular medicine is the result of the active involvement of the latest scientific achievements in clinical practice. As you know, the development of medicine began with the observation and description of diseases, the use of the first "empirical" drugs and the study of their benefits and harms. That is, there was an accumulation of certain treatment experience. In the XX century, this process moved to a more scientific stage, when attempts began to study the methods and means of treatment that give effect. It was already possible to talk about obtaining relatively statistically reliable data. The next stage was the attempts to find mechanisms of disease development.

A serious breakthrough occurred at the end of the XX century, when new directions of science began to be actively formed: biochemistry and molecular biology. The human body began to be considered as a kind of interconnected mechanism at the molecular level. It turned out that with the development of a disease, the molecular processes inherent in a healthy organism undergo significant changes precisely at the level of intermolecular interaction. Thus, there was an idea to manage molecular interactions in pathological changes by changing these interactions in a targeted way, which is what molecular medicine does.

– What is meant by the term "molecular markers" and what is their role in diagnosis and treatment?

– Pathological changes in the cell, ultimately, always lead to some kind of disease. Therefore, it is so important to determine what exactly happened at the molecular level: which molecules and how they changed. These molecules are defined by the term "molecular markers", which are identified at the level of genomic DNA, RNA and proteins, and, in fact, are markers of diseases. The search and study of the mechanism of action of these molecular markers is the main task of molecular medicine.

To date, it is known that during the development of a disease, for example, the amount of a certain protein may change, certain molecules may appear or disappear. Using special methods aimed at detecting such molecules, we can talk with a high degree of probability about the type of developing disease. At the same time, it is very important that changes at the molecular level often occur even before the first symptoms of the disease appear. And it can be used for both early and preventive (warning) diagnostics. For example, even in the absence of complaints from the patient, it is already possible to determine the risk of a certain disease and the degree of danger, which means to prevent its development.

In particular, the presence of specific tumor markers may indicate the process of an incipient tumor, that is, even before any significant manifestations of a dangerous disease. With the help of molecular medicine methods, it is possible to detect these markers, predict the risk and timing of cancer development and, consequently, take appropriate measures.

– And how can molecular medicine help in this "struggle"?

– If we talk about oncology, its fundamental problem is that tumor cells can arise in the body under the influence of various (and not always obvious) factors. To date, the traditional methods of treating cancer are surgery, chemo- and radiation therapy, the main disadvantages of which are serious side effects. Therefore, in order to effectively fight cancer, it is necessary to study how a particular tumor cell differs from a healthy cell of a particular person. Thus, molecular markers are identified, which serve as a kind of "friend– foe" signals (a healthy cell is a tumor cell).

And then appropriate approaches to treatment are selected. For example, there are methods that, as it were, "force" the human immune system to recognize tumor cells as foreign, which means that they set up the body to fight them independently. And since each tumor has a specific location, and it is important that the drug has its effect directly on the affected cells, molecular markers can serve as a kind of targets in the development of drugs.

– Is this what is called "targeted" drugs?

- Yes. Translated from English, "target" means "target", "target". From the point of view of modern approaches, any drug should be aimed at affecting a specific molecular target. And in many cases, molecular markers can be such a target. Another question is that drugs that seem to be aimed at a very specific target can also affect other cells with similar targets, which causes side effects. Therefore, it is important to find the most specific targets and conduct thorough safety studies of targeted drugs ("targeted" drugs).

Another problem in the development of targeted drugs is the presence of protective "partitions" in the human body. These are cell membranes, the blood-brain barrier, and immune-privileged zones (brain, nervous system, glands of the reproductive system, eyes). In such cases, it is important that the active substance of the drug, with the help of special "transporter" molecules, overcomes such barriers and can affect target cells.

– Are there "non-cancerous" molecular drugs?

– Of course there are. Absolutely any disease leads to changes at the molecular level, and, consequently, for each disease, it is possible to identify molecular markers that will "tell" a lot about the disease, about the degree and prognosis of its development. It is also possible to identify molecular targets, the impact on which will help to correct pathologies, that is, to embark on the path of healing. These are the main subjects of research for molecular medicine.

In addition, molecular medicine is, in many ways, a new look at previously used methods of treatment. For example, China is now actively conducting programs to identify active substances from plants that have been used in traditional Chinese medicine for thousands of years. That is, if earlier herbal extracts were simply used, now the composition of the same herbs is disassembled into molecules to identify the active substance, its mechanism of action and scope of application are determined. And in this example, herbs are considered not as a medicine, but as a source of medicinal substances in accordance with the principles of molecular medicine.

Portal "Eternal youth" http://vechnayamolodost.ru  16.12.2016