I. Abstract :
This article provides a quick review about precision medicine including methods and society’s view towards it. Begin with the definition of precision medicine, genome, DNA, until the methods of precision medicine, so it’s easier to understand. Moreover, this article provides two sides of society’s or patient’s view towards precision medicine including its advantages and disadvantages in order to provide basic information about the new precision medicine.
II. Introduction :
Precision medicine is a term used to describe the treatment of a subpopulation of people which has different susceptibility of a particular disease or a term that describes their response into a specific medicine. In the past, precision medicine was called personalized medicine which could be misinterpreted as the medication that used only for certain individual treatments. Precision medicine is also known as graded medicine, targeted specific therapy, and phenotyping of deep literature. The subpopulation concept of precision medicine is based on the genetic variations, age, gender, addictions, race, comorbidities, environmental factors etc. (Naithani N,et al., 2021). A knowledge of precision medicine as the new methods is necessary to know the basic concept of precision medicine as well as the advantages and disadvantages from the patient’s or society’s perspective.
There are several methods of precision medicine which are based on -omics which refers to the biological molecules in the human body including genomics. Genomics refers to the characteristics of the genome. Genome itself is known as the complete set of DNA within a cell in the body. Genomics itself consists of three methods which are whole genome sequencing, whole exome sequencing, and clinical exome sequencing. These methods commonly use NGS in order to study the genome in the body. Whole genome sequencing means it sequences the entire region of the genome, while whole exome sequencing means to sequence a specific part of the genome that encodes proteins. The clinical exome sequencing is the molecular diagnostic genetic test used to detect disease based on the genetic transformation within the human which is used in clinical practice. (Fogel BL, et al., 2016). The whole genome sequencing can be used to trace genetics of any organisms including bacteria, virus, and human. The result of sequencing will produce the order of the nucleotide bases which can be analyzed to differentiate each of the organisms.
One of the methods of molecular or DNA sequencing is the next-generation sequencing (NGS). Sequencing means to determine the order of DNA bases that consist of adenine (A), guanine (G), cytosine (C), and thymine (T). NGS is an instrument which translates genetic information including genomics, epigenomics, and transcriptomics by the help of several methods. How does sequencing DNA work ? The sequencing of DNA can generally be worked by adding fluorescent colors to tagged specific nucleotides bases. For example, each of the nucleotides bases is colored by four different colors respectively. So that we can determine if there is any transformation or growth within the DNA.
DNA Sequencing will undergo three steps analysis, which are primary, secondary, and tertiary analysis. Primary analysis is the process of converting the fluorescent signals of the nucleotide bases into each of the bases (A, T, G, and C) specifically. Secondary analysis includes three key steps which are demultiplexing, quality control, and alignment of the DNA sample. Tertiary analysis is visualizing the data by characterizing the expression patterns or subjecting into more complex algorithms. However, disadvantage of the NGS method is it generates a huge amount of data which requires a complete equipment of the sequencer tools and consumes a lot of time for interpreting those bioinformatics data.
III. Discussion :
Every new thing that was discovered makes the public required to adapt with it. Therefore, there are several barriers during the process of adaptation which affect the result of the society’s view toward it. Precision medicine as the new method to determine a disease of the patients may overcome doubts from the patient perspective. Moreover, the method itself requires laboratory support which may require a high cost. There are several barriers of patient acceptance toward precision medicine including cost and lack of knowledge that might lead to hesitation from the patients. (Canedo, J.R, et al., 2020).
Based on research about the awareness of the society towards precision medicine that was carried out in the U.S, the patients were mentioned about their thoughts toward precision medicine including the financial burden, lack of information about precision medicine (newness of precision medicine), until frightened toward the genetic test. Precision medicine certainly required a high cost due to the genetic testing and treatment methods, but it’s also necessary to keep in mind that once a precision medicine test was carried out, all of the data including diseases and genetics of somebody are known. Simply, all information about the body condition is discovered at once. Moreover, the newness of precision medicine leads to the lack of information and misunderstanding from the patient towards it. But, once you are curious about precision medicine, it’s actually such an interesting new method in the healthcare field. And also, the fear of genetic testing results is based on the distrust of the public toward their government to keep or have access to their genetic information which may cause misused information. That’s one of the main concerns of precision medicine that really relies on genetic information.
IV. Conclusion :
In conclusion, precision medicine is a new method to determine a disease within the body based on the genetic information that is carried out by several methods, also has pros and cons. Precision medicine is such an advanced and futuristic method that provides the patient with all information about the body condition at once with the main method of DNA sequencing, but still has disadvantages. The method of precision medicine may consume a lot of time for translation of the result of the sequencing of DNA, which in real life diagnosis is needed as quickly as possible to prevent the worst condition of the patient. For better life conditions in the future, precision medicine may need reformation to provide the best method of the patients and society.
V. References :
Andrews V, Tonkin E, Lancastle D, Kirk M. Using the diffusion of innovations theory to
understand the uptake of genetics in nursing practice: identifying the characteristics of genetic nurse adopters. J Adv Nurs. 2014;70(4):878–93.
Canedo, J. R., Wilkins, C. H., Senft, N., Romero, A., Bonnet, K., & Schlundt, D. (2020, May 1).
Barriers and facilitators to dissemination and adoption of precision medicine among
Hispanics/Latinos - BMC Public Health. BioMed Central.
https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-08718-1
Fogel, B. L., Murti, S. S., & Cohen, B. H. (2016, April 6). Clinical exome sequencing in
neurologic disease: AAN model coverage policy. PubMed Central (PMC).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828678/
Ginsburg GS, Phillips KA. Precision medicine: from science to value. Health Aff (Millwood).
2018;37(5):694–701.
Letai A. Functional precision cancer medicine-moving beyond pure genomics. Nat Med.
2017;23(9):1028–35.
Naithani, N., Sinha, S., Misra, P., Vasudevan, B., & Sahu, R. (2021, July 3). Precision medicine:
Concept and tools. PubMed Central (PMC).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8282508/
