Bionic hand, gene therapy in vivo and 4 more significant discoveries in medicine of the XXI century

1. Artificial intelligence

Neural networks make the work of specialists easier and more accurate. For example, AI canArtificial Intelligence in Medicine / Data Revenue diagnose diseases: for this, the program analyzes the results of screenings, and then looks for patterns. Moreover, everything happens much faster than if it were done by a person.

Also artificial intelligence ableE. L. Romm, I. F. Tsigelny. Artificial Intelligence in Drug Treatment / Annual Review of Pharmacology and Toxicology automate the process of selecting treatment based on the medical history, and also significantly speed upAI in Pharmaceutical Industry and Drug Development / Tec4med development of drugs and vaccines. They usually take several years to develop and put into production, and AI can reduce the time to one year. The trained network is capable of both calculating successful combinations and finding the likely percentage of success when applying them. That is, to save researchers from the need to waste time on less promising options.

And there are already proven examples. An artificial intelligence-invented drug to combat obsessive-compulsive disorder has been testedT. Burki. A new paradigm for drug development / The Lancet in public in 2020.

2. Bioprinting

Organ transplant annually helpsEstimated number of organ transplantations worldwide in 2020 / Statista save hundreds of thousands of people around the world. But suitable for donor liver, heart or kidney transplantation at all lacks, so there are huge queues for such operations.

Probably, bioprinting, 3D printing of organs or tissues, can solve this problem. Scientists around the world are experimenting with this technology and have already learned how to create skinFrench Start‑up Develops Unique Technology for 4D Laser Bioprinting of Living Tissue / 3D Medical Conference, liver tissue3D Bioprinting / Organovo and a heartResearchers 3D print a heart with human tissue and blood vessels / 3D Natives.

Bioprinting works like this:

1. Scientists collectPrinting the future: 3D bioprinters and their uses / Australian Academy of Science "ink" for printing, that is, living and healthy cells. To do this, either take the desired sample directly from a person, or use adult stem cells.
2. A model of the desired organ or tissue is created on a computer, often based on the results of a scan or MRI.
3. The printer is loaded with "ink" and other organic or synthetic material, such as collagen, which will act as a base.
4. Next up is technology. The printer heads gradually place the biomaterial in the right places. The process is slow and takes hours.

While such organs are not transplanted to people, they are used only for clinical trials. But the bones printed in a similar way, including skull bones75% of a human skull replaced with 3D‑printed material / Extreme Techpeople have already been transplanted. The possibilities of using a 3D printer in medicine are not limited to this. So, they already know how to print medicines on it: the first samples launched on sale in the US as early as 2016.

3. Bionic prostheses

Artificial substitutes for amputated limbs have been used by people for thousands of years: wooden fingers found3,000‑Year‑Old Wooden Toe Prosthetic Discovered on Egyptian Mummy / Live Science even mummies. For a long time, prostheses either performed only cosmetic functions, or equippedProtézy v minulosti: pacienti kvôli nim trpeli / Magazin interchangeable functional attachments, for example in the form of a fork or a hook. Although this alternative was useful, it still could not significantly improve the patient's quality of life.

scientists long were looking forR. Wirt, D. R. Taylor, F. Finley. Pattern‑recognition of arm prosthesis: a historical perspective‑a final report / Bulletin of prosthetics research a solution that could turn the prosthesis into a full-fledged part of the body, controlled by the power of thought. The first successful experiments took place already in the second half of the 20th century, however, the mass production of such limbs succeededBeyond human: 8 organizations making bionic breakthroughs / Wareable be established only in the 21st century. Thanks to the development of bionic technology.

The secret of the work of robotic “arms” or “legs” is in myosensors: they cling to muscle tissue, respond to brain signals and transmit them to the prosthesis. It is enough to think about the desired action, and the new limb will perform it. As a result, a person does not need to adapt for a long time, seriously change habits, give up hobbies and sports.

Bionic technologies make it possible to create other types of prostheses, for example, partially seeing eyeArtificial vision: what people with bionic eyes see / The Conversation and exoskeletonEkso bionics.

Some modern prosthetic hands even allow you to feel! For example, Modular Prosthetic Limb, which developedModular Prosthetic Limb / Johns Hopkins Applied Physics Laboratory at Johns Hopkins University. Inside it are more than 100 sensors that respond to the temperature, texture and location of the object.

4. Gene therapy in vivo

The possibility of treating hereditary diseases caused by a malfunction of a certain gene, such as cystic fibrosis or spinal muscular atrophy, startT. Friedmann, R. Roblin. Gene Therapy for Human Genetic Disease?: Proposals for genetic manipulation in humans raise difficult scientific and ethical problems / Science discussed in the 1970s. Since then appearedGene therapy - when are genes treated? / Genotek several technologies that allow "correcting" the patient's condition: introducing a new gene, turning off the old one or replacing it with a healthy copy.

The last long time was carried out only ex vivo: the necessary material was taken from the body, treated in the laboratory, and then implanted back into the body healthy. However, some of the gene diseases cannot be cured in this way: not every cell can be successfully cultivated outside the body. Therefore, scientists were looking for another way. And they found it in gene therapy in vivo: in this case, the drug is administered to the patient, and the correction of the gene going onGene Therapy: Meet the Drugs of the Future / Biomolecule right inside the body.

The first such tool was registered in Europe in 2012. It was called Glybera and was supposed to help people with an LPL gene deficiency that causes triglyceride buildup and severe pancreatitis. However, the drug was discontinued and already in 2017 recalledGlybera / European Medicines Agency its registration: there was little need for it, and there were simpler and more cost-effective treatment options.

Since then, several more drugs have appeared, already more successful. For example, Luxturna treats Leber's amaurosis, a rare form of hereditary blindness, and Zolgensma treats certain types of spinal muscular atrophy.

5. Robot surgeon

Assistant robots are needed not only to facilitate the work of the surgeon, but also to obtain a successful result in particularly precise operations, for example, on the brain. Experiments with such technologies began in the 1980s. Then several machines were created at once. Among them:

• Arthrobot. He positionedWorld's first surgical robot / The Medical Post and fixed the patient's leg during the operation - allowed to refuse to involve assistants in this work.
• PUMA‑560. usedPUMA 560/Britannica for the first robotic biopsy. The machine determined the desired insertion site of the needle based on tomography data.
• PROBOT. HelpedProbot/Imperial College London perform precise operations on the prostate.
• ROBODOC. simplifiedRobodoc’ performs first successful surgery on human / UPI joint arthroplasty, due to cutting out the exact area of ​​the hip bone.

All of them, however, were used privately and rather experimentally. The very first robot, which began to be massively attracted to the aid of surgeons, was "Da Vinci» (FDA approval, US Department of Health, gotda Vinci Surgical System / Drugwatch in 2000). It allows you to perform complex operations in a minimally invasive way, that is, with the least harm to the patient. It can be used in cardio and neurosurgery, urology, gynecology and other fields.

"da Vinci" has four "arms", but he does not perform the operation himself: he is controlled by a surgeon using a console. By the way, not necessarily from the next room: you can control the robot, beingThe surgeon who operates from 400km away / BBC even hundreds of miles away. Da Vinci is used in many countries around the world. For example, in Russia it helped to carry out more than 24.5 thousand operations.

6. Virtual Map and Cancer Immune Therapy

Every year in the world fixCancer Today / World Heath Organization millions of new cases of diagnosis of different types of cancer. And scientists are constantly working on the study of oncological diseases: they are trying to understand the peculiarities of cell behavior and find alternative effective methods of treatment.

In recent years, several interesting discoveries have appeared in this direction. For example, researchers at the University of Cambridge have created an interactive map of a cancerous tumor using VR technology. She is allows3D model uses VR to virtually examine cancer cells / Spring Wise “walk” through its different parts, just like in online city maps, and examine in detail each cluster of cells. To create the map, the scientists took a biopsy of the patient's tumor, cut the sample into thin slices, ran a series of tests to gather information about the genetic material, and uploaded the data into the system. The program can be updated by downloading new information: to record and observe exactly how the tumor progresses and how its cells interact.

Another important discovery is already connected with the treatment of cancer. It was made by American and Japanese immunologists James Ellison and Tasuku Honjo. Regardless of each other, they discoveredNobel Prize in Physiology or Medicine - 2018 / Elements mechanisms in the human body that inhibit the work of T-lymphocytes. If these mechanisms are disabled, the immune system begins to fight cancer cells on its own. For their work, scientists got Nobel Prize in 2018. Thanks to their discovery, drugs were created that unblock the immune system, in particular ipilimumab and nivolumab. Clinical Trials showJ. Larkin, V. Chiarion‑Sileni, R. Gonzalez, J. Grob, P. Rutkowski, C. D. Lao, D. Schadendorf, J. Wagstaff, R. Dummer, P. F. Ferrucci, M. smiley. Five‑Year Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma / The New England Journal of Medicinethat they really can improve the results of treatment, for example, melanoma (skin cancer).