A brief on Molecular Medicine

 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 a certain experience of treatment. In the 20th century, this process moved into a more scientific stage, when attempts began to study the effective methods and treatments used. It was already possible to speak about obtaining relatively statistically reliable data. The next step was to attempt to find mechanisms for the development of diseases.

A brief on molecular medicine           

A serious breakthrough occurred at the end of the 20th century, when new areas of science began to actively form: biochemistry and molecular biology. The human body began to be regarded as a kind of interconnected mechanism at the molecular level. It turned out that with the development of a particular disease, the molecular processes inherent in a healthy organism undergo significant changes precisely at the level of intermolecular interaction. Thus, the idea arose to control molecular interactions during pathological changes, by changing these interactions in a direction, 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 leading to some kind of disease. Therefore, it is so important to determine what exactly happened at the molecular level: which molecules changed and how. 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 disease markers. 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 speak 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) diagnosis. For example, even if the patient has no complaints, it is already possible to determine the risk of a certain disease and the degree of danger, and therefore prevent its development.

In particular, the presence of specific tumor markers may indicate the process of an emerging 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 the development of cancer, and therefore take appropriate measures.

And how can molecular medicine help in this "fight"?

- If we talk about oncology, then its fundamental problem is that tumor cells can appear in the body under the influence of various (and not always obvious) factors. To date, the traditional methods of cancer treatment are surgery, chemotherapy 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 specific tumor cell differs from a healthy cell in a particular person. Thus, molecular markers are detected, which serve as a kind of “friend or foe” signals (healthy cell-tumor cell).

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

Is this what they call "targeted" drugs?

- Yes. Translated from English, "target" means "target", "target". From the point of view of modern approaches, any drug should be directed at affecting a specific molecular target. And such a target in many cases can be molecular markers. Another question is whether drugs that are 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 drugs with directed action ("targeted" drugs).

Another problem in the development of targeted drugs is the presence of protective "partitions" in the human body. These are cell membranes, and 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, overcome such barriers and be able to act on target cells.

Are there any "non-cancer" molecular drugs?

- Of course they do. Absolutely any disease leads to changes at the molecular level, and, therefore, for each disease, molecular markers can be identified that will “tell” a lot about the disease, the degree and prognosis of its development. It is also possible to identify molecular targets, the impact on which will help correct pathologies, that is, embark on the path of cure. 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, in China, there are now active programs for the identification of active substances from plants, which have been used in traditional Chinese medicine for thousands of years. That is, if earlier herbal extracts were simply used, now the composition of these herbs is disassembled into molecules to identify the active substance, its  mechanism of action, and scope are determined. And in this example, herbs are not considered as medicine, but as a source of medicinal substances in accordance with the principles of molecular medicine.