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精准医学:改变我们对医疗保健的看法。

Precision Medicine: Changing the way we think about healthcare.

作者信息

Gameiro Gustavo Rosa, Sinkunas Viktor, Liguori Gabriel Romero, Auler-Júnior José Otavio Costa

机构信息

Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.

Laboratorio de Cirurgia Cardiovascular e Fisiopatologia da Circulacao (LIM-11), Instituto do Coração (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.

出版信息

Clinics (Sao Paulo). 2018 Dec 3;73:e723. doi: 10.6061/clinics/2017/e723.

Abstract

Health care has changed since the decline in mortality caused by infectious diseases as well as chronic and non-contagious diseases, with a direct impact on the cost of public health and individual health care. We must now transition from traditional reactive medicine based on symptoms, diagnosis and treatment to a system that targets the disease before it occurs and, if it cannot be avoided, treats the disease in a personalized manner. Precision Medicine is that new way of thinking about medicine. In this paper, we performed a thorough review of the literature to present an updated review on the subject, discussing the impact of the use of genetics and genomics in the care process as well as medical education, clinical research and ethical issues. The Precision Medicine model is expanded upon in this article to include its principles of prediction, prevention, personalization and participation. Finally, we discuss Precision Medicine in various specialty fields and how it has been implemented in developing countries and its effects on public health and medical education.

摘要

随着传染病以及慢性和非传染性疾病导致的死亡率下降,医疗保健发生了变化,这对公共卫生和个人医疗保健成本产生了直接影响。我们现在必须从基于症状、诊断和治疗的传统反应性医学过渡到一个在疾病发生之前就针对该疾病的系统,如果无法避免疾病发生,则以个性化方式治疗该疾病。精准医学就是这种新的医学思维方式。在本文中,我们对文献进行了全面回顾,以呈现关于该主题的最新综述,讨论遗传学和基因组学在医疗过程以及医学教育、临床研究和伦理问题中的应用影响。本文对精准医学模型进行了扩展,以包括其预测、预防、个性化和参与的原则。最后,我们讨论精准医学在各个专业领域的情况,以及它在发展中国家是如何实施的,及其对公共卫生和医学教育的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0867/6251254/ce7a9224b62d/cln-73-e723-g001.jpg

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