Book contents
- Frontmatter
- Contents
- Foreword
- Acknowledgements
- Chapter 1 Introduction
- Keynote Essay 1: Defining Who We Are: DNA in Forensics, Genealogy and Human Origins
- Section 1 Principles Of Cellular And Molecular Biology
- SECTION 2 MOLECULAR PATHOLOGY
- Chapter 8 Genomes and the Environment: An Overview of Molecular Pathology
- Chapter 9 Genetics, Genomics, Health and Disease: General Considerations
- Chapter 10 Chromosome Disorders
- Chapter 11 Mendelian Inheritance
- Chapter 12 Unusual Molecular Processes that Impact on Disease
- Chapter 13 Population Genetics
- Chapter 14 Complex Multifactorial Inheritance
- Chapter 15 Molecular Basis for Phenotypic Variation
- Chapter 16 Medical Genetics
- Keynote Essay 3: Human Cloning: Should We Go There?
- Chapter 17 Neoplasia: General Considerations
- Chapter 18 Oncogenes
- Chapter 19 Mammalian DNA Repair
- Chapter 20 Tumour Suppressor Genes and Inherited Susceptibility to Cancer
- Chapter 21 Carcinoma
- Chapter 22 Leukaemias and Lymphomas
- Chapter 23 Molecular Approaches to the Diagnosis, Prognostication and Monitoring of Cancer
- Keynote Essay 4: Microbes, Molecules, Maladies and Man
- Chapter 24 Molecular Basis of Infectious Diseases: General Considerations
- Chapter 25 Immunology
- Chapter 26 Human Immunodeficiency Virus
- Chapter 27 Tuberculosis
- Chapter 28 Malaria
- Chapter 29 Influenza
- Chapter 30 Oncogenic Viruses
- Chapter 31 Vaccines and Immunisation
- Keynote Essay 5: Drugs and the 21st Century
- SECTION 3 MOLECULAR THERAPEUTICS
- SECTION 4 RESEARCH AND THE CONTINUING EVOLUTION OF MOLECULAR MEDICINE
- Glossary
- Contributors’ Biographies
- Source Material And Recommended Reading
- Permissions And Credits
- Index
Keynote Essay 5: Drugs and the 21st Century
from SECTION 2 - MOLECULAR PATHOLOGY
Published online by Cambridge University Press: 04 June 2019
- Frontmatter
- Contents
- Foreword
- Acknowledgements
- Chapter 1 Introduction
- Keynote Essay 1: Defining Who We Are: DNA in Forensics, Genealogy and Human Origins
- Section 1 Principles Of Cellular And Molecular Biology
- SECTION 2 MOLECULAR PATHOLOGY
- Chapter 8 Genomes and the Environment: An Overview of Molecular Pathology
- Chapter 9 Genetics, Genomics, Health and Disease: General Considerations
- Chapter 10 Chromosome Disorders
- Chapter 11 Mendelian Inheritance
- Chapter 12 Unusual Molecular Processes that Impact on Disease
- Chapter 13 Population Genetics
- Chapter 14 Complex Multifactorial Inheritance
- Chapter 15 Molecular Basis for Phenotypic Variation
- Chapter 16 Medical Genetics
- Keynote Essay 3: Human Cloning: Should We Go There?
- Chapter 17 Neoplasia: General Considerations
- Chapter 18 Oncogenes
- Chapter 19 Mammalian DNA Repair
- Chapter 20 Tumour Suppressor Genes and Inherited Susceptibility to Cancer
- Chapter 21 Carcinoma
- Chapter 22 Leukaemias and Lymphomas
- Chapter 23 Molecular Approaches to the Diagnosis, Prognostication and Monitoring of Cancer
- Keynote Essay 4: Microbes, Molecules, Maladies and Man
- Chapter 24 Molecular Basis of Infectious Diseases: General Considerations
- Chapter 25 Immunology
- Chapter 26 Human Immunodeficiency Virus
- Chapter 27 Tuberculosis
- Chapter 28 Malaria
- Chapter 29 Influenza
- Chapter 30 Oncogenic Viruses
- Chapter 31 Vaccines and Immunisation
- Keynote Essay 5: Drugs and the 21st Century
- SECTION 3 MOLECULAR THERAPEUTICS
- SECTION 4 RESEARCH AND THE CONTINUING EVOLUTION OF MOLECULAR MEDICINE
- Glossary
- Contributors’ Biographies
- Source Material And Recommended Reading
- Permissions And Credits
- Index
Summary
INTRODUCTION
Within the past 100 years our understanding of the functioning of the human body has increased exponentially. Along with our increasing understanding of normal physiology has come insight into what can go wrong. The identification of the role of DNA heralded the beginning of the era of molecular medicine. The molecular basis of many diseases is now known. As diseases began to be understood at the molecular level, drugs directed against precise abnormalities have been developed. This allows a more rational approach to treatment selection and drug design.
In addition, it is now appreciated that there are significant differences in individuals’ responses to drugs. Many of these differences are the result of variation at the genetic level. For example, a polymorphism may cause a pharmacological agent to be processed in a different manner, changing the effect of the drug. This has led to the realisation that response to some agents can be predicted by the identification of polymorphisms before therapy is commenced. In this manner, therapy can be tailored to ‘fit’ the individual. This is known as pharmacogenomics.
The development of new drugs has also been assisted by the increasing sophistication of information technology, which has enabled us to process large amounts of data. In addition, computer programs allow prediction of the structure and folding of complex molecules such as proteins. The interaction of a drug and its target can be modelled in silico.
Globalisation has also changed the face of medicine. In the past, the individual intrepid explorer would return from journeys to foreign lands clutching a strange root with suspected medicinal properties. Now there is large-scale merging of cultures with sharing of medical traditions and practices. The Internet, of course, facilitates this exchange and allows crosscontinental collaboration.
In this chapter, concepts such as drug discovery, molecular modelling and rational drug design will be discussed. A brief look at the evolution of the science of drugs may also provide some insights into our practices today.
LOOKING BACKWARDS
Disease has always been explained in the context of the prevailing belief system of the day. Of course, the perception of the cause of the disease affected the choice of treatment.
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- Molecular Medicine for Clinicians , pp. 377 - 380Publisher: Wits University PressPrint publication year: 2008