rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0044-197X-2023-67-3-259-266wmlkdgrfhealth-1245Research ArticleДИСКУССИЯDISCUSSIONМедицина будущего: персонифицированная, стратифицированная или прецизионная? (обзор литературы)Medicine of the future: personalized, stratified or precision? (literature review)https://orcid.org/0000-0001-9777-1220ДолгополовИгорь С.DоlgopolovIgor S.noemail@neicon.ruhttps://orcid.org/0000-0002-8398-7001РыковМаксим ЮрьевичRykovMaksim Yu.

Доктор мед. наук, доцент, зав. каф. онкологии, гематологии и лучевой терапии ФГБОУ ВО «Российский государственный социальный университет»; науч. сотр. ФГБНУ «Национальный НИИ общественного здоровья имени Н.А. Семашко», 105064, Москва.

e-mail: wordex2006@rambler.ru 

MD, PhD, DSci., Associate Professor, Head of the Department of Oncology, Hematology and Radiation Therapy of the Russian State Social University; Researcher, N.A. Semashko National Research Institute of Public Health, Moscow, 105064, Russian Federation.

e-mail: wordex2006@rambler.ru

wordex2006@rambler.ruФГБОУ ВО «Тверской государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияTver State Medical UniversityRussian FederationФГБОУ ВО «Российский государственный социальный университет»; ФГБНУ «Национальный научно-исследовательский институт общественного здоровья имени Н.А. Семашко»РоссияRussian State Social University; N.A. Semashko National Research Institute of Public HealthRussian Federation202306072023673259266Copyright © Долгополов И.С., Рыков М.Ю., 20232023Долгополов И.С., Рыков М.Ю.Dоlgopolov I.S., Rykov M.Y.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/1245

«Персонализированная» медицина (ПМ) основана на убеждении, что каждый человек обладает уникальными характеристиками на молекулярном, физиологическом, экологическом и поведенческом уровнях, и в случае развития болезни лечение следует проводить с учётом этих уникальных характеристик. Это убеждение в некоторой степени подтверждено применением новейших технологий (секвенирование ДНК, протеомика, протоколы визуализации и использования беспроводных устройств для мониторинга состояния здоровья), которые выявили большие межиндивидуальные различия.

Цель исследования — обосновать, что в медицине будущего будет использоваться персонифицированный подход.

Проведён поиск литературных источников, включая опубликованные в рецензируемых журналах, индексируемых в PubMed, WoS, Scopus, Global Health, CyberLeninka и РИНЦ. Проанализированы 72 статьи, посвящённые ПМ, из которых 51 включена в обзор. Это статьи, опубликованные в течение последних 10 лет по направлениям «онкология», «генетика», а также рассматривающие правовые, демографические и социальные аспекты данной проблемы. Из анализа исключались статьи, посвящённые философским аспектам ПМ, применению компьютерных и беспроводных технологий обработки данных и связи с пациентами.

Рассматриваются исторические прецеденты, некоторые законодательные и политические аспекты внедрения ПМ в практику, новые технологии, которые делают её возможной, некоторый новый опыт, способы проверки и применения индивидуализированных лекарств, а также потенциальные способы лечения людей с проблемами фертильности и бесплодия. Представлены существующие ограничения ПМ. Поскольку аспекты ПМ уходят корнями в биологические реалии, индивидуализация медицинской практики в определённых случаях, вероятно, неизбежна.

Заключение

Заключение. По мере развития технологий и накопления опыта индивидуальный подход к пациенту становится более эффективным и рентабельным. Чтобы различные заинтересованные стороны приняли ПМ и начали работать в этой парадигме, необходимо разработать и внедрить более эффективные стратегии обучения и подготовки медицинских работников на всех этапах.

Участие авторов

Участие авторов: Долгополов И.С. — концепция и дизайн исследования, написание текста, составление списка литературы; Рыков М.Ю. — концепция и дизайн исследования, написание текста, критический пересмотр статьи с внесением ценного интеллектуального содержания. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.

Поступила 08

Поступила 08.12.2021Принята в печать 19.01.2022Опубликована 06.07.2023

“Personalized” medicine is based on the belief that each person has unique molecular, physiological, environmental and behavioral characteristics, and in case of development of the disease, each patient should be treated taking into account these unique characteristics. This belief was to some extent confirmed by the use of the latest technologies, such as DNA sequencing, proteomics, imaging protocols and the use of wireless devices for health monitoring, which revealed large inter-individual differences.

The purpose

The purpose: to substantiate a personalized approach will be used in the medicine of the future.

Literary sources (scientific articles) were searched, including those published in peer-reviewed journals indexed in Pubmed, WoS, Scopus, Global Health, CyberLeninka, and the Russian Science Citation Index. Seventy two articles devoted to personalized medicine were analyzed, of which 51 are included in this review. The review included articles on personalized medicine, published mainly over the past 10 years on the topics of oncology, genetics, and articles considering the legal, demographic and social aspects of this problem. From the analysis were excluded articles devoted to the philosophical aspects of personalized medicine, the use of computer and wireless technologies for data processing and communication. Historical precedents, some legislative and policy aspects of its implementation in practice, new technologies that make it possible, some new experiences including successes and failures, ways of testing and using individualized drugs, and future directions, including potential ways of treating people with problems concerning fertility and infertility are considered. The existing limitations of “personalized” medicine are presented. Since aspects of “personalized” medicine are rooted in biological realities, individualization of medical practice in certain cases is probably inevitable.

Conclusion

Conclusion. With the development of technology and the accumulation of experience, an individual approach to the patient becomes more effective and cost-effective. In order for the various stakeholders to embrace “personalized” medicine and begin operating in this paradigm, it is necessary to develop and implement more effective strategies for the education and training of health professionals at all stages.

Contribution of the authors: Dolgopolov I.S. — the concept and design of the study, writing the text, compiling a list of references; Rykov M.Yu. — the concept and design of the study, writing the text, critical revision of the article with the introduction of valuable intellectual content. All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: December 08, 2021Accepted: January 19, 2022Published: July 06, 2023 

 

 

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The authors declare that there are no conflicts of interest present.