Special Lecture “Medicine and Science Today” by Prof. Aron CiechanoverPosted on November 13, 2012

The Faculty of Science of King Mongkut’s University of Technology Thonburi welcomed to the most special lecture from Prof. Aron Ciechanover who won the Nobel Prize in Chemistry and was awarded in 2004 for characterizing the method that cells use to degrade and recycle proteins using ubiquitin joint together with Avram Hershko and Irwin Rose at Fox Chase Cancer Center. He was born in Haifa, Israel in 1947. He is currently a Technion Distinguished Research Professor at the Technion (the Israel Institution of Technology). He graduated master’s degree in science in 1971 and received his doctorate in biochemistry in 1982 from Technion, in Haifa.

His lecture was about medicine and science today. While we are entering 21th century, the revolution of science and medicine emerge to completely develop and transform to suit for the human’s life in this modern world. Nowadays, human has a better life and living, so they believe that there is a way to be young and live forever. We live much longer because the achievement of medicine, antibiotic, x-ray, operation, transplantation, and the understanding of all kinds biological process. Unfortunately, it would lead to problems as follows:

First problem: university professor usually retire between the ages of 60-65. However, if professors can live longer, they don’t want to retire in the age of 65 and they would like to continue working in the university. Consequently, there is no available job for young people to replace. Second problem: in the past people mostly live for 50 years and they did not die because of cancer or other diseases. Later, we start to see cancer because they live long enough to get cancer. Cancer is the disease for the age between 60-70 and we rarely see on people in the age of 25. It’s also the same for other diseases that appears on people who live long enough.  On the contrary, some diseases would be cured because of the advancement of medication in discovering the new antibiotic. Thus, people do not die from the infection of some diseases anymore and people are able to immunize them permanently after receiving the antibiotic. Third problem: due to the fact that people could live longer. It would create the excessive of population number. The natural resource would dramatically decrease and the natural balance would be destroyed because of the excessive need of food and energy consumption. Furthermore the excessive of population number would cause higher contamination in air, water and soil leading to mutation of many diseases.

Our life is better now because we live in a better condition and live longer, but with the risk that we would get cancer. Therefore, there is nothing free. We have to pay the price for our achievement. People pay the price for driving car such as contamination in the air and road accident. We take the air into our lung and then we obtain lung cancer or we may get killed by the road accident. We pave the road or build a bridge. Because we change natural balance, this would cause natural disaster. Alfred Nobel was the inventor of dynamite. The dynamite’s explosion has beneficially effect for building road, bridge and drill oil. On the other hands, we could kill people with dynamite. Even though we have to pay the price for our achievement, we have never wanted to give up on our convenient. Consequently, we should pay the price for that.

For the drug development, we can divide into three revolutions as follows:

The first revolution: It is the era of incidental recovery during 1930s-1960s. A scientist discovered very important drug like aspirin. Felix Hoffman, a German chemist, worked for a German drug company called Bayers. He made some of the formula and gave it to his farther who suffered from the pain of arthritis. As a result, his father was cured from pain, fever and his father was able to move his hands again. With good result, Hoffman went to the Bayers in order to convince them to market this new drug and they agreed to sell aspirin in 1920s. The Bayers was successful in selling aspirin because the need of aspirin and consumption of people around the world are surprisingly increase in every year. Aspirin is used in the treatment of fever, pain, rheumatic fever and inflammatory diseases. People at risk of heart attack are advised to take an aspirin a day. Lower doses of aspirin have shown to reduce the risk of death from heart attack or the risk of stroke in some circumstances. People also take aspirin to prevent inflammation diseases that could cause several types of cancers. We can view that more and more people are using aspirin for treatment and prevent several diseases and aspirin give very good result on the patient. Today, over 70 million pounds of aspirin are produced annually around the world, and Americans consume more than 15 billion tablets per year.

Another drug incidental discovery by Alexander Fleming, a Scottish biologist, pharmacologist and botanist, is Penicillin which is the world’s first antibiotic or bacteria killer. On September 3, 1928, Fleming was investigated the staphylococci in his laboratory. He went home for his vacation for several days, but he left the staphylococci’s dish opened by mistaking. Returning to his laboratory, he noticed something strange about it that some particular mold seemed to have killed the staphylococci that had been growing in the dish. Fleming grew mold in a pure culture and found that it produced a substance that killed bacteria. He identified the mold as being from the Penicillium genus. Finally, the world’s first antibiotic that killed disease-causing bacteria was released on March 7, 1929.

The second revolution 1970s-2000s: High throughput – brute force screening of large libraries of chemical compounds. This stage belongs to chemistry. The scientist synthesizes many compounds for many years. They experiment by inserting several chemical compounds into the disease’s dish and see the change of disease in the dish whether that chemical compounds work on disease or not. Akira Endo, Japanese biologist, was successful discovery the first statin drug – compactin from the result of his studied 6,000 compounds. This drug has created a revolution in the prevention and treatment of coronary heart disease. It is used for lower cholesterol that accumulates in artery because the cholesterol would block the blood flow in artery that could cause heart attack.

The third revolution: Future Medicine – Targeted and Personally “Fitted” Medicine. This stage is called personalize medicine. Personalize medicine is a medical model that proposes the customization of healthcare, with decisions and practices being tailored to the individual patient by use of genetic or other information. The traditional diagnosis, we look on patient’s appeared symptoms, medical and family history, and data from laboratory and imaging evaluation to diagnose and treatment illnesses. For the advance in medical diagnosis or personalized medicine, we look on patient’s genetics for understanding the impact of genetic in disease. For example we give the same treatment to a group of breast cancer patient. As a result, each patient would respond to the treatment differently. On the personalized diagnosis, we look in the DNA of each patient in order to tell the different of DNA in breast cancer so that we could treat them differently. Personalized medicine has been studied for over past decades based on disease mechanism. We hope that the advancement in the genetic studied of diseases would develop personalize pharmaceutical product in the future.

The obstacles of science and ethic that will be relevant to these revolutions appear to be broader and more complicated than just target identication and validation:

  1. Many diseases (metabolic, psychiatric) are multi genetic, and the causative connection between the genes products is not clear.
  2. Malignancies are characterized by genomic instability and therefor targets are not stable.
  3. Human experimentation is complicated (HRT, stents) and very cost
  4. Lack of faithful animal models (neurodegeneration, cancer, metabolic disease).
  5. Cost of developing new drugs – legal liability (Vioxx / Celebrex), markets (new antibiotics), and patents protection (AIDS, South Africa, India).
  6. End of blockbuster drugs era.
  7. Bioethical problems of availability of genetic information.