When Genomics and Personalised Medicine Meet “Tiny” Theranostics: Policy Concerns-personalised medicine conference 2017
Recent years have seen great strides being made in the “tiny” domains of microsurgery and nanomedical research and interventions (Leary 2006; Good, Monteiro, Skwarczynski and Toth 2014; Bagchi 2017; Caster, Patel, Zhang and Wang 2017; Mixson 2017). The establishment of links between genetics and personalised medicine dates back by several decades (Anderson 1985, 1988; Buchanan, Brock, Daniels and Wikler 2001; Gert, Culver and Clouser 2006), following the seminal discoveries relating to molecular genetics (Watson 1965; Sundar Rajan 2003/2016). However, it is only with the success in mapping the complete human genome, achieved at the beginning of the current millennium, that it has become possible to work to establish specific genomic correlates to particular diseases such as Tay-Sachs disease, cardiovascular pathologies, and certain cancer types, as well as to congenital pathologies such as Fragile X Syndrome (McDuffie, Thurman, Channell and Abbeduto 2017) and Specific Language Impairment (SLI Consortium 2002; O’Brien, Zhang, Nishimura, Tomblin and Murray 2003; Schwartz 2017; Tomblin 2017). There is, however, more of a need than ever for micromedical as well as nanomedical research into genetically based reactions to microtoxins, their clinical aspects as relating to, e.g., various pulmonary, alimentary-tract, and neurocognitive pathologies, and micro- and nano-medical theranostic interventions, with genomically informed personalised medicine in focus. In particular, with the field of bioinformatics having grown considerably in its database scope relating to the human genomic mass (Mount 2004; Lu, Giordano and Ning 2016), the establishment of such genomic correlations with diseases and pathologies as well as the creation of databases for such correlations have become a reality. The issue at hand, however, is the accessibility of these different kinds of databases to institutional healthcare professionals and facilities, while protecting human-subject and patient data confidentiality in non-ideal geographical and social contexts, for the practice of genomically-correlated personalised medicine. The paper concludes by highlighting the need for the formulation of expert-advised and contextually sensitive policy (as proposed for a different biomedical domain by Bagchi 2015) towards research and implementation of genomically-oriented personalised micro- and nano-medical theranostic interventions.