Biomedicine – Part 1: The Promise of Medical Technology in the 21st Century

Humanity is closer today to immortality than it has ever been. We have surpassed Darwinian survival of the fittest to reach a new stage in evolution, creating humans reshaped by advances in biology combined with technology. In the 21st century one of our human challenges will be – do we really want to go there? Is immortality what we seek? What are the consequences of intervening in natural processes, of manipulating the human genome, of ending aging?

In unlocking the mysteries of  the human genome we are learning to master the very essence of what makes us human, that orders and sequences our anatomy and operates our physiology, that explains why some of us are more susceptible to particular diseases than others, that tells us who is likely to get cancer,  develop early onset Alzheimer’s Disease, or pass a congenital illness to our descendants.

DNA is the programming language of life. It has been in existence on Earth for almost 4 billion years. In the last decade of the 20th century and the first of the 21st we have mapped our genome in its entirety. We in effect are in a position to replicate the genome and even make improved copies of ourselves. The science we have practiced in agriculture  we are starting to apply to ourselves.

Today genetic sequencing is the fastest growing biomedical industry on the planet. Biology has become biotechnology with ever more powerful computers central to us building new proteins, medicines, and biology. We are writing  genetic code just as if it were a programming language.  Instead of writing software we now are writing life. We have synthesized viruses and bacteria. When will we be capable of “creating” multicellular life? We are not far way. For those who profess religious faith they would say we are playing at being God.

The truth is we still do not know how life got started on Earth. So we don’t know how nature made us but we have discovered the tool kit nature uses. We have also looked into ourselves and made other discoveries. We are not a single entity.  We are in fact a combination of 10 trillion cells and a host for 100 trillion bacteria and viruses that help us thrive. In knowing our genome we have the means to engineer the 10 trillion cells. But we can also alter ourselves bacterially to improve our health and prolong life.

In 1900 we were humanity 1.0. Understanding our biology remained in its infancy. Insulin for treating diabetes was only discovered in 1921. The first natural antibiotic, penicillin, was identified in 1928. These two medical discoveries can be linked to the development of  humanity 1.1, a species interdependent with the medical support system that evolved in the 20th century.

In our mastery of the DNA toolkit what will humanity 2.0 be in 2050, and what will 3.0 be in 2100?

Here are some of the issues and technology trends that will drive biomedical innovation in the 21st century:

1. The evolution of computational biology and the coding of organisms. Today biologists are expressing biology using mathematics and computer programs. Like their physicist brethren mathematical concepts are being used to describe biology at its most basic constructive level – cellular, molecular and genetic. What will be the outcome of this pursuit?
2. The use of digital imaging, virtual imaging and simulation to understand human physiology better.  Creating simulation of human movement and virtual human models on computer systems will lead to better  treatment of athletes, dancers, and other humans in physically demanding occupations.
3. Biomedical engineering of organs, skin, muscle, blood vessels, blood and bone using stem cell technologies and other bio-construction materials. This will include advances leading to the ability of the body to regenerate lost limbs.
4. The development of human-machine interfaces leading to the creation of artificial organs and smart prostheses fully integrated to work with the natural body seamlessly. We will witness everything from implantable heart valves in infants that grow with the child, to artificial ears, eyes and limbs as the 21st century unfolds.
5. Synthesizing of pharmaceuticals to develop one-to-one disease management. This will be particularly effective in dealing with diseases like cancer where drugs will be closely matched to the biochemistry of specific tumors.
6. Advances in nanotechnology leading to implantable life monitors and directed treatment at disease sites within the body. Nanotechnology will make it possible to do both diagnosis and repair on an entirely new scale. With nanobots it will be possible to do on site repair of internal injuries, to deliver personalized medication to a cancerous tumor site, to remove arterial plaque, and provide mapping and imaging of internal systems at a level of detail previously unavailable.
7. Life mapping using predictive technologies.  Today we test newborns to discover whether they carry inherited diseases. As we progress through the 21st century genomic profiling will give us the means to intervene with newborns providing  prescriptive remedies to potential futures, enhancing the human experience from in utero to end of life.
8. Computer-aided surgery using remotely controlled robotic devices. Today we have developed less invasive procedures to replace heart valves and implant devices in the body. Robotic surgery will become routine using even more advanced imaging and data collection technologies than what we currently have on hand.
9. Ever since a sheep named Dolly was successfully cloned, the potential to clone humans has existed. Self-duplicating humans is the stuff of science fiction and raises many ethics questions. Stem cells from cloning may prove an effective way to produce a custom human repair kit to grow replacement body parts from skin to neurons to major body organs.
10. If we are to believe futurists such as Ray Kurzweil we will have biotechnology in place in this century to defeat aging. The implications of extended longevity for humanity are numerous.

To learn more about each of these topics revisit this blog in coming weeks as we tackle each individually. As always, questions and comments are highly welcome.