The biggest biomedical breakthrough of 2007 was the transformation of adult skin cells into the equivalent of embryonic stem cells by adding only four genes. Dr. Shinya Yamanaka of Kyoto University ignited this revolution first by himself using mice cells, then later in the year in competing papers with Dr. James Thomson of University of Wisconsin in human cells.
Until these results, embryonic stem cells — which have the potential to become any cell in the body — could only be generated by destroying either eggs or embryos. The research holds the promise of eliminating the ethical minefield that has so hampered what many scientists see as the great potential for stem cells to treat all sorts of diseases, including Parkinson’s, diabetes and spinal cord injury.
To be sure, there are technical problems with using these new cells. That is why many experts argue the embryo research must also continue parallel to the new process. One big issue is that the new cells have the potential to cause cancer. But even without solving these problems, the new discovery has expanded the research to thousands more labs because working with embryos is far more difficult than with cells in a dish. Already, labs have announced that using these new cells they have cured sickle cell anemia and Parkinson's disease in mouse models. We can expect many more such mouse cures in 2008 and perhaps the beginning of some long-awaited human trials.
Progress in targeted care
Personalized medicine has long been a buzzword among those contemplating the future of health care. The goal is to use genetic tests to find out what treatments work for what patients so people are neither undertreated nor overtreated.
A major area of progress this year has been with cancer, especially breast cancer. Immediately after the intitial surgery and radiation doctors give many breast cancer patients hormone treatments and chemotherapy to reduce the chances the cancer will return. Doctors have long known that they treat thousands of women to benefit a few. The treatments have terrible side effects, even heart failure and an increased risk of leukema.
New genetic tests on both the tumor itself and the woman’s body are showing which chemotherapy benefits a patient, and which does not. Some of this research has resulted in tests already in the clinic. Others will come on line in 2008, or soon after.
Cancer gains, setbacks
For cancer in general, the trends have been positive, with the incidence and deaths rates for many major cancers falling in people under age 85. A few continue to increase. Some blood cancers, including myeloma, continue to strike ever more people. The best guess is that these are especially sensitive to chemicals in the environment. Liver cancer is also on the rise — a result of the ever expanding epidemic of Hepatitis C, mostly the result of decades of injection drug use.
Even the overall progress with cancer threatens to be dampened by the increasing incidence of obesity, not just in the U.S., but throughout the world. If that were not bad enough, World Health Organization officials declared working nights or evenings as a potential risk factor for cancer, adding to the ever growing evidence that disrupted sleep hurts the body in many ways.
Emerging infectious diseases remain a concern throughout the world. A report from the Centers for Disease Control and Prevention estimated that in 2005 there were 94,360 infections in the U.S. with the drug-resistant form of staph bacteria called MRSA. The CDC estimated that MRSA resulted in 18,650 deaths.
Those numbers set off a firestorm of publicity as people around the country realized just how much this condition has been increasing, causing serious problems in hospitals and at community facilities, such as schools and fitness centers. Much of the news reporting just took note of what has been a problem for a long time. But there is little doubt the threat is growing in response to the overuse of antibiotics.
While bird flu may have dropped from the headlines, the threat of a massive pandemic remains, as thousands of birds and dozens of people continue to die around the world.
The stories I did in 2007 of which I am most proud concerned the amazing medical care for our troops in Iraq. To all those dedicated medics, nurses and physicians whom I had to honor to meet, I wish a happy holiday season and a safe New Year.