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Nanofabricated chips are nanoscale semiconductors that can be used as implantable microchips that automatically control the release of a drug from a pump or other source into the body as needed. Microelectromechanical systems (MEMS) combine computers with tiny mechanical devices such as sensors, valves, gears, mirrors, and actua tors that are embedded in semiconductor chips. MEMS are being used to develop miniature, implantable drug pumps and sensors that function as self-contained drug delivery and monitoring systems. Similarly, molecular manufacturing and nanobots have application ranging from rapid develop ment of designer drugs to programmable, miniature robots that can deliver drugs directly to diseased cells.
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Through the creation of online biomedical databases, medical science continues to address the challenges of well-known diseases, such as Alzheimer s and relatively new diseases such as HIV and SARS. These re sources enable collaboration among clinicians and scientists and provide the basis for decision support tools, gene chips, new therapeutic methods and other diagnostic devices. On the scienti c horizon of medicine is a better understanding of the biological relevance of the human genome and proteome, especially how the less than 30,000 genes can de ne the human species. Medical diagnosis a process based on the recognition of patterns of signs, symptoms, and laboratory results, is challenged to collect enough quality data for a human or machine to recognize different disease presen tations. In this regard, capturing data from gene chips and other tests for incorporation into biological databases is a prerequisite for creating dis ease pro les that can provide the basis for automated decision support tools. Several biotech companies are attempting to devise gene chips that can quickly, cheaply, and accurately detect gene sequences related to spe ci c diseases. Furthermore, data regarding the expression of speci c genes and their association with particular diseases will increase as these prod ucts begin to be used on a regular basis by clinicians, other health-care workers, and the lay public. In the areas of infectious disease, gene therapy, and genetic engineer ing, one of the enabling technologies is nanotechnology, in the form of arti cial viruses, which may eventually be used to treat diseases. Simi larly, nanotechnology methods hold promise as a means of rewiring damaged nerves following accidents, potentially reversing otherwise ir reversible conditions such as spinal cord injuries. A related area of scien ti c exploration is embryonic stem cells, which researchers hope to use one day to treat conditions ranging from Alzheimer s to spinal cord in
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Scientific Horizon
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juries and for use in the initial screening phase of drug development and tissue generation. Another area at the scienti c forefront in medicine is over-the-counter tests for medical diagnosis in the privacy of the patient s home. Patient con cerns over the privacy of their test results, the trend for the worried well to make use of alternatives to the traditional medical infrastructure, and the general frustration with the American medical system are drivers for per sonalized at-home testing. Over-the-counter and mail order tests exist for pregnancy, diabetes, HIV, hepatitis, alcohol, cholesterol, prostate cancer markers, and drug use. These have been supplemented with tests for genes, speci c proteins and enzymes linked to gene activity, and gross chromo some analysis. At-home tests are available to predicting adult-onset disor ders such as Huntington s disease, cancer, and Alzheimer s disease, and for identity and paternity veri cation. The cost of at-home testing, which ranges from hundreds to thou sands of dollars, is most often borne completely by the patient. Although these piecemeal advances in genetic testing are signi cant, on the scienti c horizon is personal genome sequencing, which will likely become as commonplace and affordable as a common chest x-ray. Once that happens, the data required to de ne custom drug requirements can be made avail able to pharmaceutical companies, assuming that patient privacy issues are addressed. One of the most promising lines of scienti c research that may address the upcoming designer drug demand stems from work at the Institute for Biological Energy Alternatives, a nonpro t organization founded by Craig Venter. The initial goal of the institute is to create custom organisms de novo. Unlike conventional genetic engineering, which is based on modify ing the DNA sequences of existing life, the institute is attempting to build a new genetic sequence, one base pair at a time. The rst items on the draw ing board include organisms intended to reduce environmental pollution by absorbing carbon dioxide and producing hydrogen fuel. Whether new organisms prove technically and economically viable for controlling pollution and providing fuel, the technological underpinnings of the project hold signi cant promise for the biotech markets, including designer drugs. Prototype DNA assembly machines can create DNA se quences in a matter of hours instead of months required when using tradi tional manual laboratory methods. Eventually, drug and biomaterial designers will be able to design a protein on a computer and have a DNA assembly machine create the protein in a matter of hours. Perfecting this technology is one of the major hurdles associated with creating personal ized medicine. In many respects, the ability to create personalized medi cines on a machine quickly and on an as-needed basis is akin to what the personal computer offered the mainframe-dominated computer industry in
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