Billed as “a slow catastrophe” by public health officials, the golden age of antibiotics is winding down. “We’re seeing more drug-resistant infections,” said Harvard University infectious disease epidemiologist William P. Hanage in an article. “And people will die.” This isn’t hyperbole. In 2016, the U.S. found its first case of a bacterium with the mcr-1 resistance gene. This gene is responsible for making the disease impervious to mankind’s strongest antibiotics. The presence of bacteria possessing this gene has already been found in numerous other countries. If humankind is to survive, new pathogen-defeating treatments must be found, and found fast.
Our next best line of defense will come from bioinformatics and genomics. That much is obvious. And the pressure to produce results fast is intensifying.
There’s more at stake than a lot of people realize. Medical procedures that we now think of as routine and non-threatening will soon become deadly. Everything from dental work to minor surgeries, such as tonsillectomies and tubes in the ears of small children, becomes a death-defying feat. People will die of a mere scratch on the skin, a sore throat, an ear ache, a sinus infection – ailments we think bear little consequence when antibiotics are effective.
But take those antibiotics away, and suddenly everything changes. Even a paper cut could kill people. Yes, seriously.
Check out this short video on how bacteria can actually swap and trade genes like baseball cards to quickly spread antibiotic-resistance. In other words, they don’t need to wait on slow-moving evolution to give them these superpowers.
Any highly invasive surgery becomes an almost guaranteed death sentence, from open heart and stent surgeries, to Cesarean births and organ transplants. Implants, from hip and knee replacements to cosmetic breast implants, are already pathogen magnets and they will amplify infections even more when antibiotics no longer work at all.
Even with so many lives hanging in the balance, some people see genetic-based medicine and public health as science gone a bit mad, or maybe gone full out fiction. Or, perhaps too futuristic to be of much help in their lifetimes. But the advances scientists are already making with these technologies in both personalized medicine and public health are breathtaking.
Take for example, the work researchers are doing to end the Zika virus as a threat to humans. They are attacking the problem and seeking a fix on several genetic fronts simultaneously. One of the more recent efforts involves tampering with the mosquito’s reproductive system so that its eggs either don’t form or don’t mature. Tweak specific gene expressions after the disease-carrying female mosquito has a blood meal and her eggs are no longer viable.
A more scientific explanation of mosquito egg sabotage is found in an article in Infection Control Today (ICT):
“The CLIP-seq data have given us insight into which genes the microRNA target, providing a solid foundation for future studies of miRNA regulation during the egg production cycle," said Alexander S. Raikhel, a distinguished professor of entomology at UC Riverside. "Now that we know these genes, we are a step closer to controlling the spread of Aedes aegypti [mosquito] by disrupting a key process in the reproductive cycle: egg production."
Preventing humans from getting a disease in the first place is infinitely better than trying to cure it after infection takes hold.
But, of course, some infections do take hold. Indeed, our own bodies are the natural habitat for teeming bacteria of both the good and bad varieties. We can hardly sterilize ourselves as that would mean many of our bodily functions would no longer work. Our environment also is teeming with bacteria and climate change is making that situation even worse.
Genomics and bioinformatics make it possible for us to identify where pathogens can be blocked from taking hold on a human host, where malfunctions such as cancer cells can be treated or corrected, and where new treatment options may exist, where none existed before.
Take, for instance, cancerous brain tumors. Through genomics and bioinformatics, scientists have been able to identify specific genetic causes of this very difficult to treat form of cancer. “So for example, what we thought of as two related subtypes of the disease turn out to have quite different genetic causes which may require different approaches to treatment," Richard Houlston, professor of molecular and population genetics at the Institute of Cancer Research in London, said in an article in Medical News Today.
Molecular genetics impacts every discipline in medicine, but the data is so huge that without bioinformatics and genomics, we'd be at a loss to use it. Bioinformatics and genomics helps us innovate, optimize and invent treatments; and because of these disciplines, we'll find our way safely past the age of antibiotics.
To learn more about how bioinformatics and genomics is changing medicine, watch this short video.