[Dry goods] What is the "precise medical treatment" that people are talking about?

Gene sequencing , from real-time quantitative PCR, to first-generation sequencing, second-generation sequencing, the entire range is relatively wide. The following is mainly to share with you the application of targeted capture sequencing in precision medicine .

[Basic Edition]

Precision medicine and targeted capture

Now everyone has an impression that precision medicine is the same as that proposed by Obama. In fact, the source of advancement, individualized medicine and translational medicine are the predecessors of precision medicine.

In Western medical history, a doctor in Maryland in 1940 put forward the concept of precision medicine. This reminds me of watching Animal World in my childhood. During the migration season, many zebras in the West African prairie migrated there, and we looked at each zebra at the same time. But in fact, when you get closer, you will find that the texture and color of each zebra is unique. This is the core of precision medicine, and every patient and every individual is unique.

Going forward, there are also some ancestors of precision medical theory in China. In the Eastern Han Dynasty, Zhang Zhongjing put forward dialectical treatment in the "Treatise on Febrile Diseases", which is the core of a precise medical theory. Each case must have different objective treatment methods. It was not until 2015 that Obama took the podium and told everyone that precision medicine is the national strategy of the United States. Then our country held a meeting of experts on precision medical strategy in March, preparing to invest 60 billion by 2030. In December, the Health Planning Commission formulated a strategic plan for precision medicine, a major project of the 13th Five-Year Plan. At the end of last year, almost one-third of the provinces started pilot-level precision medical programs. In March of this year, the Ministry of Science and Technology also released a major special project for precision medicine.

It can be said that precision medicine has a long history in medical history and medical theory, but why did it really come into our field of vision like 2015?

The NIH (National Institutes of Health) believes that the rapid development of the three technologies has driven the outbreak of precision medicine. The first is gene sequencing technology, which is mainly based on the second-generation sequencing of genetic testing, which shows an exponential decline in speed, accuracy and cost. There is also the promotion of gene capture technology and the development of liquid biopsy technology, making the timing of precision medical treatment more and more mature. The second is bioinformatics, including cloud computing, data integration analysis methods, and the advancement of data analysis and data interpretation. The third is also the very active artificial intelligence, which makes our analysis more intelligent, can find many new things, and learn new rules to make genetic predictions.

Immediately after, the gene sequencing technology is one of the basic technologies and driving forces of precision medicine. What kind of development process has it gone through? It was the first human genome project, and more than a dozen countries spent more than a billion dollars on it for many years. After sequencing becomes more and more mature, genome-wide sequencing is more and more convenient, and a large amount of data accumulation has been achieved in different species. Further narrowing down the scope, we sequence all the gene coding regions, which is familiar with the exon sequencing. In fact, exon sequencing is also a kind of gene capture, just enriching all gene coding regions. Finally, the more precise target is the target region capture sequencing, which is designed for any gene, or gene segment in a specific application scenario, or even a non-coding region, including some hotspots, and then develops a panel for specific genetic testing.

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