Borba protiv raka se pokazala kao jedan od najvećih intelektualnih i praktičnih izazova modernog vremena. Pre sto godina, hirurške intervencije uz podršku rani oblici radioterapije su jedini oružja na raspolaganju doktora. Od tada, nekoliko ključnih revolucije su to promenio.
Prvi je bio uvod hemoterapije, u obliku lijekova koji su izvedeni, ironično, od iperita koji je korišten kao oružje za vrijeme Prvog svjetskog rata. Doktori koji su izvršili obdukciju na žrtve gas napomenuti da inhibira podjela ćelija, i razvio verzije koje su pomogle da se zaustavi tumorske stanice iz proliferaciju. Ove je postao rutina tretmana u 1950.
Kao genomske istraživanja napredovala u 20. stoljeću, naučnici su koristili to znanje da razviju nove tretmane. Nedavni napredak su uključeni ciljane terapije. To su više specifični u akciji protiv tumora jer djeluju na molekularnoj ciljeve u vezi sa posebnim ćelije raka, dok većina standard hemoterapijama djelovati na sve brzo dijeljenjem ćelija, bilo da su normalni ili kancerogeni.
Na primjer, u oko jedan u pet pacijenata od raka dojke, tumorske stanice imaju previše proteina rasta-promoviše poznata kao HER2 na njihovoj površini. Raka dojke s previše ovog proteina su posebno agresivni, naučnici su otkrili. Veliki broj lijekova, kao što su Herceptin, razvijeni su za cilj ovog proteina i blokira širenje tumorskih ćelija. Ove ciljane terapije su sada glavni oslonac u borbi protiv raka.
Koji su glavni problemi?
Veliki napredak je postignut, ali u nastajanju problem može biti finansijski, nego tehničke. Nova generacija lijekova se razvija vrlo skupo, podizanje pitanja priuštivosti.
Uzmite mlada tehnologija imunoterapija. ćelije raka imaju neku vrstu tajni pozdrav da ubedi T-ćelija, ključni dio odbrane protiv bolesti organizma, da ih ne napadaju. U 1990-ih, naučnici otkrili molekulu na T-ćelije koje je bio dio ovog rukovanja. Poznato je kao programirane smrti 1 (PD1) i, Od svog otkrića, Istraživači su pokušavali da poremeti svoju funkciju.
Nova droga otkrivena u Chicagu prošle sedmice su rezultat tog rada. Suđenja u pacijenata sa uznapredovalim melanomom, koja ima visoku stopu smrtnosti, već ohrabrujuće rezultate, ali naučnici upozoravaju da bi moglo biti ozbiljnih neželjenih efekata kod nekih pacijenata.
Demencija zapravo nije bolest. To je rezultat mnogih različitih uslova. Alzheimerova bolest je najčešći od ovih ali drugi uključuju vaskularne demencije i frontotemporalna demencije. Svi ovi oblici dijele zajedničke simptome, međutim. To uključuje gubitak pamćenja, zbunjenost i ličnost promjene.
Iako demencija svakako nije neizbježan ishod starenja, vjerojatnost razvoja stanja nesumnjivo povećava sa godinama. tako, kao zarazne bolesti su savladan u Velikoj Britaniji, i stope smrtnosti za uvjete raka i srčanih gurnuti, sve više i više ljudi su bili u mogućnosti da žive u starosti. (Očekivano trajanje života u Velikoj Britaniji je sada 79 za muškarce i 83 Za ženu.)
danas, it is calculated that there are now more than 850,000 people with dementia in the UK.
po 2025, the number of cases of dementia in the UK is expected to rise to more than 1 milion. po 2050, it is projected to exceed 2 milion. dodatno, the condition has been found to be particularly common in women. Of the 850,000 dementia patients in Britain, 500,000 are female. Kao rezultat, women over 60 are now twice as likely to get dementia as breast cancer.
Scientists are now working on ways to use genetic and stem-cell technologies to understand the detailed causes of the various forms of dementia and, in the long run, to develop drugs that could slow down the loss of faculties in those affected by the condition.
Scientists caution that this aspiration remains a long-term goal and warn there is much work that still needs to be done.
What are the problems?
A key problem for those trying to tackle dementia is a lack of resources. There have been major investments in heart disease and cancer research in recent years and these have helped bring down death rates.
But that has not happened with dementia, said Matthew Norton, head of policy for Alzheimer’s Research UK. “Just look at the figures,"Rekao je.
“Total spend in the UK – from charities and the government – on dementia in 2013 was £73.8m. Za razliku od toga, for cancer, that figure was £503m.” This underfunding means reduced manpower, say campaigners. There are some 3,600 dementia researchers working in the UK –about 19,000 fewer than those working on cancer, even though dementia costs the UK economy more. tako, prospects of finding treatments to slow or halt the loss of faculties associated with dementia will be limited, say researchers.
Over the past 50 godina, there has been an impressive improvement in mortality rates from cardiovascular disease in Britain. This point was precisely summed up by Peter Weissberg, medical director of the British Heart Foundation. “The foundation was established in 1961, when heart disease was ravaging the country. It caused nearly half of all deaths in the UK in that year.”
With hindsight, it is not hard to see why. Smoking levels were four times higher than today, while eating foods high in saturated fats – whole milk, butter and red meat – was the norm.
danas, those foods have been replaced by lower-fat options, vegetable oils, skimmed milk and poultry. We have medicines to reduce blood pressure and cholesterol levels, and it is possible to open blocked or narrowed arteries without major surgery.
Devising drugs to treat damaged hearts suffers from a key problem: they are difficult to test. “We cannot keep cutting patients open to remove heart-tissue samples. That is just not practical or ethical,” said Chris Denning of Nottingham University.
A solution for scientists in recent years has been to turn to the use of stem cells. At Nottingham University researchers have taken cells from patients’ skin and bathed them in nutrients in order to transform them into stem cells, a type of cell that can be turned into any tissue. These cells are then developed into heart cells, which are kept in Petri dishes for testing purposes.
“That means they are ideal for trying new drugs on. It is an incredibly important development,” added Denning.
Other scientists believe that it may be possible to use stem cells to directly repair, damaged hearts in the near future.
What are the problems?
Although medical procedures continue to improve prospects for saving the lives of those who suffer from cardiovascular disease, there are a host of epidemiological issues that threaten to offset these benefits.
Na primjer, the rate of smoking declined sharply between 1972 i 1994 but the fall-off has since slowed down. And the prevalence of heavy drinking has not changed substantially since the 1970s. Gore, childhood obesity has been increasing in both boys and girls since the mid-1980s, while adult obesity rates are also continuing to rise – as is the incidence of diabetes in the UK. All these factors increase the risk that heart disease mortality rates could rise again in the near future.
Weissberg has warned that these factors “threaten to derail the decreasing trends in heart disease and death rates that we are now experiencing”.
Defeating the scourge of infectious disease in the western world is generally attributed to the development of vaccine programmes and antibiotics, although improved sanitation and health education have also been key factors.
“In fact, death rates from tuberculosis, a pernicious killer, had begun to drop by the mid-19th century,” said Carsten Timmermann of Manchester University. “In 1838, there were around 4,000 deaths per million as a result of TB, but this had dropped to around 1,000 po 1900. Vaccines and antibiotics had nothing to do with that. Zaista, it is not clear why the decline occurred at all. But it is also evident that programmes such as the BCG vaccine project had really stopped tuberculosis being a serious killer by the middle of the 20th century.”
In the west, most infectious diseases are now kept at bay. Međutim, the balance is an uneasy one. “In the 1960s, a US surgeon-general was alleged to have claimed that infectious diseases had been completely defeated,” said Jeremy Farrar, who is head of the UK Wellcome Trust.
“The story may be apocryphal but it certainly sums up attitudes at the time. Onda, a couple of decades later, we had the arrival of HIV in the west and a very clear lesson about the ever-present danger of infectious diseases, koji can spread very quickly from other parts of the world.”
dodatno, the rise of antibiotic resistance – a result, in part, of overuse – has led to growing fears that one of the west’s key defences against infectious disease may be lost in the near future, unless pharmaceutical companies speed up the development of new versions.
What are the problems?
In an increasingly connected world, it’s more and more difficult to contain infectious diseases. Changes in weather patterns and increased migrations from areas affected by rising sea levels or spreading deserts will also intensify the risk of new diseases or new strains of existing conditions arriving in the west.
“In developing nations, we have replaced the problems of infectious disease with health issues such as diabetes and obesity,” said Farrar. “But in developing nations, they still have major problems with infectious diseases – malaria, TB and HIV, na primjer – but are also being affected by obesity and diabetes. Countries such as these – Vietnam is a good example – need considerable help from global agencies such as the World Health Organisation. Međutim, these agencies are not getting the support they need from the west any more.”
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