As a method of saving lives, medicine’s history stretches backwards in time by millennia. More recently, its intertwining relationship with modern technology has unlocked the potential for any number of benefits to human health.
The American Association for the Advancement of Science, UK scientists presented research into the future of personalised medicine recently. The team of scientists from University College London (UCL) led by Professor Peter Coveney, have used supercomputers to simulate one particular protein responsible for HIV infection in humans. Different drug molecules were then ranked according to how to effectively block the activity of the protein in an individual patient.
Due to small genetic differences between patients, some drugs may have different outcomes depending on the person taking them. The genetic sequencing and computational techniques implemented by Professor Coveney’s team have demonstrated how this situation may be overcome. Drug selection specific to each patient is expected to eventually become a common practice, and this research marks another step closer to this reality.
The protease molecule present in HIV, which was used as the target for this study, may be essential for the creation of the virion in a cell. This viral particle then infects a subsequent cell. The protease takes a subtly different shape in each patient. For each person, the genetic sequence of the virus may be specific. The only way to determine which pharmaceutical product may be most effective at binding with the protease is to determine its shape. This new research describes how it is possible to infer a shape from the specific viral sequence and then determine the best drug for the patient.
As Professor Coveney puts it: “We show it’s possible to take a genomic sequence from a patient; use that to build the accurate, patient-specific, three-dimensional structure of the patient’s protein; and then match this protein to the best drug available from a set. In other words, to rank those drugs – to be able to say to a doctor ‘this drug is the one which is going to bind most efficiently to that site…’”
The US Federal Drug Administration has currently approved nine HIV protease inhibitors for sale on the market, seven of which were ranked in this experiment. The principle behind the simulations run by the UCL team may seem relatively straightforward, yet, as UCL’s director of the Centre for Computational Science explains, determining the shape of each protease protein requires a tremendous amount of computing power: “We’re having to run upwards of 50 simulations of these models, each one of which needs 100 cores on a computer. So that’s a machine with 5,000 cores, and then you run the calculations for about 12 to 18 hours […] You get a huge amount of output data, and then do post-processing and analysis to get the ranking.”
Whilst the process outlined by Professor Coveney’s team may seem slightly unfeasible with the technology currently available to most medical practitioners, computer processors are continually being improved upon. Professor Coveney asked the question: “Today’s supercomputer is on your desktop in 10 years, right?” This might potentially be an ambitious prediction, however, it is almost certain the technique may eventually be accessible to all. The only uncertain element is the timescale for such an eventuality.
Information technology and computing are becoming increasingly prolific in most forms of medical practice. What else might be offered to the world of modern medicine?