Irrevocably, we have left the era where the main drive of natural science was to break down all lifeforms to their smallest biological components, such as the atoms and proteins they consist of. We now find ourselves in an era where the focus has shifted to how these basic building blocks of life connect, interact and respond to changes in their surroundings. Lagging well behind this significant shift of focus in science, many other aspects of our lives have not paid much attention to the implications of this.
Today, any medical article aimed at making an academic mark cannot omit stating the effects of a new drug or certain environment on a specific locale of a certain gene. Genetic responses to changing environments and new therapies are now key considerations in almost any publication read in medicine or veterinary science. Scientists have mapped the genomes on a growing list of species and are able to visualise the effects of disease, specific drugs or lifestyle changes and link them to exact locales on specific genes. Once identified such flawed parts of a gene can now potentially be spliced out and replaced with ’normal’ bits. We have entered the era where it is no longer considered science fiction to design how we feel or what we are. Science can now genetically modify rabbits to glow in the dark while predicting the outcome of a specific drug or certain environment based on a patient’s genetic makeup. In practice we can tell, based on a relatively simple genomic screen, whether a patient will benefit from a certain drug, or perhaps have serious side effects. We realise the impact of our polluted cities, stress and poor lifestyle choices on a much more flexible and responsive genome than previously thought.
With the advent of things like atomic tip scanning microscopes, an ultimate reductionist tool, it was recently also realised it failed to consider how biological cells, organs, tumours and organisms entangle themselves with their evolving environments while simultaneously changing the way they behave. All biological cells continuously combine and recombine and collectively use their structures at every scale (from nanostructures to the beyond) to keep on living, evolving and surviving in changing environments. Cells have the potential to respond in an array of different ways to the same drug while carrying with them in their DNA a genomic memory of this event.
Unknown to most, we already exist in this new 'nano-world 'where pharmogenomics can be applied to a growing list of commonly used drugs. With issues like climate change and healthcare still wrestling with costs and short-term profits to be made, others remain cut off (or remain oblivious) to the wonders this new science can soon offer humankind. Perhaps more significantly, from an evolutionary perspective at least, is the fact that we have left our primeval perceptive past where emphasis was set on hoarding resources in short supply to survive, to one now enabling us to over-supply vital resources, such as food, housing, energy and water in a more humane healthcare system and harmonious society.
The primary issue now should be (and still it is not), how to interconnect and share these recent advances and surpluses justly and fairly. The dogmatism of the reductionist approach to life and disease has in recent decades been severely challenged by many intellectuals, unfortunately with concepts often drowned in the greedy algorithms of an acquisitive internet aimed at sales. The costly and largely ineffective trial-and-error methods used to identify new drugs, and the difficulty of conducting clinical trials (where often only small short-term benefits can be seen) are also partly driving this change in direction. Antibiotic resistance as an example is now widely identified as one of the biggest public health threats; meanwhile, the ability of cancer cells to build defences against chemotherapy has stalled pharmacologists searching for cancer cures.
More recently (December 2019) in a multidisciplinary approach, a UK collaboration between physicists, nanotechnologists, biophysicists, biologists, biomedical and computer scientists led by Maxim G. Ryadnov of the National Physical Laboratory published in the journal ACS Nano that they had constructed a nanoicosahedron (a nano sized structure with 20 plane faces). Using bits of proteins present in our immune system to make this nano-protein structure, they claim it can kill bacteria in a very efficient manner. The team was inspired by the way that viruses (like our own innate immune systems) kill bacteria by making nanoholes in their surface. Clearly attention in much of science is now drawn to what we can learn from how biological life interacts, rather than reduce it to its smallest forms, and then cut it off or eradicate it in our attempts to heal.
We were taught as students that proteins are the building blocks of life in various combinations of 20 different units of amino acids. In a multidisciplinary and more open approach and tapping on physics, these proteins can now take on any imaginable shape and function at the nanoscale. In fact, scientists still don’t know how many different proteins there really are in our bodies. Perhaps it is unknowable, as they continuously evolve and adjust to rapidly changing environments. Since our cells could have the capacity to create and modify proteins as and when they are needed while simultaneously adjusting themselves to constantly changing and modified environments, in a now post reductionist world it seems only the sky's the limit.
Interactive and communicative proteins work as light detectors in our eyes, electrical switches in our neurons, nanowalkers in our muscles, and to catalyse chemical reactions. They are responsible for detecting and reacting to the signals, forces and information from the environment in which an organism resides, and also for creating the structures that allow movement, the extraction of energy from food or the destruction of pathogens. No human-made artificial nanotechnology can dream of such capacities, we can only continue to try and learn how life does it. Scientists remain constantly fascinated by the capacity of biology to produce materials that adapt, evolve, survive and even think – materials that surpass human technological abilities in every possible way.
With words like microbiome and epigenome now quite familiar in medical circles, there is sadly still severe neglect in creating and connecting life to healthy environments and suitable lifestyles to avoid the overprescribing of drugs that may affect this more interactive and alive part of the genome. Few patients will be given the option to alter their diets or make lifestyle choices to remedy conditions now inarguably linked to poor lifestyle and bad dietary choices, with their negative impact on the epigenome neglected during hurried consultations. The marketing fraternity keep pushing over-processed foods while using financial muscle to promote products. We seem to have one foot still in the reductionist era with a blinkered approach on profits to be made, and another foot in a new more enlightened era with focus on how to better interact with our environment and live together in harmony—whatever it takes or costs.
Never before were we on the brink of benefiting from such an abundance of new knowledge, and if we want to, new wisdom. We can provide sufficient amounts of healthy food, housing, clean water and proper healthcare to a global population, and humanely treat all life forms as valuable and interlinked. The only question that remains now is will we use this new knowledge wisely; it is entirely our choice as practitioners and concerned members of society and the bliss or burden of future generations to carry.
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