Our genes are not our destiny: incorporating molecular medicine into clinical practice

被引:16
作者
Genuis, Stephen J. [1 ]
机构
[1] Univ Alberta, Fac Med, Edmonton, AB, Canada
关键词
chronic disease; environmental health; epigenetics; evidence-based medicine; genome; health policy; health services; human exposure assessment; molecular medicine; nutrition; toxicology;
D O I
10.1111/j.1365-2753.2007.00808.x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
In many developed nations, the state of publicly administered health care is increasingly precarious as a result of escalating numbers of chronically ill patients, inadequate medical personnel and hospital facilities, as well as sparse funding for ongoing upgrades to state-of-the-art diagnostic and therapeutic technology - an increased emphasis on aetiology-centred medicine should be considered in order to achieve improved health for patients and populations. Medical practice patterns which are designed to provide quick and effective amelioration of signs and symptoms are frequently not an enduring solution to many health afflictions and chronic disease states. Recent scientific discovery has rendered the drug-oriented algorithmic paradigm commonly found in contemporary evidence-based medicine to be a reductionist approach to clinical practice. Unfolding evidence appears to support a genetic predisposition model of health and illness rather than a fatalistic predestination construct - modifiable epigenetic and environmental factors have enormous potential to influence clinical outcomes. By understanding and applying fundamental clinical principles relating to the emerging fields of molecular medicine, nutrigenomics and human exposure assessment, doctors will be empowered to address causality of affliction when possible and achieve sustained reprieve for many suffering patients.
引用
收藏
页码:94 / 102
页数:9
相关论文
共 113 条
[1]  
*AM COLL OBST GYN, 2001, CLIN MAN GUID OBST G
[2]   High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased Km):: relevance to genetic disease and polymorphisms [J].
Ames, BN ;
Elson-Schwab, I ;
Silver, EA .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 2002, 75 (04) :616-658
[3]  
[Anonymous], NUTR CLIN CARE
[4]  
[Anonymous], HORMONE DECEPTION EV
[5]   Epigenetic transgenerational actions of endocrine disruptors and mate fertility [J].
Anway, MD ;
Cupp, AS ;
Uzumcu, M ;
Skinner, MK .
SCIENCE, 2005, 308 (5727) :1466-1469
[6]   Immunologic effects of dioxin: New results from Seveso and comparison with other studies [J].
Baccarelli, A ;
Mocarelli, P ;
Patterson, DG ;
Bonzini, M ;
Pesatori, AC ;
Caporaso, N ;
Landi, MT .
ENVIRONMENTAL HEALTH PERSPECTIVES, 2002, 110 (12) :1169-1173
[7]   Frequency of Down's syndrome and neural-tube defects in the same family [J].
Barkai, G ;
Arbuzova, S ;
Berkenstadt, M ;
Heifetz, S ;
Cuckle, H .
LANCET, 2003, 361 (9366) :1331-1335
[8]   Effect of α-tocopherol and N-acetylcysteine on benzoyl peroxide toxicity in human keratinocytes [J].
Bellei, E ;
Rota, C ;
Bergamini, S ;
Manfredini, P ;
Albertazzi, A ;
Tomasi, A ;
Iannone, A .
JOURNAL OF BIOCHEMICAL AND MOLECULAR TOXICOLOGY, 2004, 18 (02) :107-114
[9]  
Bigsby R, 1999, ENVIRON HEALTH PERSP, V107, P613, DOI 10.2307/3434553
[10]   Organochlorines and heavy metals in pregnant women from the Disko Bay area in Greenland [J].
Bjerregaard, P ;
Hansen, JC .
SCIENCE OF THE TOTAL ENVIRONMENT, 2000, 245 (1-3) :195-202