**5. Reactive and predictive medicine**

Reactive medicine is the treatment of a disease after its symptoms are revealed and the full-blown disease appears. During your annual health checkup, your physicians order a number of tests. For example, if you are a 40-year-old male and go to the doctor, he prescribed a PSA (prostate-specific antigen) test for the early signs of prostate cancer, if you are a 40-year-old woman, your doctor prescribes the mammograms for the early signs of breast cancer, and if you are 50 years old, he prescribes the colonoscopy for colon cancer. Once the symptoms are revealed, the standard treatment is prescribed for a disease such as surgery, radiations treatment, or chemotherapy. The treatment after the appearance of its symptoms is considered as the reactive medicine.

A specific example is as follows: suppose your physician finds that you are sick with high temperature and high blood pressure, he prescribes Plavix a medicine of standard treatment for lowing your blood pressure and temperature. It is a reactive medicine. You receive treatment after your illness is diagnosed. Plavix is a useful drug for treating high blood pressure, but it does not respond in 15% of the patients. In treating reactive medicine, we do not really know what is going on in the body of those patients until after sequencing their genome, and identifying the abnormal mutation in their genetic makeup and then designing drugs to treat those patients is the true genomic medicine.

Predictive medicine, on the other hand, is the treatment of a disease long before its onset by examining your normal genomic script of the effected organ from your book of life and comparing its entire script with the genome of a sick patient. Spelling errors in our genome are the mutations responsible for causing diseases. The difference between the reactive medicine and the predictive medicine is whether you have the disease or you will come down with the disease because you are carrying a mutation which could become activated and make you sick. Genomic medicine will have predictive quality. When comparing genome sequences, we find differences called variants. Good variants are responsible for our evolution, and abnormal variants are responsible for causing diseases. Using restriction enzymes (molecular scissors) like EcoR1, we can cut, paste, and copy a gene (conduct genetic engineering) and prepare a chart (called restriction site map) of all 6000 variants responsible for causing all 6000 diseases. By comparing the sequence of a genes from the chart, we can predict which specific gene variant is expected to cause which disease.

As cells grow, the mutations accumulate and defects in genotype manifests in phenotype. By using MRI (magnetic resonance imaging which provides threedimensional image) method, one could see the progressive microscopic abnormal changes in the nucleotide bases and predict the onset of a disease. The threedimensional MR imaging could serve as a diagnostic technique. Once the diagnosis is confirmed, drug design must begin to treat the disease. There are 220 different tissues in our body. We take the MRI of all 220 tissues of a healthy person and during his annual medical checkup compare the present MRI with the previous years' MRI to see any unusual microscopic changes predicting diseases. Once identified, the next logical step is to design drugs to shut off mutated genes to prevent diseases.

Genetic disorders can be caused by a mutation in one gene (monogenic disorder), by mutations in multiple genes (multifactorial inheritance disorder), by a combination of gene mutations and environmental factors, or by damage to chromosomes (changes in the number of copies or structure of entire chromosomes, or part of the chromosome that carries genes). What specific nucleotide damage forming the codon is responsible for causing catastrophic diseases? By comparing the mutations in a DNA sequence (genotype), we can predict the onset of a disease in human (phenotype). The microscopic changes not detected by observations can be confirmed by three-dimensional MRI technique, which will diagnose diseases long before the symptoms appear.

To some degree, we have achieved the quantity control of the population by genome sequencing. Western countries are far ahead of the Eastern nations. The sequencing of the human genome provides rational approach to the quality control of the population. We have good news for those families who are suffering from severe heritable diseases generations after generations. Some of those rare allele diseases are mental diseases such as Parkinson, Huntington, schizophrenia, bipolar disorder, etc. often known as the Mendelian diseases. Those family members can still have children, but we recommend that they have conception by in vitro fertilization, that is, they conceived children outside their bodies, that is, in the test tube. The fertilized egg is harvested in the incubators for 3 days until it grows from a single cell to eight number cells. Without any ill effect, one cell could be removed and its genome is sequenced. Suppose the sequenced cell identify abnormal mutations when implanted will produce an incurably blind child or mentally retarded child. Is there a reason to bring this child into this intensely competitive world? Education is a very long process. To complete his education from age 5 to 25 years, when he completes his education and receives his Doctorate Degree, a child has to take several tests. If he fails one test, he is thrown out of the success train. No matter how painful it is on either religious or moral ground, we must ask ourselves a simple question. Does this fertilized ovum produce an acceptable member of the human society? If the answer is no, then we must throw out the defected ovum and use a new ovum. Out of eight, we have screened only a single cell. Should we sequence and select a cell for implantation which is free from all harmful mutations? Will society approve this reasonable request?

**103**

diseases.

**6. Cancers**

*The Rational Drug Design to Treat Cancers DOI: http://dx.doi.org/10.5772/intechopen.93325*

**5.1 Drug design for rare allele diseases**

**5.2 Drug design for common allele diseases**

genus *Streptomyces*.

These are the diseases of people of all ages. Before the development of antibiotics, most people died of infectious diseases around age 50. First, antibiotics, penicillin (discovered by Alexander Fleming), was used for treating wounds before the WWII. As I said above, enormous funds were made available by the army to develop large-scale antibiotics to treat wounded soldiers returning from the battle ground during WWII. During the following decades, novel class of aminoglycoside antibiotics were discovered, which are valuable therapeutic agents. Some of them are streptomycin, neomycin, kanamycin, paromomycin, apramycin, tobramycin, amikacin, netilmicin, gentamicin, etc. Dozens of their water/fat-soluble derivatives were synthesized. They are considered broad spectrum antibiotics because they inhibit the growth of both Gram-negative and Gram-positive bacteria causing deadly diseases and save human life. All aminoglycoside antibiotics are relatively small, basic, and water-soluble molecules that form stable salts. Most aminoglycoside antibiotics are products of fermentation of filamentous actinomycetes of the

These are the diseases of old age people. Nowadays, people rarely die of infectious diseases. Because of the availability of a variety of antibiotics, today, most people live beyond age 70 years and some of them go on living beyond 80 years of age. Those who live beyond 70 are faced with three major old age diseases, which are responsible for causing the death of most patients during their lifetime and they are cancers, cardiac diseases, and Alzheimer. These are genetic diseases and could be treated either by gene therapy (using CRISPER technology by replacing bad gene with the good gene using CRISPER-Cas9) or by drug therapy. There are about 3000 monogenic diseases and could be treated by replacing the defected gene with good gene, that is, by gene therapy or designing drugs to shut off the bad genes that is drug therapy. Gene therapy cannot be applied to treat multiple genetic defects such as Alzheimer, cancer, and cardiovascular diseases. Drug therapy could be used to develop novel treatments. Recently completed 1000 Human Genome Project identify with precision and accuracy the genes responsible for causing these diseases. It is now possible to design drugs to shut off these genes and save human life. Genes code for proteins and a mutated gene codes for abnormal proteins resulting in these

Cancer is the leading cause of death and has surpassed the death of cardiovascular diseases. Over 636,000 people died of cancer; 1.9 million new cases will be diagnosed this year including 78,000 prostate cancer, 40,000 breast cancer, 16,000 lung and bronchus cancer, and 15,000 colon and rectal cancer. Once diagnosed by

All three old age diseases, that is, cancer, cardiovascular diseases, and Alzheimer carry multiple mutated genes responsible for causing these diseases. In each of the above three diseases, it is the mutated genes that code for wrong protein which

gene sequencing, the next step is to design drug to shut off those genes.

**6.1 The rational drug design to treat cancers**

*Drug Design - Novel Advances in the Omics Field and Applications*

which disease.

diseases.

long before the symptoms appear.

society approve this reasonable request?

medicine will have predictive quality. When comparing genome sequences, we find differences called variants. Good variants are responsible for our evolution, and abnormal variants are responsible for causing diseases. Using restriction enzymes (molecular scissors) like EcoR1, we can cut, paste, and copy a gene (conduct genetic engineering) and prepare a chart (called restriction site map) of all 6000 variants responsible for causing all 6000 diseases. By comparing the sequence of a genes from the chart, we can predict which specific gene variant is expected to cause

As cells grow, the mutations accumulate and defects in genotype manifests in phenotype. By using MRI (magnetic resonance imaging which provides threedimensional image) method, one could see the progressive microscopic abnormal changes in the nucleotide bases and predict the onset of a disease. The threedimensional MR imaging could serve as a diagnostic technique. Once the diagnosis is confirmed, drug design must begin to treat the disease. There are 220 different tissues in our body. We take the MRI of all 220 tissues of a healthy person and during his annual medical checkup compare the present MRI with the previous years' MRI to see any unusual microscopic changes predicting diseases. Once identified, the next logical step is to design drugs to shut off mutated genes to prevent

Genetic disorders can be caused by a mutation in one gene (monogenic disorder), by mutations in multiple genes (multifactorial inheritance disorder), by a combination of gene mutations and environmental factors, or by damage to chromosomes (changes in the number of copies or structure of entire chromosomes, or part of the chromosome that carries genes). What specific nucleotide damage forming the codon is responsible for causing catastrophic diseases? By comparing the mutations in a DNA sequence (genotype), we can predict the onset of a disease in human (phenotype). The microscopic changes not detected by observations can be confirmed by three-dimensional MRI technique, which will diagnose diseases

To some degree, we have achieved the quantity control of the population by genome sequencing. Western countries are far ahead of the Eastern nations. The sequencing of the human genome provides rational approach to the quality control of the population. We have good news for those families who are suffering from severe heritable diseases generations after generations. Some of those rare allele diseases are mental diseases such as Parkinson, Huntington, schizophrenia, bipolar disorder, etc. often known as the Mendelian diseases. Those family members can still have children, but we recommend that they have conception by in vitro fertilization, that is, they conceived children outside their bodies, that is, in the test tube. The fertilized egg is harvested in the incubators for 3 days until it grows from a single cell to eight number cells. Without any ill effect, one cell could be removed and its genome is sequenced. Suppose the sequenced cell identify abnormal mutations when implanted will produce an incurably blind child or mentally retarded child. Is there a reason to bring this child into this intensely competitive world? Education is a very long process. To complete his education from age 5 to 25 years, when he completes his education and receives his Doctorate Degree, a child has to take several tests. If he fails one test, he is thrown out of the success train. No matter how painful it is on either religious or moral ground, we must ask ourselves a simple question. Does this fertilized ovum produce an acceptable member of the human society? If the answer is no, then we must throw out the defected ovum and use a new ovum. Out of eight, we have screened only a single cell. Should we sequence and select a cell for implantation which is free from all harmful mutations? Will

**102**
