[Freemanlist2] Doctors and scientists peer into the future By JUDY SIEGEL-ITZKOVICH

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Mon Jul 1 07:29:21 CDT 2013


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Doctors and scientists peer into the future 
By JUDY SIEGEL-ITZKOVICH 
JPost.com - 06/29/2013 22:45     
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The Fifth Presidential Conference brought thousands to Jerusalem, with many listening to top experts predicting medicine in the coming decades will be very different.  
THE ENTRANCE to the conference’s brain science exhibit. Photo: Judy Siegel-Itzkovich 
            
If you think the six decades following the discovery of the structure of DNA  have been a boon to science and medicine, you haven’t seen anything yet. The  next 60 years – and even the next decade or two – are expected to produce a  cornucopia of revelations, treatments and cures. And as the brain controls  everything humans do and is to blame for over 500 neurological and psychiatric  diseases, brain research will be at the forefront of this effort.

With  the theme of Shimon Peres’s recent Presidential Conference being “Facing  Tomorrow,” it was only natural that the future of science and medicine was a  major topic, and thousands of people listened in rapt attention to a variety of  lectures.

Brain science received special focus during the convention as a  number of universities, hospitals and technology manufacturers held an  exhibition on brain science in a large hall not far from the deliberations. The  exhibits represented
 universities throughout Israel – the Hebrew University of  Jerusalem, Ben-Gurion University of the Negev in Beersheba; the University of  Haifa, Tel Aviv University and Bar-Ilan University in Ramat Gan. Among the  hospitals represented was Haifa’s Rambam Medical Center.

Young people,  including scientists at these institutions, manned the exhibits during the two  full days of the conference and spoke to passersby about the discoveries and  trends.

The brain research panel was moderated by Hebrew University Prof.  Eilon Vaadia, director of the Edmond and Lily Safra Center for Brain Sciences  and The Jack H. Skirball Chair and Research Fund in Brain Research (ELSC) at HU.  Vaadia called for the evolution of medicine from disease treatment to disease  prevention.

“This thing we all have on our heads was involved in what was  thought to be intriguing and a mission impossible,” he said. “But now our  challenge is realistic. We
 believe we will be able to understand completely how  the brain works,” said Vaadia, who the day before helped inaugurated the new  building for ELSC on the university’s campus. “We intend to discuss this  wondrous voyage into ourselves.”

He pointed out that there are more  synapses in the brain than stars in our galaxy. “It looks impossible, but it is  true.”

The best, he said, “is yet to come. But even today, we can look at  electrical activity of the brain and modify it. We can condition patterns to  become different. We will able to understand what a person wants to do. New  technologies will be used to make new discoveries that will help mankind. We  will be able to create human-like machines or robots.”

PROF. YADIN Dudai,  a leading neurobiologist at the Weizmann Institute of Science in Rehovot, spoke  next. His research focuses on the investigation of memory systems in the brain,  whether memory tells the
 truth and the interaction of individual memory with the  social milieu.

“How will we relate to the other – humanoid robots that  are like us? This certainly creates anxiety in people if the robots are very  similar to us. Nurse robots have been used in hospitals abroad, but if patients  are not demented they feel uncomfortable when they encounter humanoid robots as  nurses.”

One would think that memory is about the past – events that  happened in real life, suggested Dudai. “But this is not true. Memory is not  necessarily about the past or what happened in reality. Memory is not  monolithic, there are many types – and most of them we have without being able  to use them. If you drove here, you didn’t pay much attention to the road unless  you saw a police car in the mirror. There is memory when [we] pay attention and  other memory that we don’t notice.”

Episodic memory, said Dudai, “is what  happened to us. You
 can change them a few hours after you experience them. When  you remember what happened, you can probably change it by redepositing it in  long-term memory. We change our memories quite a lot.” Memory, Dudai continued,  “is not faithful to reality. Remember, you do mental time travel to the past.  You can also do mental time travel to the future and can imagine what will  happen.”

Prof. Richard Frackowiak, director of the department of clinical  neuroscience at the CHUV University Hospital in Lausanne.

Switzerland,  confessed to the audience: “I am a frustrated neurologist. We don’t know the  causes of dementia. We know brains can compensate for degeneration that causes  dementia. Today, we use magnetic resonance instruments [MRIs] and other devices  to see the normal brain; before, we could see only when a neurosurgeon opened up  the head.”

Alzheimer’s disease, the main form of dementia, will take on  epidemic
 proportions in the decades to come. Frackowiak, deputy director of the  international Blue Brain Project to create a functional model of the brain,  said, “We want to open brain databases, computerize anonymous information from  all hospitals in the world to find abnormal results. The problem of dementias  has to has to be solved.”

Prof. Henry Markram, a neuroscientist at the  Swiss Federal Institute for Technology, founded and directs the eight-year-old  Blue Brain Project and is coordinator of the Human Brain Project, one of two  10-year, billion-euro “Flagship Projects” approved by the European  Commission.

“This year, the European Commission took a giant step for  mankind to simulate the human brain. We have massive responsibility, because it  means building the equivalent of a new Hubble Space Telescope that will look  inside the brain and discover what exactly is going wrong in brain  disease. We need to build a virtual
 biological copy,” said  Markram.

PROF. IDAN Segev, the director of HU’s department of  neurobiology and an expert in computational neuroscience, heads a team that uses  computational and theoretical tools to study how neurons compute and dynamically  adapt to their environment.

In recent years his group has worked as part  of the Human Brain Project to help model a whole piece of the mammalian  cortex.

Their ultimate goal is to unravel how local fine variations  within the cortical network underlie specific behavioral function and possibly  create either brain diseases or healthy and individual brains.

“Our same  genes make the heart and the brain,” said Segev. “Sir Alan Lloyd Hodgkin and Sir  Andrew Fielding Huxley won the Nobel Prize for their work in discovering The  Spike. They wrote an electrical equation that looks like a spike in brain  activity. One can regulate all brain activity by writing equations and
 simulate  biological phenomenon that can be described mathematically. If you can’t  write an equation to depict this, you can’t really understand it. So we will be  able to simulate a piece of the brain to become Parkinson’s or epilepsy or  depression. I could then probe the model and fix the biological problem  to get rid of the disease,” Segev concluded.

Dr. Inna Slutsky, a senior  lecturer at Tel Aviv University’s Physiology and Pharmacology Department and the  Sagol School of Neuroscience, concluded the panel discussion.

Her  research is focused on understanding the basic mechanisms that maintain synaptic  plasticity and memory function and initiate memory dysfunction in Alzheimer’s  disease.

“In the past decade there hasn’t been even one drug to improve  Alzheimer’s. We need to know mechanisms that initiate a gradual transition from  physiology to pathology – from a healthy to a sick brain. We need to create
  neuronal networks with defined properties that could reverse brain  dysfunction.

We must then identify the molecules that are involved. We  have to merge brain physiology and molecular pathology to get the answer. I hope  that in the coming decade, we will be able to bring about a real  solution.”

THE SECOND major scientific forum at the conference was  dedicated to the future of medicine. The session was moderated by Rambam Medical  Center director-general Prof. Rafael Beyar, a senior interventional  cardiologist, expert in biomedical engineering and former dean of the Technion’s  Rappaport Faculty of Medicine.

“Israel is part of the the effort of  bringing medicine forward,” he said. “We lead the world in patents per capita  and have 700 companies involved in hi-tech medicine fields, including cardiac  mapping, swallowed cameras, surgical roots, focused ultrasound, and  bioinformatics” Beyar said.

Prof. Henri
 Atlan, a former biophysics  professor in Paris and director of the Human Biology Research Center and the  Department of Medical Biophysics and Nuclear Medicine at the Hebrew  University-Hadassah Medical Center, explained that in personalized medicine,  treatment is adjusted to the individual’s genetic makeup.

“The DNA  sequence of every person is unique, except for identical twins. But it isn’t  true that genes determine everything. We know that two identical twins  are not the same – not only psychologically but also their nervous, immune and  other systems. If identical twins have a mutation that produces a high  probability of disease, it isn’t certain that both will get it. And one sibling  may get it earlier and the other later or in a more aggressive  manner.”

“Gene activity,” explained Atlan, “is controlled by other genes,  as well as molecules and proteins. It isn’t dependent on DNA  alone.”

People
 mistakenly believe that the future is in their genome and  that by buying a kit to test themselves they will know in advance every disease  they can expect, Atlan said.

“Truly personalized medicine won’t be  achieved quickly – or at all. Research results have to be reproducible in other  patients but if medicine is personalized to only a small number of patients  because they have different diseases, it will be hard to prove,” he  concluded.

Prof. Dina Ben-Yehuda is head of the hematology department at  Hadassah University Medical Center in Jerusalem’s Ein Kerem. A leading  researcher in the molecular biology of blood cancers, epidemiology and gene  therapy, she recently designed a protein connected to cell death that is now  being developed to fight cancer.

A type of leukemia named chronic myeloid  leukemia (CML) is a model for personalized medicine, she said. For this disease,  an oncogene named BCR/ABL and the cancer
 are linked.

“The future is  already here. Bone marrow transplants were performed on patients before 2000.  But fewer than 20 percent of patients were suitable because they were effective  only in young people. Many died. But then the Novartis company developed  a drug named Gleevec (imatinib) that binds to the gene site and prevents the  entrance of proteins. The gene remains inactive so there is no cell death and no  CML.”

Most patients today are in complete remission, but some developed  resistance to Gleevec as CML cells created a mutation.

However, somewhat  different drugs have been produced that can overcome the mutation. More than  half a century after researchers identified this kind of cancer, “we can say  that CML is curable, but it isn’t clear yet whether patients have to take the  drug for life.”

“We have to learn to demystify disease,” suggested Dr.  Leroy Hood, president and founder of the
 Institute for Systems Biology and one  of the world’s leading scientists in molecular biotechnology and genomics. A key  participant in the Human Genome Project, he advocated a “systems approach to  medicine.”

“If you want to understand how a radio works, you naturally  take it apart. But that isn’t enough. You have to study the electronic circuits.  That’s what systems biology is about – components and interactions and dynamics  of behavior. Disease is caused by digital information of the genome and  environment. Some people respond to drugs, and some don’t. So if you know who is  sensitive before taking drugs, you can reduce complications and the costs of  medication. This could lead to the democratization of healthcare. Data  will be dirt cheap. All parts of the healthcare industry will have to  rethink their business plan, and some will become dinosaurs that can’t  cope.”

PROF. HOWARD Cedar – a recipient of many
 prestigious international  and Israel awards, who conducts pioneering cancer research at the Hebrew  University Faculty of Medicine, put his finger on the importance of  prevention.

“When I started medical school in New York 50 years ago, the  dean said:‘You all think you came to learn how to cure diseases. But it  isn’t true. The doctor’s role is to prevent disease.’ Today, this is so  obvious.

But it is still very hard to do. Preventive medicine – not only  to fix a problem but actually make sure it doesn’t happen – needs a different  level of research. The emphasis today is on wellness.”

Cedar also  discussed his 35 years of work on discovering a process to make  proteins.

“Each one has a little place in a ‘book’ on how to make it. The  ‘book’ can be annotated.

One goes over the ‘text’ and puts emphasis on  certain things and make changes. Annotation tells you how to read it. The body
  puts markings on the ‘book’ to note what should be read in this cell or another.  From this, we learned a lot. In cancer, this annotation system is disrupted, so  cancer cells behave badly. It isn’t specific for any cancer,” said Cedar, “but  is a general process. This approach is a new way to look at disease and may even  lead to a way of slowing down or preventing diseases.” 
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