2021 has been a year full of stories about public health and healthcare.
March 2022 will mark two full years with the COVID-19 pandemic, which has reoriented the way we approach our lives and the world around us, as well as our relationships with healthcare.
With the pandemic still present, last year was also the year that marked a series of health innovations – large and small – including the application of CRISPR gene editing technology, World Health Organization approval for the first malaria vaccine and access to new in cardiology.
Experts point to a range of medical disciplines, public health and talk about what were some of the defining innovations, in terms of health during 2021. Not only do they all focus on a year of innovation, but they also show what can be we expect more in the future.
Increased mRNA vaccines
A retrospective of the major impact that health innovation has had on society cannot be done without affecting mRNA vaccines. Some of the anti-COVID vaccines currently being distributed (Pfizer-BioNTech and Moderna) have been developed as a result of a gene-modifying process that modifies RNA (mRNA) to elicit an immune response in the body.
Lior Brimberg, an assistant professor at the Institute of Molecular Medicine at the Feinstein Institute for Medical Research in Manhasset, New York, told Healthline that “mRNA-based vaccines given to millions of people to fight the coronavirus have changed the story, not just the treatment.” of the COVID-19 pandemic, but also for future viruses ”.
In fact, there is ongoing evidence to evaluate the efficacy of possible mRNA-based influenza and HIV vaccines. “This technology will allow faster and more efficient development of new and current virus vaccines,” Brimberg added.
Eric H. Chang, another assistant professor in Bioelectronic Medicine at the Feinstein Institute for Medical Research, echoed these points. He told Healthline that while mRNA vaccine technology may seem like a 2020 title, “increasing vaccine production and the possibility of specific variations of the variants is truly unique.”
Chang added that the development of more effective “rapid COVID-19 home tests” that have “very high accuracy” is a turning point in the ongoing fight against the pandemic. “They enable the average citizen to know quickly if they are positive and to change their behavior without having to go to a clinic or laboratory,” Chang said.
New developments with gene modification
In October 2020, Emmanuelle Charpentier and Jennifer A. Doudna made history by winning the Nobel Prize in Chemistry for their historic development of the gene modification technology, CRISPR / Cas9. To decipher what this is in simple terms, think of it as genetic scissors – enzymes that cut pieces of DNA and return them to their normal function.
This genetic technology from Charpentier and Doudna could strategically break down any type of DNA molecule in a given location. Last year, the announcement of CRISPR technology underlined new horizons in fighting a range of diseases in a new way. Now, experts say we are seeing that theoretical promise in real time.
“This year it was shown for the first time that this technology can be used in humans. “A CRISPR-based drug was injected into the blood of people born with a disease called fatal disease transthyretin amyloidosis and was shown to significantly reduce the production of toxic proteins by their livers,” Brimberg explained. “This is a milestone in mRNA-based drugs.”
Dr. Donald Lloyd-Jones, president of the American Heart Association, told Healthline that this application of gene modification has major implications for heart health. Lloyd-Jones explained that some people have a gene that facilitates the production of many toxic proteins that build up in the heart muscle over time. He said this “makes the heart become very thick and it becomes difficult to pump efficiently”. People can then experience heart failure.
CRISPR / Cas9 technology was able to target this genetic defect to make it stop the overproduction of proteins, “showing dramatic reductions in blood levels of that protein production by up to 90 percent in the blood, so “They will continue to build in the heart muscle,” said Lloyd-Jones.
“This particular demonstration of this technology in this disease shows that we can make a real living person actually get this technology to modify the gene and stop their liver from producing so much of that protein. “It’s bad that is causing their heart to fail,” he said. “It’s really interesting and I think it’s an important demonstration that, when it reaches a gradual level, it can really change the course of a fatal disease evenly.”
Lloyd-Jones said it is extraordinary to see the change she has made over the course of a year when it comes to this technology and its application in the real world. “It was promising, but now we are seeing its current implementation,” he said.
Beyond these examples, Lloyd-Jones noted that gene modification can be used under more common conditions. For example, he noted how it might work with people who have familial hypercholesterolemia, a genetic disorder in a gene that means they have difficulty “clearing cholesterol from their blood because they do not make the receptor it needs. clear that cholesterol ”.
“The right protein does not work to clear cholesterol from their blood, but what if we could give them the opportunity to make the right protein and those receptors could work again?” Said Lloyd-Jones. “These are people who have a heart attack in their teens and early 20s. If we could repair that gene and give it back to them, then that’s not the only thing. You give them back their cell with a normal gene in many cases. “You then have the opportunity to extend the lives of these people tremendously.”
In essence, the 2020 Nobel Prize-winning discovery is now being used in a way that shows promise not only for treating rare diseases, but for treating the most common problems online.
Importance of a malaria vaccine
By October 2021, World Health Organization (WHO) officials had formally approved the widespread use of the RTS, S / AS01 (RTS, S) malaria vaccine for children in sub-Saharan Africa and other high-transmission areas. of the parasite Plasmodium falciparum which causes malaria.
At the time, WHO officials said the recommendation was due to the results of an ongoing pilot program that has been used among 800,000 children since 2019 in Ghana, Kenya and Malawi.
“This is a historic moment. “The long-awaited malaria vaccine for children is a breakthrough in science, child health and malaria control.” Tedros Adhanom Ghebreyesus, Director-General of the WHO. “Using this vaccine on top of existing tools to prevent malaria could save tens of thousands of young lives each year.”
“Malaria kills about half a million people every year, almost half of them children under the age of five. The new vaccine, developed by GlaxoSmithKline and approved by the WHO, will help prevent many of those cases, ”Brimberg explained.
Asked to put into context the medical and public health importance of this vaccine, Philip Welkhoff, director of malaria at the Bill & Melinda Gates Foundation, told Healthline that this is not only the first malaria vaccine, but it is also the vaccine of seen “targeting a parasite”. He called it “a milestone in the development of vaccines, a scientific innovation for malaria and a potential for long-term public-private partnerships.”
This discovery did not happen unexpectedly. Welkhoff said it is based on a series of effective innovations that, when used together, have been instrumental in making progress against this deadly but preventable and treatable disease.
Technology to make medicine easier
Chang cited some examples of technology – outside of gene editing – that have taken steps forward in simplifying some common problems in healthcare. An example is Bluetooth-enabled pacemakers, which he said “allow fast and frequent communication between a device placed on the body and doctors”.
Moreover, he mentioned another common technology that became particularly popular during the peak of coronavirus quarantines: telemedicine.
“Large-scale telemedicine, which had to be deployed due to the pandemic, but improvements in quality and accessibility this year were significant,” Chang added. Beyond high-tech pacemaker technology and the increasingly normalized application of telemedicine as part of our daily lives, Chang emphasized learning machine-enabled artificial intelligence (AI).
“Machine learning in digital pathology is influential because we can now use AI-based analytics to diagnose tissue biopsies for early detection of disease,” Chang said.
New advances in cardiology
Lloyd-Jones said that “one of the good things” about working in the field of cardiovascular health is the fact that “there is so much research going on all the time that really moves the field forward.”
He said that 20 years ago there was almost nothing that could help treat heart failure. That has changed. “We have life-prolonging drugs, preventing hospitalizations for heart failure, the ability to really change the quality of life for our patients with heart failure. “It’s a whole new world,” he said. “Some of my colleagues have changed from what is called ‘heart failure’ to ‘heart success’.”
This year, Lloyd-Jones said, we have witnessed evidence and data that looked at a newer group of drugs called sodium-glucose-2 inhibitors (SGLT2) inhibitors.
“They were created to be medicines for diabetes that are really effective in treating heart failure, reducing cardiovascular death, reducing hospitalizations for heart failure and changing the true history of heart failure, and “Improving heart function,” he said. “I think it’s been the history of recent years and this year the evidence continues to show how powerful that class of medicine is.”
“Inhibitors are really very safe and extremely effective and will be an important part of what we do for our patients moving forward,” he added. Lloyd-Jones noted the Salt Replacement and Stroke Study outside China this year as a research breakthrough that builds a guide on how we can rethink our approach to sodium consumption.
He said the study addresses an “old question” about how important dietary salt intake is in influencing the risk of heart attack and stroke. “Debates have erupted over ‘does it matter, should we reduce the sodium content in the food supply, should people reduce the salt they add to their foods?'” He explained.
In this salt study, we surveyed about 21,000 people in China who were either over 60 or had poorly managed high blood pressure.
The researchers randomized the villages that made up the size of the study population into different groups. Some used a salt substitute, while others continued to use just plain salt, or sodium chloride, in their food when cooking.
In short, the risk of stroke, major cardiovascular problems, and death were reduced in those who used the salt substitute compared with those who used the normal salt.
Basically, no list of medical advances for each year can be comprehensive or exhaustive. There are countless innovations being made to make life better for more people and to address some of the most pressing health issues of our day.