RNAs介导的干细胞诱导技术研究进展

诱导性多能干细胞(i PSCs)技术可重编程体细胞为胚胎干细胞(ESCs)样的多能性细胞,在药物筛选、再生医学等领域具有巨大的应用潜力。i PSCs技术自2006年首次报道用逆转录病毒转导一组转录因子,将小鼠(Mus musculus)成纤维细胞成功重编程为i PSCs以来,便不断改进和完善。近年来,不引起任何基因组改变的RNAs介导的i PSCs技术成为新兴的研究热点,主要包括修饰m RNAs法、mi RNAs法、si RNAs法和lnc RNAs法等。本文综述了RNAs介导的各种i PSCs技术的研究进展,分析了这些技术的优势、存在的不足及改进的方向等,为i PSCs技术的发展与应用提供参考。     

生物医药关键技术发展趋势

近年来,生物医药研究人员正在药物的设计、发现、试验、制备,以及检测技术、其他诸如纳米、信息、光学等高技术的融合应用方面致力于更新观念的研究开发,并已取得众多突破,在相关领域形成新的技术趋势。在药物设计方面,随着遗传信息方面的研究进展越来越快,核酸为靶的药物设计已成为新的热点;在疫苗方面,基因疫苗的研制已成为新方向,其技术应用趋向可调控、更安全、更高效生产等,科研人员同时还致力于解决基因疫苗的安全性;在治疗方面,抗体工程和组织工程分别成为药物治疗和组织器官再造的热点;新型药物输送技术正成为业界追逐的目标,药物传输公司正在开发多技术平台,提高药物的效能,减少不良反应和降低成本;药物安全问题已在全球范围内达成共识,美、英、日、欧盟等国均在积极开展药物安全性方面的研究,开发药物安全监测系统;疾病诊断与检测的新技术表现为更高效、准确、快速、早期的趋势,科研人员同时还致力于降低诊断检测产品的价格,以使更多人受益;IT技术、光电技术、纳米技术等新技术正被积极应用于生物医药领域,为大型制药公司和生物技术公司提供药物发现、设计、毒性研究等更新途径的新技术系统。     

Opportunities and surprises in crops modified by transgenic technology: metabolic engineering of benzylisoquinoline alkaloid, gossypol and lysine biosynthetic pathways

The development of new or improved traits in plants, whether that is through traditional genetic modification and selection or through transgenic technologies, is associated with the potential risk of unintended changes with harmful or unacceptable consequences. The greater definition and precision of transgenic modification and the regulatory oversight of such technology may, however, confer advantages in safety and efficacy. This bears considerable relevance to the use of transgenic-based metabolic engineering in agricultural trait development. Metabolic engineering seeks to modify the amounts or chemical structures within selected biosynthetic routes without introducing inadvertent effects on other metabolic pathways. Examples discussed here include attempts to; (i) modify benzylisoquinoline alkaloid biosynthesis in poppy, (ii) improve the nutritional value of maize by increasing levels of free lysine, and (iii) increase the nutritional value of cottonseed by eliminating gossypol production. Clearly, evaluation of the efficacy (and unintended consequences) of such approaches is vital. A role for metabolomics in the compositional and metabolite analyses of new plant varieties derived from transgenic-based metabolic engineering is discussed. Major themes discussed in this review include; (i) the heightened level of scrutiny associated with genetically modified (GM) crop evaluations has markedly contributed to the safety in the adoption of transgenic technology, and (ii) the nature of any introduced trait may prove more relevant to safety assessments than the means by which the trait is introduced.     

CRISPR/Cas9-mediated genome editing: From basic research to translational medicine

The recent development of the CRISPR/Cas9 system as an efficient and accessible programmable genome-editing tool has revolutionized basic science research. CRISPR/Cas9 system-based technologies have armed researchers with new powerful tools to unveil the impact of genetics on disease development by enabling the creation of precise cellular and animal models of human diseases. The therapeutic potential of these technologies is tremendous, particularly in gene therapy, in which a patient-specific mutation is genetically corrected in order to treat human diseases that are untreatable with conventional therapies. However, the translation of CRISPR/Cas9 into the clinics will be challenging, since we still need to improve the efficiency, specificity and delivery of this technology. In this review, we focus on several in vitro, in vivo and ex vivo applications of the CRISPR/Cas9 system in human disease-focused research, explore the potential of this technology in translational medicine and discuss some of the major challenges for its future use in patients.     

Emerging technologies and their impact on regulatory science

There is an evolution and increasing need for the utilization of emerging cellular, molecular and in silico technologies and novel approaches for safety assessment of food, drugs, and personal care products. Convergence of these emerging technologies is also enabling rapid advances and approaches that may impact regulatory decisions and approvals. Although the development of emerging technologies may allow rapid advances in regulatory decision making, there is concern that these new technologies have not been thoroughly evaluated to determine if they are ready for regulatory application, singularly or in combinations. The magnitude of these combined technical advances may outpace the ability to assess fit for purpose and to allow routine application of these new methods for regulatory purposes. There is a need to develop strategies to evaluate the new technologies to determine which ones are ready for regulatory use. The opportunity to apply these potentially faster, more accurate, and cost-effective approaches remains an important goal to facilitate their incorporation into regulatory use. However, without a clear strategy to evaluate emerging technologies rapidly and appropriately, the value of these efforts may go unrecognized or may take longer. It is important for the regulatory science field to keep up with the research in these technically advanced areas and to understand the science behind these new approaches. The regulatory field must understand the critical quality attributes of these novel approaches and learn from each other''s experience so that workforces can be trained to prepare for emerging global regulatory challenges. Moreover, it is essential that the regulatory community must work with the technology developers to harness collective capabilities towards developing a strategy for evaluation of these new and novel assessment tools.     

People's concerns about biotechnology: some problems and some solutions

Pharmaceuticals and vaccines made by genetic engineering are well accepted all over the world. In contrast, there are many people, particularly in Europe, who are worried that food, made by the same new technology, may harm their health or cause damage to the environment. This is despite the growing evidence that genetically modified crops have the potential to improve world food security and the fact that there have, as yet, been no adverse results of their use in the food chain. Because of these worries and the mechanisms of politics, agricultural biotechnology has become the target of concerns about food safety (BSE, Foot & Mouth Disease), along with globalisation and the power of multinational companies. These concerns will, hopefully, be overcome by a more open and well-informed dialogue between scientists, opinion leaders, educators and the public. If judiciously applied, genetically modified crops will help increase sustainability and the fight against hunger in the world.     

Transforming scientific evidence into better consumer choices

Translational research using evidence-based and comparative effectiveness research continues to evolve, becoming a useful tool in improving informed consent and decision-making in the clinical setting. While in development, emerging technologies, including cellular and molecular biology, are leading to establishing evidence-based dental practices. One emerging technology, which conjoins bench proteomic findings to clinical decision-making for treatment intervention, is the Translational Evidence Mechanism. This mechanism was developed to be a foundation for a compact between researcher, translational researcher, clinician, and patient. The output of such a mechanism is the clinical practice guideline (CPG), an interactive tool for dentists and patients to game evidence in reaching optimum clinical decisions that correspond to individual patient preferences and values. As such, the clinical practice guideline requires the vesting of decision, utility, and cost best evidence. Evidence-based research provides decision data, a first attempt at supporting decision-making by providing best outcome data. Since then comparative effectiveness research has emerged, using systematic review analysis to compare similar treatments or procedures in maximizing the choice of the most effective cost/benefit option within the context of best evidence. With innovation in the clinical practice guideline for optimizing efficacy and comparative effectiveness research, evidence-based practices will shape a new approach to health-based systems that adhere to shared decision-making between bench scientists, healthcare providers and patients.     

The impact of eHealth on the quality and safety of health care: a systematic overview

Background

There is considerable international interest in exploiting the potential of digital solutions to enhance the quality and safety of health care. Implementations of transformative eHealth technologies are underway globally, often at very considerable cost. In order to assess the impact of eHealth solutions on the quality and safety of health care, and to inform policy decisions on eHealth deployments, we undertook a systematic review of systematic reviews assessing the effectiveness and consequences of various eHealth technologies on the quality and safety of care.

Methods and Findings

We developed novel search strategies, conceptual maps of health care quality, safety, and eHealth interventions, and then systematically identified, scrutinised, and synthesised the systematic review literature. Major biomedical databases were searched to identify systematic reviews published between 1997 and 2010. Related theoretical, methodological, and technical material was also reviewed. We identified 53 systematic reviews that focused on assessing the impact of eHealth interventions on the quality and/or safety of health care and 55 supplementary systematic reviews providing relevant supportive information. This systematic review literature was found to be generally of substandard quality with regards to methodology, reporting, and utility. We thematically categorised eHealth technologies into three main areas: (1) storing, managing, and transmission of data; (2) clinical decision support; and (3) facilitating care from a distance. We found that despite support from policymakers, there was relatively little empirical evidence to substantiate many of the claims made in relation to these technologies. Whether the success of those relatively few solutions identified to improve quality and safety would continue if these were deployed beyond the contexts in which they were originally developed, has yet to be established. Importantly, best practice guidelines in effective development and deployment strategies are lacking.

Conclusions

There is a large gap between the postulated and empirically demonstrated benefits of eHealth technologies. In addition, there is a lack of robust research on the risks of implementing these technologies and their cost-effectiveness has yet to be demonstrated, despite being frequently promoted by policymakers and “techno-enthusiasts” as if this was a given. In the light of the paucity of evidence in relation to improvements in patient outcomes, as well as the lack of evidence on their cost-effectiveness, it is vital that future eHealth technologies are evaluated against a comprehensive set of measures, ideally throughout all stages of the technology''s life cycle. Such evaluation should be characterised by careful attention to socio-technical factors to maximise the likelihood of successful implementation and adoption. Please see later in the article for the Editors'' Summary     

Transforming scientific evidence into better consumer choices

Translational research using evidence-based and comparative effectiveness research continues to evolve, becoming a useful tool in improving informed consent and decision-making in the clinical setting. While in development, emerging technologies, including cellular and molecular biology, are leading to establishing evidence-based dental practices. One emerging technology, which conjoins bench proteomic findings to clinical decision-making for treatment intervention, is the Translational Evidence Mechanism. This mechanism was developed to be a foundation for a compact between researcher, translational researcher, clinician, and patient. The output of such a mechanism is the clinical practice guideline (CPG), an interactive tool for dentists and patients to game evidence in reaching optimum clinical decisions that correspond to individual patient preferences and values. As such, the clinical practice guideline requires the vesting of decision, utility, and cost best evidence. Evidence-based research provides decision data, a first attempt at supporting decision-making by providing best outcome data. Since then comparative effectiveness research has emerged, using systematic review analysis to compare similar treatments or procedures in maximizing the choice of the most effective cost/benefit option within the context of best evidence. With innovation in the clinical practice guideline for optimizing efficacy and comparative effectiveness research, evidence-based practices will shape a new approach to health-based systems that adhere to shared decision-making between bench scientists, healthcare providers and patients.     

“Golden Rice”, a GMO-product for public good,and the consequences of GE-regulation

Compared to a non - genetically engineered (GE) variety, the deployment of Golden Rice suffers from a delay of more than 10 years. The cause for this delay is GE-regulation. Considering the potential impact of Golden Rice on the reduction in vitamin A-malnutrition, this delay is responsible for loss of numerous lives, mostly children and women. GE-regulation is also responsible for the fact that public institutions are prevented from delivering a public good GE-product with the consequence that we are faced with a de-facto monopoly in favour of a few potent industries. Considering the forgone benefits from putative public good GE-products, GE-regulation can be blamed of being responsible for millions of lives, all of them, of course, in developing countries. As there is no scientific justification for present GE-regulation and as it has, so far, not prevented any harm, our society has the responsibility to reconsider present regulation which is based on the concept of an extreme interpretation of the precautionary principle. It would be justified to change regulation to a science-base and to regulate traits instead of technology. This would make regulation cheaper and faster, without compromising safety. GE-technology has an unprecedented safety record and it is far more precise and predictable than any other “traditional” and unregulated breeding technology.     

Bioethics and biotechnology

Biotechnology is at the intersection of science and ethics. Technological developments are shaped by an ethical vision, which in turn is shaped by available technology. Much in biotechnology can be celebrated for how it benefits humanity. But technology can have a darker side. Biotechnology can produce unanticipated consequences that cause harm or dehumanise people. The ethical implications of proposed developments must be carefully examined. The ethical assessment of new technologies, including biotechnology, requires a different approach to ethics. Changes are necessary because new technology can have a more profound impact on the world; because of limitations with a rights-based approach to ethics; because of the importance and difficulty of predicting consequences; and because biotechnology now manipulates humans themselves. The ethical questions raised by biotechnology are of a very different nature. Given the potential to profoundly change the future course of humanity, such questions require careful consideration. Rather than focussing on rights and freedoms, wisdom is needed to articulate our responsibilities towards nature and others, including future generations. The power and potential of biotechnology demands caution to ensure ethical progress.     

Overview of marker vaccine and differential diagnostic test technology.

Recent advances in molecular biology, immunology, microbiology, genetics and microbial pathogenesis have lead to the development of a wide variety of new approaches for developing safer and more effective vaccines based on designs such as subunit vaccines, gene deleted vaccines, live vectored vaccines, and DNA mediated vaccines. Technology tools can be as basic as identifying naturally occurring strains with deletions that support differentiating infected from vaccinated animal (DIVA) needs or be based on higher technology developments such as improved protein expression and purification methods, transgenic plant- and plant virus-based antigen production, and novel adjuvants that target specific immune responses. These new approaches, when applied to the development of marker vaccines and companion diagnostic test kits hold tremendous potential for developing improved tools for eradication and control programs. Marker vaccines and companion diagnostic test kits must meet the established licensing requirements for purity, potency, safety and efficacy. Efficacy claims are based on evaluation of the level of protection demonstrated in host animal trials and may range from "prevents infection with (a specific agent)", to "for use as an aid in the reduction of disease due to (a specific agent)." The differences in claims and recommendations are a function of the variation in protection elicited by various vaccines. For designing effective eradication programs, vaccine efficacy characteristics such as for reducing susceptibility to infections and spread of infections must be well defined; similarly, diagnostic test performance characteristics (efficacy) must be determined. In addition to data to support efficacy claims, it is imperative that safety of production and use of vaccines be evaluated. During the design of marker vaccines and diagnostic tests, it is important to consider the application of appropriate technologies to improve the safety of these products. Use of recombinant technologies for production of vaccines and/or diagnostic test antigens can reduce the biosafety concerns during production and during use, including human exposure to zoonotic pathogens during production and use, and potential spread of foreign animal disease agents due to loss of biocontainment. In addition, vaccines may induce adverse reactions. It is important to determine the frequency of adverse events and to reduce the likelihood of induction of adverse reactions through proper design.     

Implantable device recalls: are we throwing away the baby with the bath water?

Over the past year, there has been a sharp increase in the number of recalls, or `field safety corrective actions'' concerning implantable defibrillators. This may be due to an actual rise in device or component-related problems (for which there is some evidence), overzealous reporting of potential problems (which is apparent), or most probably a combination of the two. In this day and age of increasing numbers of ICD implantations, it is essential that all concerned realise that ICDs are no more infallible than other man-made devices and that the incidence of complications is therefore likely to increase commensurately. It is also important to weigh the procedural risk of replacing the device against the risk not only of device failure, but more importantly related harm to the patient. Odds actually favour replacement in very few cases. Above all this demands critical attention to communication between stakeholders, medical, industry, patients and press. This article attempts to place a number of these issues in some perspective, and offer future directions for management of ICD recalls and safety actions.     

Realizing the promise of IVF in cattle--an overview

The in vitro-produced embryo could play a central role in dairy and beef production systems because of its potential role in genetic selection strategies and crossbreeding schemes, and because it can be integrated into reproductive management strategies for improving pregnancy rates in herds with low fertility. The promise attendant upon use of in vitro-produced embryos is not being fully realized, however. Indeed, there are important technical limitations to their production that reduce the desirability of in vitro-produced embryos because of increased costs, sub-optimal embryonic and fetal survival, and offspring that are occasionally abnormal. Most technical problems associated with in vitro production of embryos can be overcome through research. Among the requirements for a successful research program will be renewed emphasis on conducting embryo transfer trials to determine effects of modifications to embryo production protocols on pregnancy rates and fetal development. Given the promise of in vitro embryo technologies, there is an urgent need for a concerted and sustained investment in research to improve these technologies. Developing a consensus that the study of embryo technology is one of the most important areas of agricultural research should be both an individual and organizational priority.     

Necromancing the stones.

Since its introduction 15 years ago extracorporeal shockwave lithotripsy (ESWL) has become a standard treatment for urinary stones. The author comments on the results of Adrian R. Levy and Maurice McGregor''s study of the use of ESWL for urinary stones in Quebec (see pages 1729 to 1736 of this issue). The rapid increase in the use of ESWL that occurred in the first 2 years of the study points to the fact that the application of a new technology is often quickly expanded before thorough assessments of effectiveness and safety have been carried out. New technologies also lead to shifts in cost distribution that must be considered in cost analyses. The author argues that continuing research is needed to document the dissemination of new technologies and points to methodologic concerns that should be addressed to make such research as fruitful as possible.     

Factors affecting commercial application of embryo technologies in New Zealand: a modelling approach

New reproductive technologies include sexed sperm and embryo-based technologies. The technology of sperm sexing, for various reasons, is not available in New Zealand and its use has not been modelled. Embryo technologies are however already in use on a limited scale and various scenarios for their use in both the dairy and beef industries in New Zealand have been modelled. This review briefly discusses the various technologies available and some of their potential strengths and weaknesses. In the dairy industry, modelling has been used to simulate the production of breeding bulls for large breeding companies and the production of replacement heifers in dairy herds. For the beef industry, similar modelling has been carried out to determine the opportunities for more efficient beef production.All the models confirmed that at current levels of performance, embryo-based reproductive technologies are usually not profitable in New Zealand except in niche market situations where the returns from the resulting offspring are significantly greater than can be obtained from natural mating or artificial insemination (AI) reproduction systems. This is confirmed by the low uptake of these technologies in this country to date. Even if performance lifts to levels similar to AI, profitability is likely to occur only if the costs of pregnancies to embryo-based reproductive technologies can occur at prices less than two to four times greater than AI or natural mating. This break-even requirement depends on the returns that can be achieved and the advantages that can be captured by the technology over and above those available from AI or natural mating. Two new uses for reproductive technologies in dairy cattle could be the proliferation of novel or rare genotypes from gene discovery programs and improving the female reproductive rate for optimal marker assisted selection. In both these uses the technology is not at present competing with AI or natural mating. The challenge exists therefore for the biological scientists to satisfy these requirements, coupled with the ethical and human factors involved in the introduction of any new technology.Potential end users of the technologies have been surveyed. They are quite positive about the technologies provided they can use them profitably and are keen to obtain more information about them.     

Assessment of dietary intake: NuGO symposium report

Advances in genomics science and associated bioinformatics and technology mean that excellent tools are available for characterising human genotypes. At the same time, approaches for characterising individual phenotypes are developing rapidly. In contrast, there has been much less investment in novel methodology for measuring dietary exposures so that there is now a significant gap in the toolkit for those investigating how diet interacts with genotype to determine phenotype. This symposium reviewed the strengths and limitations of current tools used in assessment of dietary intake and the potential to improve these tools through, for example, the use of statistical techniques that combine information from different sources (such as modelling and calibration methods) to ameliorate measurement error and to provide validity checks. Speakers examined the use of approaches based on technologies such as mobile 'phones, digital cameras and Web-based systems which offer the potential for more acceptable (for study participants) and less laborious (for researchers and participants) routes to more robust data collection. In addition, the application of omics, especially metabolomics, tools to biofluids to identify new biomarkers of intake offers great potential to provide objective measures of food consumption with the advantage that data may be collected in forms that can be integrated readily with other high throughput (nutrigenomic) technologies.     

Biomarker technology roundup: from discovery to clinical applications, a broad set of tools is required to translate from the lab to the clinic

Biomarkers are being utilized throughout the drug discovery and development process to understand fundamental biological processes and relationships. Specific biomarkers for disease states, prognosis, and response to therapy have been applied to screening tissues and serum, and serve as new tools in the development of therapeutics, to segment the population for specific treatments. The use of specific biomarkers to screen subjects to determine clinical trial eligibility, and for early toxicology studies, holds the potential to decrease drug failure rates in the later phases of the clinical trial process. Traditional research tools have been employed to study the genes, proteins, and metabolites of interest. In addition, new technologies and permutations of existing technologies have been developed particularly for investigation in the preclinical and clinical phases of drug development. More importantly, the transition of a compound from preclinical to clinical is aided by technologies that span both process segments. Identification of biomarkers that can be studied throughout the development process requires technologies that are both feasible and cost-effective for large patient populations.