BBC Health- Putting genetic testing at the heart of the NHS could herald a “revolution” in diagnosing, treating and preventing disease, according to the government’s genetics adviser.

Prof Sir John Bell has been presenting a report on how the NHS should prepare for advances in the field. He said missing out would come at a high cost to patients. Health Secretary Andrew Lansley has announced plans to speed up the introduction of genetic cancer tests. One of the problems with modern medicine is that some of the definitions of disease are too broad.

Prof Bell told the BBC: “Breast cancer has always been defined because it is a tumour in the breast. “But if you look at the molecular detail of those cancers, some are much more similar to ovarian cancers than they are to other breast cancers, in molecular terms and in terms of their response to therapy.”Cancer drugs are generally effective in fewer than one in three patients who take them, the report says.

The theory is that by looking at which genes are active inside a tumour, it will be possible to pick the correct treatment. This is already happening in some cases. Bowel cancer patients with the defective gene K-RAS do not respond to some drugs, while the breast cancer drug herceptin works only if patients have a specific mutation, HER2.

One of the driving forces behind genetics in medicine is the plummeting cost of working out a patient’s genetic code. To sequence one patient’s genome once cost millions of pounds but it now costs thousands, and Prof Bell argues that in the future, the “cost could be essentially nothing”. Prof Bell has previously accused the NHS of being “completely unprepared” for advances in the field of genetics. He has called for ministers to develop a strategy which would see the NHS adopting genetic tools, and training current and new staff in genetics.

He also wants a national centre which could store genetic information about patients who were sequenced. It would allow doctors to compare mutations in the genetic code with other patients who had the same mutation, to help plan treatment. (01/25/12)

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BBC Medical Science – Tiny capsules engineered to mimic part of the body’s immune system could strengthen its response to vaccines, say researchers. The nanoparticles, described in the journal Nature Materials, are a message sent from cells in the skin to warn of a threat.

Scientists from Duke University in the US said mice given them as part of a vaccine coped with otherwise lethal infections. They could soon be suitable for humans.

Vaccination involves priming the immune system to recognise particular bacteria or viruses, so that it is ready to counter-attack quickly in the event of a genuine infection. As well as a deactivated or weakened version of the bacteria or virus in question, many vaccines contain “adjuvants” – extra ingredients designed to enhance this priming process.

The Duke University team aimed to hijack a natural immune response involving cells called mast cells found in the skin. These cells are a key part of the driving force behind the itching and swelling during an allergic reaction, but are also thought to play a role in the “innate immune system” which reacts to infection.

It is believed that when they encounter certain bacteria and viruses, they release small capsules called “granules”, which contain a body chemical called tumour necrosis factor (TNF). These travel to nearby lymph nodes, where the immune response to the infection can begin to be mobilised.

The researchers produced their own granule, also carrying TNF, designed to behave in the same way. When injected at the same time as the vaccine, they are set up to travel to the lymph node and release the chemical, as if sent by an activated mast cell, and hopefully producing a more powerful immune response to the vaccine contents.

To test this, they vaccinated mice against influenza A, adding the nanoparticle “granules”. When exposed to a level of the virus which would normally prove lethal, the vaccinated mice had an improved survival rate. The researchers said it would be possible to add different immune system chemicals to the nanoparticles to tailor the response to exactly the type of vaccine involved. (01/23/12)

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