10.3 Medical Biotechnology in Advancement of Healthcare in Diabetes and Cancer

Introduction

Medical biotechnology is the use of living cells and organisms for the synthesis of diagnostic and pharmaceutical products used in the treatment of various diseases. It has significantly advanced healthcare, particularly in the management of diabetes and cancer. This topic explains how medical biotechnology has improved the diagnosis and treatment of these two major diseases.

Definition

Medical biotechnology: The use of living cells and organisms for the synthesis of diagnostic and pharmaceutical products used in treatment of various diseases.

Main Idea

Medical biotechnology has significantly advanced healthcare to manage diabetes and cancer through continuously improving the treatments and diagnostic tools for these diseases.

Core Concept

Medical Biotechnology in Diabetes and Cancer

Detailed Explanation

Part 1: Diabetes

Diagnosis of type and level of disease is a key step in its effective cure. Bio medical technology is being used for earlier, accurate and efficient diagnosis of diabetes.

Following are some important contributions of biotechnology in diagnosis of diabetes:

(a) Biosensors for Glucose Monitoring (Glucose Meters)

Biosensors for glucose monitoring (glucose meters) have been developed by experimenting with genetically engineered organisms. Biosensors are used to measure blood glucose levels. The devices have electrodes which sense the level of enzymes in the blood that react with glucose. These devices generate an electrical signal proportional to glucose concentration per unit volume of blood.

Simple explanation: Glucose meters are small devices that measure blood sugar levels. They use enzymes and electrodes to generate an electrical signal.

(b) Continuous Glucose Monitoring (CGM) Devices

Continuous glucose monitoring (CGM) devices have been developed which are the product of biotechnological innovation. These devices provide real-time data of blood glucose levels in a diabetic patients to manage their disease condition more effectively. Thus help in timely adjustments of insulin doses and dietary plans for patients.

Science Titbits:

The CGM sensor checks blood sugar levels every few minutes and wirelessly sends the information to a digital controller. The controller, which can be a computer program in the pump or a mobile app, analyzes the data and instructs the insulin pump to deliver the right amount of insulin. The pump then delivers insulin when blood sugar levels rise above a target range.

Simple explanation: CGM devices continuously monitor blood sugar and send the data to a controller, which can automatically deliver insulin.

(c) Assays for HbA1c Levels

Assays have been developed through biotechnology to measure HbA1c levels in blood. HbA1c test measures the amount of blood glucose attached to hemoglobin in RBCs. As RBCs generally live for about three months so, HbA1c levels reflect the average blood glucose levels over the past 2-3 months. This provides insights into long-term glucose control.

Simple explanation: The HbA1c test measures average blood sugar over the past 2-3 months.

(d) Biomarker Molecules

Biomarker molecules (proteins or other metabolites) for diabetes have been identified by biotechnologists for diagnosis of disease in its early stages or monitoring the progression of disease.

Simple explanation: Biomarkers are molecules that indicate the presence or progression of diabetes.

(e) Insulin Production

Initially insulin for the use of diabetic patients have been derived from animal sources but now biotechnology has transformed insulin production by genetically modified bacteria. Insulin is now chiefly produced through recombinant DNA technology. This method is reliable for large-scale production of human insulin with purity and best quality, ensuring a stable and safe supply for diabetic patients worldwide.

Simple explanation: Insulin is now produced using genetically modified bacteria through recombinant DNA technology. This ensures a safe and stable supply.

(f) Artificial Pancreas

Recent advancements in medical biotechnology is the development of the closed-loop insulin delivery systems. Patients with diabetes Type-1 can use this device. It is an insulin pump which release required amount of insulin after the detection of blood sugar levels. Insulin pump is connected to the monitor through a computer programme which continuously detect the blood sugar levels. This is also called artificial pancreas. These systems improve the glucose control and minimize complications.

Simple explanation: The artificial pancreas is a device that automatically delivers insulin based on continuous blood sugar monitoring.

Part 2: Cancer

Cancer is one of the most damaging and fatal disease all over the world and its prevalence is rising every year. Uncontrolled divisions of some the body cells is called tumor. All tumors are not termed as cancer. Tumor that remain small and localized in the tissue of its origin called benign tumor but when tumor grows aggressively to increase in size and spread to neighbouring tissues or organs, it is termed as malignant tumor. Spreading of tumor to other body tissues and organs is called Metastasis. Cancer is the group of diseases or abnormalities faced by the body due to aggressive growth and spreading malignant tumors.

Cancer may start almost in any organ of the human body. Most prevalent types of cancers include the cancers of lung, breast, prostate, oral and colorectal region. Cancer is the leading cause of deaths globally, with more than 10 million deaths in 2020 (Ali et al., 2022). According to World Health Organization statistics, collected by International Agency for Research on Cancer (IARC) 185,748 new cancer cases and 118,631 deaths have been reported in Pakistan in 2022.

To manage and treat this drastically fatal disease, biotechnology has helped the human in many ways. Effective management and treatment of any type of cancer mainly depends upon following factors:

a. Early and accurate diagnosis b. Result oriented Targeted therapies c. Patient Specific Medicine d. Continuous research for innovative tools of cancer treatment

(a) Early and Accurate Diagnosis of Cancer

Diagnosis of cancer at initial stages is helpful for better and complete cure of cancer with least chances of reoccurrence. Biotechnology research involving different types of cancer cell lines has significantly helped oncologists for early and accurate detection of cancer type and stage of disease.

1. Confirmation of roles of different genes and protein in proliferation and metastasis is carried out by research involving in-vitro growth of the cancer cell lines.

2. Increase or decrease in level of specific proteins in the body of the suspected cancer patient is used as biomarkers. Over production of specific proteins in the human body is used as tumor marker for breast, ovarian and lung cancer. Over production of some proteins is related to aggressive nature of breast cancer. Higher levels of such protein can help in early diagnosis of cancer.

3. Mutations in different genes may lead to initiation and progression of cancer. Mutations in some tumor suppressor genes are significantly associated with high risk of breast, ovarian and uterine cancers.

Science Titbits:

• Over production of HER2/neu protein in a cancer patient (called HER2/neu positive) is related to aggressive nature of breast cancer.
• CA125 protein is tumor marker for ovarian and lung cancer.
• BRACA1 and BRACA2 genes are tumor suppressor genes that produce proteins which help in repair of damage to DNA. Mutations in these genes affect the ability to suppressor tumor and significantly increase the risk of breast, ovarian and uterine cancers.

4. Target genes are experimentally knockdown or knockout in cell lines to validate the involvement of specific genes in cancer.

5. Experiments on animal models like rats and rabbits are also performed to confirm the role of specific genes and proteins markers in cancer.

6. Research for screening of cancer patients for the mutations and abnormal levels of specific protein markers also help for early diagnosis of cancer.

7. Biotechnologist have also developed the mechanism to get liquid biopsies instead of direct surgeries. Liquid biopsies are used to isolate and analyze circulating tumor cells, cell free DNA and other biomarkers in blood samples.

Simple explanation: Biotechnology helps in early and accurate diagnosis of cancer through biomarkers, gene mutation analysis, and liquid biopsies.

(b) Result Oriented Targeted Therapies

Treatment of cancer by chemotherapy and radiotherapy may have wide range of side effects on the normal body tissues. Biotechnological research using different cancer cell lines has developed the drugs or chemicals for targeted therapies for various types of cancer. Multiple anticancer chemicals have been designed which are absorbed mainly by cancer cells and normal body cells either do not absorb these chemicals or absorb in negligible quantities. Thus, these chemicals specifically target tumor cells and thus minimize the damage to healthy tissues of the body. Now, doses of targeted anticancer drugs can be safely raised for effective damage to cancer cells. Monoclonal antibodies and specifically designed molecule inhibit multiple enzymes of cell cycle thus block the specific pathways which are crucial for cancer cell growth. This research has led the oncologists to have improved treatment outcomes with minimal side effects.

Simple explanation: Targeted therapies use drugs that specifically attack cancer cells without harming healthy cells.

(c) Patient Specific Medicine

Every cancer patients has different disease history and need specific medicine for treatment. Biotechnology has been playing an important role to decide precise medicine for cancer treatment. On the basis of their genetic makeup, tumor type, stage of cancer, age, gender and race, specific medicines and doses are decided for individual patients. This approach is continuously helping the oncologists to design the most effective therapies. Actions of newly designed medicines are investigated by experiments on cancer cell lines and animal models before applying to patients. Such patient specific precise plans, predictions and responses lead to greater success in treatment and long term disease free survival.

Simple explanation: Patient-specific medicine uses genetic and clinical information to choose the best treatment for each patient.

(d) Continuous Research for Innovative Tools of Cancer Treatment

Continuous research involving Biotechnology is playing a critical role in improved cancer detection and treatment. Extensive research on cancer biotechnology is in progress to develop innovative tools of cancer treatment.

Science Titbits: Innovative Tools of Cancer Treatment

1. Liquid biopsy techniques to detect cancer through a simple blood test by identifying circulating tumor DNA (ctDNA), circulating tumor cells (CTCs) etc. as cancer-related biomarkers.

2. Next-Generation Sequencing (NGS) to analyze cancer related genetic mutations in DNA for earlier detection of cancers and its types.

3. Monoclonal Antibodies are being designed to specifically target cancer cells without harming healthy tissue e.g. Trastuzumab (Herceptin) for HER2-positive breast cancer.

4. Immunotherapy to engineer T-cells of patients to develop receptors for destroying cancer cells.

5. Gene knockdown is carried out to reduce the expression of a specific gene temporarily by interfering the gene's mRNA. Thus production of protein, responsible for cancer progression is suppressed. The knockdown gene remains present in the genome so suppression can be reversed anytime.

6. Gene knockout is carried out to completely inactivate or remove the gene from the genome. To get the complete and permanent loss of gene function, gene is either completely deleted or mutated in such a way that normal functional protein responsible for cancer progression is not produced.

7. Animal models are experimentally used to verify the initial effects of gene mutations, gene knockdown or gene knockout. For this purpose rabbits, mouse or guinea pigs are used instead of direct humans as experimental animals in cancer research.

8. Cancer Vaccines and Viruses: vaccines are also being developed by experimentally using cancer cells or antigens of cancer patients to stimulate their immune system. White blood cells of patients start producing antibodies against cancer cells. Similarly, Viruses are engineered to selectively infect and destroy cancer cells only and healthy cells are not affected.

9. Nanoparticles are developed and used to deliver cancer drugs directly to specific cancer cells. By using nanoparticles, effectiveness of chemotherapy and radiation therapy is increased to get better cure.

10. Use of artificial intelligence (AI) will be greatly helpful for researchers to investigate the outcome of ongoing researches from available data. AI is being used to identify the disease patterns, cancer diagnosis and treatment results in clinical trials. AI will be helpful to biotechnologists in designing novel combinations of vaccines, viruses and targeted therapies of cancer.

Simple explanation: Biotechnology is developing new tools like liquid biopsy, NGS, monoclonal antibodies, immunotherapy, gene knockdown/knockout, cancer vaccines, nanoparticles, and AI for better cancer treatment.

Summary Table

Diabetes

Cancer

Intermediate Level

Medical biotechnology has advanced healthcare in diabetes and cancer.

Diabetes:

Cancer:

Key points:

• Biotechnology has transformed insulin production.
• CGM and artificial pancreas improve diabetes management.
• Cancer diagnosis is improved by biomarkers and liquid biopsies.
• Targeted therapies minimize side effects.
• Patient-specific medicine improves outcomes.
• Innovative tools are being developed for cancer treatment.

Important Points

• - Use of living cells and organisms for the synthesis of diagnostic and pharmaceutical products used in treatment of various diseases is termed as Medical Biotechnology.
• - Medical biotechnology has significantly advanced healthcare to manage the diabetes and cancer through continuously improving the treatments and diagnostic tools for these diseases.
• - Diabetes:
• - Diagnosis of type and level of disease is key step in its effective cure.
• - Bio medical technology is being used for earlier, accurate and efficient diagnosis of diabetes.
• - Following are some important contributions of biotechnology in diagnosis of diabetes:
• - Biosensors for glucose monitoring (glucose meters) have been developed by experimenting with genetically engineered organisms. Biosensors are used to measure blood glucose levels. The devices have electrodes which sense the level of enzymes in the blood that react with glucose. These devices generate an electrical signal proportional to glucose concentration per unit volume of blood.
• - Continuous glucose monitoring (CGM) devices have been developed which are the product of biotechnological innovation. These devices provide real-time data of blood glucose levels in a diabetic patients to manage their disease condition more effectively. Thus help in timely adjustments of insulin doses and dietary plants for patients.
• - Assays have been developed through biotechnology to measure HbA1c levels in blood. HbA1c test measures the amount of blood glucose attached to hemoglobin in RBCs. As RBCs generally live for about three months so, HbA1c levels reflect the average blood glucose levels over the past 2-3 months. This provides insights into long-term glucose control.
• - Biomarker molecules (proteins or other metabolites) for diabetes have been identified by biotechnologists for diagnosis of disease in its early stages or monitoring the progression of disease.
• - Insulin Production: Initially insulin for the use of diabetic patients have been derived from animal sources but now biotechnology has transformed insulin production by genetically modified bacteria. Insulin is now chiefly produced through recombinant DNA technology. This method is reliable for large-scale production of human insulin with purity and best quality, ensuring a stable and safe supply for diabetic patients worldwide.
• - Artificial Pancreas: Recent advancements in medical biotechnology is the development of the closed-loop insulin delivery systems. Patients with diabetes Type-1 can use this device. It is an insulin pump which release required amount of insulin after the detection of blood sugar levels. Insulin pump is connected to the monitor through a computer programme which continuously detect the blood sugar levels. This is also called artificial pancreas. These systems improve the glucose control and minimize complications.
• - Cancer:
• - Cancer is one of the most damaging and fatal disease all over the world and its prevalence is rising every year.
• - Uncontrolled divisions of some the body cells is called tumor.
• - All tumors are not termed as cancer.
• - Tumor that remain small and localized in the tissue of its origin called benign tumor but when tumor grows aggressively to increase in size and spread to neighbouring tissues or organs, it is termed as malignant tumor.
• - Spreading of tumor to other body tissues and organs is called Metastasis.
• - Cancer is the group of diseases or abnormalities faced by the body due to aggressive growth and spreading malignant tumors.
• - Cancer may start almost in any organ of the human body.
• - Most prevalent types of cancers include the cancers of lung, breast, prostate, oral and colorectal region.
• - Cancer is the leading cause of deaths globally, with more than 10 million deaths in 2020 (Ali et al., 2022).
• - According to World Health Organization statistics, collected by International Agency for Research on Cancer (IARC) 185,748 new cancer cases and 118,631 deaths have been reported in Pakistan in 2022.
• - To manage and treat this drastically fatal disease, biotechnology has helped the human in many ways.
• - Effective management and treatment of any type of cancer mainly depends upon following factors:
• a. Early and accurate diagnosis
• b. Result oriented Targeted therapies
• c. Patient Specific Medicine
• d. Continuous research for innovative tools of cancer treatment
• - Early and accurate diagnosis of cancer: Diagnosis of cancer at initial stages is helpful for better and complete cure of cancer with least chances of reoccurrence. Biotechnology research involving different types of cancer cell lines has significantly helped oncologists for early and accurate detection of cancer type and stage of disease.
• - Result Oriented Targeted Therapies: Treatment of cancer by chemotherapy and radiotherapy may have wide range of side effects on the normal body tissues. Biotechnological research using different cancer cell lines has developed the drugs or chemicals for targeted therapies for various types of cancer.
• - Patient Specific Medicine: Every cancer patients has different disease history and need specific medicine for treatment. Biotechnology has been playing an important role to decide precise medicine for cancer treatment.
• - Continuous research for innovative tools of cancer treatment: Continuous research involving Biotechnology is playing a critical role in improved cancer detection and treatment. Extensive research on cancer biotechnology is in progress to develop innovative tools of cancer treatment.
• - Innovative tools of cancer treatment:
• 1. Liquid biopsy techniques to detect cancer through a simple blood test by identifying circulating tumor DNA (ctDNA), circulating tumor cells (CTCs) etc. as cancer-related biomarkers.
• 2. Next-Generation Sequencing (NGS) to analyze cancer related genetic mutations in DNA for earlier detection of cancers and its types.
• 3. Monoclonal Antibodies are being designed to specifically target cancer cells without harming healthy tissue e.g. Trastuzumab (Herceptin) for HER2-positive breast cancer.
• 4. Immunotherapy to engineer T-cells of patients to develop receptors for destroying cancer cells.
• 5. Gene knockdown is carried out to reduce the expression of a specific gene temporarily by interfering the gene's mRNA. Thus production of protein, responsible for cancer progression is suppressed. The knockdown gene remains present in the genome so suppression can be reversed anytime.
• 6. Gene knockout is carried out to completely inactivate or remove the gene from the genome. To get the complete and permanent loss of gene function, gene is either completely deleted or mutated in such a way that normal functional protein responsible for cancer progression is not produced.
• 7. Animal models are experimentally used to verify the initial effects of gene mutations, gene knockdown or gene knockout. For this purpose rabbits, mouse or guinea pigs are used instead of direct humans as experimental animals in cancer research.
• 8. Cancer Vaccines and Viruses: vaccines are also being developed by experimentally using cancer cells or antigens of cancer patients to stimulate their immune system. White blood cells of patients start producing antibodies against cancer cells. Similarly, Viruses are engineered to selectively infect and destroy cancer cells only and healthy cells are not affected.
• 9. Nanoparticles are developed and used to deliver cancer drugs directly to specific cancer cells. By using nanoparticles, effectiveness of chemotherapy and radiation therapy is increased to get better cure.
• 10. Use of artificial intelligence (AI) will be greatly helpful for researchers to investigate the outcome of ongoing researches from available data. AI is being used to identify the disease patterns, cancer diagnosis and treatment results in clinical trials. AI will be helpful to biotechnologists in designing novel combinations of vaccines, viruses and targeted therapies of cancer.

Remember

• - Medical biotechnology = use of living cells for diagnostic and pharmaceutical products
• - Diabetes:
• - Biosensors (glucose meters)
• - CGM devices
• - HbA1c assays
• - Biomarkers
• - Insulin production (recombinant DNA technology)
• - Artificial pancreas
• - Cancer:
• - Early diagnosis (biomarkers, gene mutations, liquid biopsies)
• - Targeted therapies
• - Patient-specific medicine
• - Innovative tools (liquid biopsy, NGS, monoclonal antibodies, immunotherapy, gene knockdown/knockout, cancer vaccines, nanoparticles, AI)
• - Cancer = uncontrolled cell division, malignant tumor, metastasis
• - Most prevalent cancers = lung, breast, prostate, oral, colorectal
• - 10 million deaths globally in 2020
• - 185,748 new cases and 118,631 deaths in Pakistan in 2022

Common Mistakes

• 1. Confusing benign and malignant tumors.
• - Benign = localized, not cancer.
• - Malignant = aggressive, spreads (cancer).
• 2. Forgetting the role of biomarkers in cancer diagnosis.
• - Biomarkers like HER2/neu and CA125 help in early diagnosis.
• 3. Mixing up gene knockdown and gene knockout.
• - Knockdown = temporary suppression.
• - Knockout = permanent inactivation.
• 4. Thinking all tumors are cancer.
• - Benign tumors are not cancer.
• 5. Believing cancer has no treatment.
• - Biotechnology has developed many treatments (targeted therapies, immunotherapy, etc.).
• 6. Confusing CGM and artificial pancreas.
• - CGM = monitors glucose.
• - Artificial pancreas = monitors and delivers insulin automatically.
• 7. Ignoring the importance of early diagnosis.
• - Early diagnosis improves cure rates and reduces recurrence.

Quick Revision

Diabetes

Cancer

60-Second Revision

• Medical biotechnology = use of living cells for diagnostic and pharmaceutical products
• Diabetes:
• Biosensors (glucose meters)
• CGM devices
• HbA1c assays
• Biomarkers
• Insulin production (recombinant DNA technology)
• Artificial pancreas
• Cancer:
• Early diagnosis (biomarkers, gene mutations, liquid biopsies)
• Targeted therapies
• Patient-specific medicine
• Innovative tools (liquid biopsy, NGS, monoclonal antibodies, immunotherapy, gene knockdown/knockout, cancer vaccines, nanoparticles, AI)
• Cancer = uncontrolled cell division, malignant tumor, metastasis
• Most prevalent cancers = lung, breast, prostate, oral, colorectal
• 10 million deaths globally in 2020
• 185,748 new cases and 118,631 deaths in Pakistan in 2022
• Warning: Do not confuse benign (not cancer) with malignant (cancer) tumors. Gene knockdown is temporary; gene knockout is permanent.