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6 non infectiousdiseases&geneticengineering


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6 non infectiousdiseases&geneticengineering

  1. 1. 6. Non-infectious Diseases and Genetic Engineering Diabetes Type 1 and Stem Cells
  2. 2. What Do You Know About It?       Do you know which are the causes of diabetes type 1? (Maria) And of diabetes type 2? (Lola) Do you think that grandmother would be right to believe she is responsible for Maria’s diabetes? What is endocrinology department concerned in? What do you know about insulin? What is it? Where is it produced? Which is its function? Do diabetes type 1 and 2 have a definitive cure?
  3. 3. What is Diabetes Type 1?    The pancreas has features of both exocrine (pancreatic juice) and endocrine glands (hormones that regulate blood glucose level) One of these hormones is insulin, secreted by β cells in islets of Langerhans Insulin is secreted responding to a high blood glucose level
  4. 4.    Insulin passes into bloodstream and provokes the entering of glucose to tissues of muscles and liver to be put in storage as an energetic reserve and keeps the normal level of blood glucose between 60 and 120 mg·dL-1 If β cells do not produce insulin, or produce an insufficient amount, blood might have an excess of glucose that would not enter the tissues It is detected with a blood or urine analysis
  5. 5. The Glucose Curve
  6. 6.   1-B: Maria’s mother, normal blood glucose level and insulin 2-A: Grandma Lola, high BGL, very little insulin 3-C: Maria, high BGL, no insulin Data of blood glucose concentration before and after an ingest cannot be compared. After an ingest, insulin makes glucose enter the cells and return to basal values. It makes no sense to take more pills
  7. 7. Non-infectious Diseases    Most of non-infectious diseases are genetic, in the sense that genes determine biological activity in our cells and organ functioning So that a disease can be shown, tens of altered genes may have been implied: it is about a multigenic disease Genes operate under regulation depending on external factors like feeding or habits (tobacco, alcohol, sedentary lifestyle)
  9. 9. Causes of Diabetes Type 1 and Type 2?   Childhood chronic disease Predisposition to suffer it is inherited, but the most frequent type has an autoimmune origin (like rheumatoid arthritis, lupus or multiple sclerosis): due to some genes malfunction, immune system does not recognize β cells from islets of Langerhans as of its own and destroys them, as if they were infectious microorganisms
  10. 10.  Lola’s diabetes is type 2, adult’s diabetes. Glycaemia (BGL) increases out of control because cells do not recognize insulin, although pancreas does synthesize it: resistance to insulin  A diet poor in carbohydrates must be gone on, but in the most serious cases some medication must be taken or insulin must be injected to control glycaemia
  11. 11. A Treatment for Diabetes Type 1     We must supply the daily required insulin dose With the help of a glucometer we can daily measure the blood glucose level from a drop of blood With the help of a syringe we must inject the required insulin dose An insulin infusion pump injects you the required dose, but you must be connected there all the time
  12. 12. A Genetic Revolution   Until recently pig’s insulin was used, but it provoked undesirable immune reactions, due to some little differences with human insulin Now biotechnology techniques or genetic engineering are used: recombinant DNA technology (rDNA), techniques that are also applied to prenatal diagnose and police inquiry
  13. 13.    1953 : Watson and Crick show the DNA molecular structure and open the research in molecular genetics 1983 : Kary B. Mullis applies the technique of the polymerase chain reaction (PCR), what makes possible to repeat hundredths of times a specific sequence of DNA 2004 : first publications of human genome that includes 3000 million of nucleotide pairs with four types of bases: A (adenine), T (thymine), G (guanine), C (cytosine)
  14. 14. Recombinant Insulin     Human insulin synthesized by means of genetic engineering techniques Insulin is produced by genetically modified bacteria (Escherichia coli) The gene of human insulin is extracted from human cells, it is cloned (it is enlarged and copied) and introduced into the bacteria genome, which is a usual microorganism in our intestine All that has become possible thanks to restriction enzymes, molecules that cut and stick fragments of DNA in a selective way
  15. 15.   Genetically modified bacteria E. Coli produce an insulin identical to the one produced by humans, but they are GMO (genetically modified organisms) or transgenic organisms Once the transgenic organisms are obtained, one goes to an industrial production scale: cultures of millions of modified bacteria cells are obtained to produce insulin. Finally you only need to purify, isolate and collect the product: insulin fit for treating diabetic patients
  16. 16. Biotechnological Industry and Patents    NASDAQ Biotechnology Index: it is about an exclusive index to North-American biotechnological industries Today a lot of medicaments are obtained with genetic engineering techniques Success is mainly founded in patents: molecules discovered by recombinant techniques can be patented, and also new devices for medicine’s administration and diagnose equipment
  17. 17.   Patents mean money: every time you buy a medicine or a diagnose equipment, a percentage of the price is set aside to pay the patent. So, the firm that has made the research recovers the investment made, at least in part Future of biomedical research does not only depend on the economic power that these firms have, but also on the resources that public administrations set aside
  19. 19. The Future: Stem Cells for Maria?   Grandma Lola’s treatment consists of a strict diet (no sweets at all) and some physical exercise (walking). For the time being she needs not to inject herself with insulin, her glycaemia can be under control only with pills The little girl has recovered her child ’s vitality, but she needs synthetic insulin
  20. 20. Psychological Disorders in Child Patients     Children suffering a chronic disease may undergo some behavior disorders The little girl must learn that she must have her fingers pricked and her thighs, belly or arms injected Maybe she felt guilty and punished, hostile with her parents and grandma, but she has already overcome it Her parents have spoken clearly to her and have not overprotected her. Sharing her illness with grandma maybe has helped
  21. 21. Stem Cells   Is it possible to find a future solution for Maria? The doctor tells her parents that now there is a research as a therapeutic option, but it cannot be applied yet
  22. 22.    Embryonic stem cells are pluripotent, say, they can be transformed in whatever the 200 types of cells in our organism Chemical signals, substances, induct them to change gene expression, so they produce some proteins or others and become cardiac, epithelial, retina or β pancreatic cells If we could only obtain in lab embryonic stem cells without any problems of immunologic rejection:
  23. 23.     We could transplant pancreatic βcells to a patient with diabetes We could renew the harmed cardiac muscle of a patient waiting for a heart transplantation We could repair the spinal cord of a patient with a spinal cord injury because of a road accident Now they are only possibilities for the future, but they are not science fiction, because a lot of efforts and research are devoted, but not exempt of controversy:
  24. 24.  There are bioethical reasons : the use of stem cells implies the use of human embryos, although other alternative sources for these cells are into research  Embryonic stem cells are obtained from a blastocyst :
  25. 25.    Blastocyst is a very initial stage in embryonic development (4 or 5 days of pregnancy) These cells would develop an embryo until reaching the fetal stage, that is why its use in research is controversial One alternative are adult stem cells . These ones are spread through different tissues in our organism and they are occupied in regenerating in a natural way damaged tissues
  26. 26.  Many public groups, universities and firms in biomedical research compete for obtaining promising results  The new Law for biomedical research , from July 2007, offers a new frame to regulate that research  There are a lot of interests at play(patents, money, prestige) but there is also the risk to make frauds and present fake data
  27. 27. To Learn More Web dedicat a la diabetis:  Web nord-americana de l’enciclopèdia mèdica Medline: pe1.html  Pàgina web sobre patents: atentes 
  28. 28. BUENO, David. Òrgans a la carta. Barcelona: Universitat de Barcelona, 2007  Roslin Institute, la institució que va aconseguir el clon animal més conegut: l’ovella Dolly:  National Institutes of Health (USA):  Llei d’investigació biomèdica, juliol de 2007: coleccion=iberlex&id=2007/12945 