University of California, San Francisco (UCSF) Experts Pick Hottest Science and Medicine Trends for 2015

UCSF Experts Pick Hottest Science and Medicine Trends for 2015


With advances in technology and better understanding of people, the health sciences are constantly pushing toward more effective treatments and cures. The question is: where will we see the next breakthroughs?

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Researchers and physicians at UC San Francisco (UCSF) have identified the top trends in health care and biomedical science to watch in 2015:

1. Hacking the Brain

For nearly a century, scientists have sought to understand the workings of the human brain. Now, significant and technological advances are ushering in an era that would have been unimaginable to early brain scientists.

Long-lasting implants employing hundreds or thousands of electrodes can be placed in the brain to both deliver stimulation and to “listen” to brain activity for signs of trouble.

"Powerful new tools allow researchers to monitor activity patterns across brain circuits, bringing us closer to understanding how perception, thought and action arise from different circuits,” said Phillip Sabes, PhD, professor of Physiology.

This technology will eventually allow amputees and patients with paralysis to directly control artificial limbs with brain signals, will predict and head off epileptic seizures, and will better treat Parkinson’s disease and other movement disorders.

In addition, UCSF scientists are exploring the possibility that brain implants could ease the symptoms of – and perhaps even cure – psychiatric disorders including anxiety, depression, and addiction.

2. Breakthroughs in Teamwork

Scientific labs long flourished using a model not unlike that followed by professional sports teams: keep your game plan to yourself, recruit the best rising stars and aggressively compete with rivals to be first out of the gate with important findings.

But as technology grows increasingly powerful and opens up new complex ways to tackle problems, scientists are embracing a multidisciplinary team effort.

Take genomic research, for example. Increased risk for many diseases may reside in very rare, difficult-to-find mutations, so many researchers have begun assembling large international research groups to freely share data.

“One of the major drivers of recent progress has been a wholesale shift in culture. Investigators who were once fierce competitors are now finding ways to collaborate with one another in large-scale, multi-site genomic studies," said Matthew State, MD, PhD, chair of Psychiatry.

Two recent collaborative studies of the genetics of autism involved 50 laboratories worldwide and uncovered more than 100 genes linked to the risk of autism. Before this work, smaller efforts had identified only 11 genes that confer a risk for autism.

Nothing succeeds like success, so expect to see more “shared science” in the coming years.

3. Diagnosing Disease through DNA

DNA – from an individual or a virus or bacteria or a pathogen – can now be sequenced for less than $1,000. The tools of so-called "next-generation DNA sequencing," also known as massively parallel sequencing, allow lab workers to read out the equivalent of an entire genome’s worth of sequence in a day.

“We are gradually moving away from using next-generation sequencing exclusively as a powerful research tool and we are starting to use it in the clinic,” said Charles Chiu, PhD, director of UCSF Viral Diagnostics and Discovery Center.

The technology is already having real impacts when time is of the essence: Chiu and his team used it to identify the cause of life-threatening meningitis, saving the life of a 14-year-old boy after all standard diagnostic tools failed. After sequencing all the DNA found in his spinal fluid, from the patient’s own DNA to bacteria and viral DNA, scientists were able to identify the culprit within 24 hours: an unusual, but easily treated bacterial infection. Chiu is now working on applying this technology to develop a rapid diagnostic test for the Ebola virus.

Next-generation sequencing offers unprecedented throughput, scalability and speed that could have untold impacts on studying disease, biology and clinical research.

4. Rejuvenation through the Blood

It sounds straight out of a vampire novel, but a recent study found that infusions of young blood can perk up the brains of older mice.

Villeda made front-page news with these findings when his team identified evidence of cognitive improvements in the old mice after they were connected to the circulatory systems of younger mice. At the same time, a team at Stanford University found that young blood could help rejuvenate heart muscle, too.

“Today it seems as if everyone is going after molecules in the blood that might help reverse biological aging. There also are factors that can be removed from old blood to slow aging, and we want to explore these, too,” said Saul Villeda, PhD, Sandler Faculty Fellow.

In fact, young blood seems to improve muscle, liver, heart and brain – discoveries that have spurred a quest for the specific molecules responsible for rejuvenation.

All this raises hopes that molecules in the blood may be identified to do the same for humans. As the search continues, Villeda’s collaborators already have launched a small clinical trial to test young blood in Alzheimer’s disease.

5. Prime Time for Telemedicine

After years of fitful growth, telemedicine is finally coming into its own in American health care.

Hospital IT departments have sorted out video camera and other equipment challenges, allowing experts to consult remotely. Major social and economic forces are driving the adoption of such technologies as virtual office visits, radiological readings and even remote ICU monitoring. Hospitals everywhere face intensifying pressure to lower costs, and, perhaps most of all, consumers are demanding better access to their health care providers.

"Telehealth is the right technology for our times. Americans want high quality, personalized care. Providers and patients alike are beginning to trust information technology with their health,” said Seth Bokser, MD, MPH, medical director for IT at UCSF Benioff Children's Hospital.

Additionally, as primary care doctors are retiring, rural areas are struggling more than ever, and community hospitals need cost-effective ways of providing both primary and specialty care.

Experts say that, especially when patients are experiencing new symptoms, nothing can replace an in-person visit. But telemedicine is finding its place in modern medicine.

6. Breaking Down Cancer Categories

Though once viewed as a monolithic entity, cancer is now known to be a diverse collection of diseases demanding a wide range of treatments, often in combination.

The exponentially increasing power of genome-sequencing technology is allowing scientists to examine tumors letter by genetic letter, with surprising results. A 2014 study led partly by UCSF scientists suggested that these new techniques could lead to more accurate diagnoses for as many as one in 10 patients, compared to traditional methods.

"For the first time ever, we're able to pinpoint to important molecular features shared by cancers that affect different tissues. This will have huge implications for therapy as we begin to design treatment plans based on a cancer's molecular signature," said Denise Wolf, PhD, computational biologist at UCSF Helen Diller Comprehensive Cancer Center.

Combined with decades’ worth of accumulated clinical experience, such insights are already leading to radical new treatment recommendations.

7. Systems Pharmacology

Thirty years ago, molecular biology transformed the field of pharmacology by allowing researchers to isolate and purify the particular receptors through which drugs acted. Despite the great promise of focusing drug research on the molecular level, fewer drugs have since been discovered – and at greater expense.

The focus, many researchers say, needs to be on both molecular and systemic impacts.

This emerging field, known as systems pharmacology, integrates the behavior of molecules to understand the effects of drugs on the whole organism.

"Scientists can now design molecules with exquisite potency and specificity for particular receptors, and by combining this knowledge with our understanding of whole body systems, there’s huge potential for a rebirth of pharmacology,” said Brian Shoichet, PhD, professor of Pharmaceutical Chemistry.

8. Transparency in Health Care Pricing

Consumers' bills for health care tests and treatments can vary greatly across the country and even in the same city, making it difficult for patients to predict what their out-of-pocket costs will be. Complex language – charges versus costs versus prices versus bills – adds to the confusion.

As patients are increasingly being asked to take on more of their health care costs, hospitals and health plans are looking for ways to provide better transparency.

"Patients expect clear, comprehensive and understandable charges, so they can make informed decisions about their health care, and hospitals are responding to this need," said Barrie Strickland, chief financial officer of UCSF Medical Center.

UCSF, for one, has embarked on key initiatives that include estimating patients' costs upfront and sharing information about available financial assistance programs.

UCSF is the nation's leading university exclusively focused on health. Now celebrating the 150th anniversary of its founding as a medical college, UCSF is dedicated to transforming health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with world-renowned programs in the biological sciences, a preeminent biomedical research enterprise and top-tier hospitals, UCSF Medical Center and UCSF Benioff Children's Hospitals.

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UC San Francisco
Jennifer O’Brien, Assistant Vice Chancellor/Public Affairs


Laura Kurtzman, 415-502-6397 (NEWS)
Twitter: @LauraKurtzman

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