[Special Feature: 10th Anniversary of the Faculty of Pharmacy] Keio Pharmacy in the Era of 100-Year Life: Leveraging the Strengths of a Comprehensive University for Ideal 4P Medicine

2018/10/05

The efficacy of any drug varies from person to person; there are those for whom it works well and those for whom it does not, and those who experience side effects and those who do not. Even for the same individual, a drug may or may not be effective depending on their symptoms and physical condition at the time.

Anticancer drugs are a typical example of such medicine. Anticancer drugs are, so to speak, a "poison" used to attack cancer cells. If administered in large quantities, they can kill cancer cells, but they also damage normal cells, leading to serious side effects. To reduce side effects, the dosage can be lowered, but then the cancer cells cannot be sufficiently attacked. Determining which anticancer drug to administer and in what dosage for individual cases is extremely important.

The genome, which is the blueprint of a human being, is written with 3 billion letters consisting of four types of alphabets: A, T, G, and C. This sequence of 3 billion characters (the human genome sequence) differs slightly from person to person, with a difference of about 0.1%. In other words, the genome sequences of different individuals differ by roughly one in every thousand characters. These differences account for variations in appearance, physique, and constitution.

Sensitivity to various drugs and the presence or absence of side effects will also become predictable by looking at the genetic sequences in the genome. The cost of genome analysis has become very inexpensive recently. A time will surely come in the near future when computers will predict the optimal dosage and select the most effective drug with the fewest side effects based on a patient's genomic information.

Since the genome is a blueprint, it reveals innate constitution, but it does not reveal the current physical condition. Therefore, as a method for analyzing physical condition, the Institute for Advanced Biosciences at the Tsuruoka Town Campus of Keio (TTCK) in Yamagata Prefecture developed "metabolome analysis" technology for the first time in the world. Human blood, urine, and saliva contain hundreds of types of metabolites, such as amino acids and sugars, and their amounts change from moment to moment, reflecting the physical condition at that time. Metabolome analysis is the ultimate component analysis technology that can measure these metabolites all at once. It is also possible to diagnose various diseases by performing metabolome analysis on blood, urine, saliva, and stool, and a venture company from Tsuruoka is moving forward with its practical application.

SalivaTech has developed technology to detect pancreatic cancer by performing metabolome analysis on saliva. Toward the practical application and social implementation of "cancer testing via saliva," research and development are steadily progressing, including a trial conducted this year targeting 1,000 employees in partnership with a major corporation.

Human Metabolome Technologies, Inc. (HMT) aims to commercialize the diagnosis of depression through blood tests. In patients with depression, the concentration of a metabolite called PEA (phosphoethanolamine) in the blood decreases, so it is possible to infer whether a person has depression by measuring the PEA value. When depression improves through drug treatment, the PEA value returns to normal. In other words, since the PEA value represents the degree of depression, it can serve as an important indicator when determining the dosage of medication. HMT has listed its shares on the TSE Mothers market.

In the near future, an era will come where computers in hospitals will predict the optimal medicine and dosage based on a patient's genome and metabolome data. The results of that treatment—information such as "which drug was administered in what amount and what effects and side effects occurred"—will be anonymized and accumulated in public databases. As the data grows larger, the predictive accuracy of computers will improve.

Meanwhile, at home, sensors will be built into toilets to automatically analyze urine and stool, constantly monitoring health status. If there is a suspicion of illness or a pre-symptomatic state, an email will be sent to a smartphone to that effect, enabling appropriate treatment or prevention at the earliest possible stage.

In this way, "4P Medicine" will be the key to the healthy longevity society of the near future. 4P stands for:

Personalized / Predictive / Preemptive / Participatory

and I believe the role of pharmacy will become increasingly significant.

At this Juku, pharmaceutical research is conducted mainly in the Faculty of Pharmacy, as well as in the School of Medicine, the Faculty of Science and Technology, SFC, and Tsuruoka. We occasionally hold cross-faculty training camps and research presentations with these students. Because the culture and research approaches of each campus differ, it is very fresh and stimulating. Leveraging the strengths of a comprehensive university and overcoming the walls between faculties, students discuss the future of health sciences. Such Keio Pharmacy will strongly lead the healthy longevity society in the era of 100-year life.