Innovations and discoveries in biotechnology are revolutionizing medical
research. Recent advances in molecular biology, proteomic technologies, genomic
applications, cellular and tissue engineering, computational methods, and
bioengineering and bioimaging techniques have markedly accelerated the pace
of medical research and have created unprecedented opportunities for progress
in medical science.
This theme issue of JAMA illustrates the promise
and potential of biotechnology in medicine, with reports that demonstrate
cutting-edge advances and novel discoveries in several rapidly evolving areas
of medical research. In 2 studies on cancer detection, Casey and colleagues1 demonstrate that conversion analysis increases the
diagnostic yield of germline mutations in colorectal cancer compared with
conventional genomic sequencing, while Grossman and colleagues2 report
that a proteomic assay may be a useful adjunct to cystoscopy for detecting
bladder cancer. The elegant study by Nettles and colleagues3 using
an ultrasensitive genotyping assay to detect drug resistance mutations suggests
that intermittent episodes of detectable viremia (ie, “blips”)
in patients receiving highly active antiretroviral therapy for human immunodeficiency
virus infection most likely represent random variation, rather than clinically
significant viremia. Hering and colleagues4 show
that single-donor, marginal-dose islet cell transplantation restores insulin
independence in patients with type 1 diabetes. Two intriguing reports demonstrate
new applications of biotechnology for fetal genetic analysis. Larrabee and
colleagues5 suggest that cell-free fetal messenger
RNA can be isolated from amniotic fluid and hybridized to gene expression
microarrays, while Li and colleagues6 report
that paternally inherited fetal point mutations for β-thalassemia are
detectable using cell-free DNA in maternal plasma. In 3 overview articles,
Jaffer and Weissleder7 describe advances in
molecular imaging, Talamini and Hanly8 present
current and potential applications of robotic surgery, and Kesselheim and
Avorn9 discuss intellectual property issues
related to biotechnology research.
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