Recent Developments in Cell-Based Microscale Technologies and Their Potential Application in Personalised Medicine

Abstract

It is becoming increasingly apparent that some individuals are more susceptible to disease than others and more importantly some patients respond to prescribed therapies better than others. One of the main reasons for differences in disease susceptibility and the effectiveness of drug treatment lies in the genetic makeup of the patient. In addition to many environmental factors, genetic variations such as mutations, DNA polymorphisms and epigenetic gene regulation are the key players involved in the fate of a person’s health. Recent advances in genomics and proteomics are providing novel insights into the complex biological process of disease. These insights will ultimately help to tailor personalised approaches to the treatment of disease based upon individual molecular “blueprints” of their genome and proteome. Personalised medicine extends beyond the traditional medical approach in the treatment of patients as it aims to identify and target molecular factors contributing to the illness of individual patients. The personalised medicine approach is already playing a significant role in the way we treat and monitor disease. As many as 10 out of 36 anti-cancer drugs approved by the European Union in the last 10 years are considered to be personalised medicines (Eicheler, 2010). Breast cancer is one of the best examples whereby a personalised medical approach is adopted to detect the expression status of an oestrogen receptor called ESR1 in the nucleus of breast cancer cells. Approximately 70% of breast cancer patients overexpress this protein which is an important prognostic and predictive marker. Outcomes for these patients have been significantly improved by targeting the ESR1 using a hormonal treatment known as Tamoxifen. Interestingly this is the most commonly prescribed anticancer treatment in the world, highlighting the importance of a personalised approach in the management of disease. Microscale technologies are emerging as an enabling platform for the development of novel personalised medicines and their broad accessibility. Miniaturised devices have the potential to process minute clinical samples and perform extensive genetic, molecular and cellular analyses directly on a microfluidic chip. The integration of pre-analytical sample handling with a subsequent sample analysis on a single microfluidic device will help to achieve highest reproducibility of results and minimise inter-laboratory bias and operators