Every person has a unique DNA sequence in their genome. Now researchers from the University of Copenhagen and the MRC Laboratory of Molecular Biology in Cambridge have tried to quantify what these differences in the genome mean in the context of the genes targeted by drugs.
In a new study published in the scientific journal Cell they look at certain receptors (GPCRs) in the human cell. These protein receptors are the main targets of the biggest group of marketed modern medicine. By mining existing data sets they have mapped the extent to which mutations occur within GPCR drug targets in individuals and studied what impact these mutations could have on the therapeutic effect of medicine.
"We estimate that an average of 3 percent of the population have receptors that contain mutations which can alter the effect of medicine", says first author of the study, PhD Fellow Alexander Hauser from the Department of Drug Design and Pharmacology at the University of Copenhagen.
"When the patients have visitors, the rooms are so small that (the visitors) spill into the hallways," he said. "Then they can observe everything that is going on."
The expansion will feature patient rooms that are 250 to 300 square feet. The new operating rooms will be six to seven times larger than they are now.
"People's expectations have changed," said Jo Petersen, president of the UMC board. "Years ago, I don't think many people thought much about sharing a room with somebody. I don't think people want to share a room with somebody today."
"This might mean that the medicine simply works less efficiently. It can also mean that the medicine does not work at all or causes adverse effects on patients", adds Madan Babu, last author of the study, from the MRC Lab of Molecular Biology in Cambridge, where Hauser conducted this research.
The researchers have analyzed the mutations in human GPCRs by using whole genome sequencing data from the 1,000 Genomes project with about 2,500 participants as well as exome data from the ExAC project with over 60,000 participants.
They then used structural data to infer critical sites in GPCRs to uncover which mutations are more likely to alter the outcome of medicine.
"The 3 percent of the affected population is an average. For some important receptors, it is way more. For instance, the relevant mutations occur in 69 percent of people in the GLP1 receptor that is the target of diabetes medicine and in 86 percent of people in the CNR2 receptor that is used as a target for medicine to relieve nausea induced by chemotherapy. But of course, we cannot know every person"s genome and so these are estimates based on the data sets available", says Alexander Hauser.
The researchers use their findings and sales data for the 279 GPCR-relevant drugs from the National Health Service in the UK to estimate how much money is spent on medicine with little or no effect.
Unity Medical Center plans to break ground on the three-story addition late next summer or in early fall on the west side of the current facility, CEO Alan O'Neil said this week. It's possible construction could wrap up in late 2019.
"It's served the community well, but you need to keep up in this business," he said of the building. "It's a very competitive business and we needed to modernize. Health care is a lot different than what it was 60 years ago."
The current two-story hospital building houses the operating department, patient rooms, physical therapy and rehab services. That building will be repurposed for office space.
The expansion calls for a larger operating department on the first floor, improved and larger patient rooms on the second floor and a third floor that will be used for educational purposes, offices and mechanical rooms. That can be used to facilitate medical students, as well as training for staff, O'Neil said.
The hospital doesn't need to issue bonds for the project but will be working with the U.S. Department of Agriculture and the Bank of North Dakota for financing. The hospital's foundation will raise funds for the project. Forecasts for the hospital's financial future are stable, O'Neil said.
"The prevalence and potential impact of variation in drug response between individuals is a strong argument for further researching this field. It also constitutes a fine example of why personalized medicine might be the way forward; even when we are talking about common drugs", says Hauser.