Listening Aaron Chiechanover talking about a new Era of Medicine, the most revolutionary that will change the destiny of humanity as it will allow the man to access more and more personalized treatments: preventive, predictive and patecipative is like get off of a spacecraft on an unknown planet.


On the contrary we are in the Inselle of Lindau, but the atmosphere is that and it is appreciated by the more than 600 young researchers taking part in the 64th Meeting of the Nobel laureates to quench at the springs of Science. He, who won the Nobel prize for Chemistry in 2004 for the mechanism of proteic degradation, explains that this revolution was born like a reaction to the "one size fits all" medicine that treated in the same way different illnesses with falures and adverse reactions to the drugs. "too day it is not anymore like that: we treat the desease in the contest of the patient that is a different way: a word of proteins, of emotions a familiar one. Therefore medicine is contestual, personalised, and predictive and will tell us which diseases we will encounter in the future and which drugs we should avoid in order to skip their collateral effects.
This, thank to the evolution of the preventive medicine which wil be partecipative with the patient who will take part in their therapy. Chiechanover explains that it is not anymore the time when the doctor could say to the patient "I am the doctor, trust me..." and that today thanks to the information to which the patient can access, doctors can transfer more and more responsabilities to the patient and his relatives.
As regards, the expectancy of the man from the tecno-medicine for the "length of the life, without disases" he says that we cannot make illusions and that even if we can prolonge our life, in nature there are not "free lunches" and that everything has a price. He recalls that even if the life is 30-40 years longer the price to pay is the higher incidence of cancer, cardiovascular and neurodegenerative diseases. The burden of these diseases will not be susteinable for long because people will be so old that it will not be possible to cure all of them. The economies of the countries, even the most rich, will be threatened by the aging of population.
That is why the new revolution is explosive.
About the great challenges for the today medicine, A.C. recalls that from the first sequencing of the human genome in 2000 (1 bilion dollars) only 14 years have passed and today we can have the genoma of a peson in few hours and at few hundreds of dollars, with a more precise profile of a person and a better treatment. at the cost of problems non only scientific but also bio-ethical, social and religious.
If we do a mastectomy of a patient with mammal cancer and after we tell her that she is bearing a gene that predispose her to have a cancer on the controlateral breast too, should we advise her to undergo mastectomy? Ovariectomy? To tell that to her doughters?
In several cases of our life it looks to us that not knowing the future is intollerable. In medicine often the contrary is true - Chiechanover gets emotioned when he remember that his father, when he still was a medical student, told him "it is not permitted to walk on the world for 80 years and go away without leaving any thing safter you" it does not matter which role you will have, that of a teacher or that of a doctor or other. Our role is to leave a mark of our passage, by thinking to others and to the society in which we live. That is what I believe.

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