STRATEGY Clinical Hospital «NEUROVITA»
The recent events in medicine can be named a biotechnological post-genome and regenerative revolution. The healthcare of the world witnesses the biotechnological boom and stands at the threshold of a new era of genome and post-genome molecular-biological (epigenomics, RN-omics, proteomics, transcriptomics, metabolomics, secretomics and so on) human research. Active introduction of the advances of genomics, post-genomics and bio-informatics into the clinical practice has significantly expanded and still keeps expanding our understanding of the pathological processes at the level of molecular and cellular structures of the human organism. The achievements of the genetics and molecular biology permitted the discovery of a great number of the protein, DNA and RNA markers of the pathological processes in the body. This progress offers an opportunity to focus at the pre-clinical stage of the disease, that is, at the earliest stage of the pathology onset when there are no clinical signs of the disease.
Now it is possible to monitor the dynamics of the pathological process by the biological markers of the disease.
The key links of the work with the patients in our Hospital are prediction of the risk of the disease, preclinical diagnostics and detection of the stage of the disease and the earliest of all possible molecularly targeted pharmaceutical interference or use of the technologies of the regenerative (genomic, gene engineering, peptide engineering, cellular engineering tissue engineering and so on) medicine in order to prevent the disease development or its transfer to a more pronounced stage. These principles are the basis for a new strategy of three Ps of contemporary global and national medicine: predictive, preventive and personalized. To date this strategy is a priority both for global and for national medicine and is officially approved by the Order of the Ministry of Healthcare of Russia #186 dated April 24, 2018.
The personalized medicine became our main instrument in the therapy of our complicated patients. According to the definition of the US President's Council of Advisors on Science and Technology the term'Personalized medicine' refers to the tailoring of medical treatment to the individual characteristics of each patient. It does not literally mean the creation of drugs or medical devices that are unique to a patient, but rather the ability to classify individuals into subpopulations that differ in their susceptibility to a particular disease or their response to a specific treatment. Preventive or therapeutic interventions can then be concentrated on those who will benefit, sparing expense and side effects for those who will not’. Horizon 2020, the EU's research and innovation funding program defined personalized medicine as 'a medical model using characterization of individuals’ phenotypes and genotypes (e.g. molecular profiling, medical imaging, lifestyle data) for tailoring the right therapeutic strategy for the right person at the right time, and/or to determine the predisposition to disease and/or to deliver timely and targeted prevention.'
The results of the prediction, prevention and personalization approach to the therapy of our patients can be summed up in several paragraphs. For 20 years of the work of the hospital, the principle of three Ps became essential in the diagnostics and therapy of extremely difficult contingent with neurological diseases, autoimmune, oncological and neurooncological diseases as well as hereditary diseases of nervous system. This innovative methodological individualized approach to every patient of the Hospital provided the efficiency of the personalized therapy in 60.4% of our low curable cases. It became possible thanks to the development of the predictive system of ultra-early diagnostics of some types of cancer, neurogenerative and autoimmune diseases on the basis of the biomarkers of the membrane surface of the hematopoietic stem cell (the method is protected by the patent). The biomarkers permit prognosis of the presence, dynamics and probability of the disease progress at the preclinical stage of the disease using the technologies of artificial intelligence. Detection of the disease by the unique profiles of molecular markers of the HSC at the pre-clinical stage when the standard molecular (cancer-specific, neurospecific an immunospecific) protein and RNA markers are not detectable yet, lets us propose unique medical and biological measures to prevent lethal oncological disorders and some of the neurodegenerative disease (Parkinson’s, Alzheimer’s, Binswanger diseases, amyotrophic lateral sclerosis, systemic cortical atrophy and others) to our patients. Proteomic assay of HSCs and the proteomic profile of the membrane antigen of HSC give us the information about the pathologically specific (cancer-specific, neurospecific, autoimmune) immune insufficiency of an individual and stability of their HSC genome. In case the state of the HSC proteome is compensated and, accordingly, the genome is stable, to prevent the disease we first started using the protocol of the harvest of the patient’s HSCs and their cryopreservation. That is, for the first time we applied molecular proteomic diagnostic knowledge for prediction and prevention of the disease. If the donor develops a disease, the medical-biological insurance is already provided, especially in the cases of familial oncological, neurodegenerative and autoimmune diseases and thus offering an opportunity to arrest the disease progress and survive in the development of the lethal disease due to the transplantation of the autologous HSCs.
We have shown that in the cases of autoimmune disorders, such as multiple sclerosis or systemic lupus erythematosus when the transplantation of the autologous bone marrow effectively arrests the disease development, the proteomics of the patient’s HSCs must be studied before the transplantation. It appears that only if the HSC is healthy, the efficiency of the bone marrow transplantation can be guaranteed in 95%, in all other cases the disease relapses.
The personalized approach that we have developed is based on the biotechnologies of the regenerative and post-genomic medicine. Just as in the hospitals of the EU and USA, we use patients’ own (autologous) non-manipulated and/or minimally manipulated cell products according to the mechanism of “exclusion for hospital production” considered the medical technology. These products are routinely manufactured in our hospital in Russia according to the individual quality standards by the personal prescription for one specific patient. The Hospital has a practical experience of the development and clinical use of these technologies in over 9000 patients from 50 countries of the world. This work led to 202 publications in national and international peer-reviewed journals, 13 monographs, three of which are published in the USA and Sweden in English, 7 chapters in the multi-authored monographs; ten technologies have been patented in 35 patents of the Russian Federation and one US patent.
To date, 19800 patients have been treated in the Hospital, 12500 of them received our highly technological therapy. The key fields of the hospital activity are personalized neurology, neurosurgery, oncology, preventive neurooncology and oncoimmunology, regenerative and post-genome medicine and hereditary diseases of the nervous system.
Over 4000 intrathecal, intra-ventricular and intra-arterial transfusions of the cell preparations and products, 105 highly technological surgeries on tissue-engineering of the spinal cord in humans. The Hospital is a world leader in the remote-controlled contactless multi-wave radioneuroengineering. The innovative remote-controlled approach to the restoration of the brain and spinal cord was patented and awarded by the Rospatent as one of the top hundred best inventions in Russia in 2017.
