Üsküdar Üniversitesi Rector's Advisor Prof. Dr. Muhsin Konuk drew attention to the importance of personalized treatment and pharmacogenomics, making significant evaluations in the field of personalized treatment and pharmacogenomics, which is considered the future of medicine. Stating, "When you give the same drug for the same disease to people with three different genetic structures, you get completely different results," Konuk said, "When treatment is performed by looking at patients' genetic profiles, the success rate reaches 99.5%."
Prof. Dr. Konuk explained that Turkey’s first applied pharmacogenomics laboratory was established at Üsküdar Üniversitesi and actively started analyses, stating, “Many scientific studies have been carried out in this field to date. Approximately 15 master’s students have completed their thesis work. These studies, particularly focusing on neuropsychiatric diseases (neurodegenerative diseases such as bipolar disorder, autism, schizophrenia, Alzheimer’s, Parkinson’s), investigated the connections between relevant genes and diseases, and the effects of mutations.”
Prof. Dr. Konuk emphasized that approximately 80% of the state’s drug expenditures could be prevented by determining individuals’ genetic predisposition profiles to drugs from 2 ml of blood.
Üsküdar Üniversitesi Rector's Advisor and Head of the Molecular Biology Master's Program, Prof. Dr. Muhsin Konuk, made significant evaluations in the field of personalized treatment and pharmacogenomics, which is considered the future of medicine.
Almost All of the Drugs We Take Are Not Used Directly as They Enter Our Body
Prof. Dr. Muhsin Konuk stated that pharmacogenomics is a scientific field that examines how individuals' genetic structures react to drugs they take from outside, saying, “It is said that there are approximately 22,000 genes in the human body. However, we do not clearly know which of our characteristics 25% of these are truly related to. The drugs we take are not used directly as they enter our body. Especially the proteins produced by the Cytochrome P450 gene family in our liver convert these drugs into active molecules that our body can use. The working speed of these proteins also varies from person to person.”
When Treatment is Performed by Looking at Genetic Profiles, the Success Rate Reaches 99.5%
Prof. Dr. Konuk, stating, “When you give the same drug for the same disease to people with three different genetic structures, you get completely different results,” summarized the process as follows:
“If a person’s enzymes metabolize the drug very quickly, no matter how much dosage you give, the drug remains ineffective. If they metabolize it at a normal level, even a low dose creates a significant response. If they metabolize it slowly or not at all, the drug has no effect. That’s why, when treatment is performed by looking at patients’ genetic profiles, the success rate reaches 99.5%.”
Healthcare Expenditures Can Decrease
Prof. Dr. Konuk stated that all patients with the same disease are given the same type of drug, and continued:
“Today’s statistical data indicates that the success rate of treatment using the same drug for every patient with the same disease is 20%. Therefore, 80% of our resources are wasted. This results in very serious expenses. In fact, the state has an important duty here. In this context, just as three drops of blood are taken from babies' heels before discharge from the hospital to screen for three different genetic diseases; it is possible to develop the same system one step further. If a fourth screening were added to these tests, and individuals' genetic predisposition profiles to drugs could also be determined from that single drop of blood, approximately 80% of the state's drug expenditures could be prevented. This is because the effects of drugs on individuals vary greatly according to genetic differences. Research in this field shows that the most fundamental reason for the difference between 20% and 100% in treatment success is whether the drug is suitable for the individual. Some Western countries, particularly the Netherlands, have started integrating such pharmacogenomic screenings into their healthcare systems. Turkey implementing this practice would be a great gain for both patient health and economic efficiency.”
The Role of Genetic Tests in Personalized Treatment Has Increased
Prof. Dr. Muhsin Konuk pointed out that the role of genetic tests in personalized (individualized) treatment approaches has been steadily increasing in recent years, stating, “The accuracy and reliability rate of these tests are almost 100%. Thanks to studies particularly on gene expression (how a gene works) and the epigenetic factors affecting this expression, much more complex mechanisms are beginning to be understood, such as not just the presence of genes but also when and how they function. We now have significant information on which genes and which types of mutations should be examined in which disease group. The most critical point here is not just learning this information; it is translating this information into clinical practice and shaping the treatment of diseases accordingly.”
There Is No Obstacle From Both Ethical and Medical Perspectives
Prof. Dr. Konuk also noted that since pharmacogenomic analyses are carried out entirely based on patient consent, there are no ethical issues in this field, stating, “The application of the test is only possible with the patient's consent. Furthermore, as a result of this analysis, it is observed that the patient can benefit nearly 100% from the treatment, meaning an effective treatment plan can be created directly at a 5 out of 5 ratio, not a 1 out of 5 ratio as in the classical approach. Therefore, there is no obstacle to these practices from both ethical and medical perspectives. However, if these analyses can be made a state policy and the pharmacogenomic profiles of all individuals in our country can be determined, significant savings in healthcare expenditures could be achieved. This saving could even allow expenditures in some areas to drop to one-fifth.”
A Change in Mindset Is Necessary in Medical Education
Prof. Dr. Konuk also drew attention to the fact that due importance is not given to this subject in the current medical education system, stating, “Although we use the expression ‘modern medicine,’ we see that some academics providing medical education are still not sufficiently open to this field. Yet, pharmacogenomics is a translational science that goes beyond classical medicine, and this approach must be taught to new physician candidates.”
Turkey’s First Applied Pharmacogenomics Laboratory Is at Üsküdar Üniversitesi
Prof. Dr. Konuk explained that Turkey’s first applied pharmacogenomics laboratory was established at Üsküdar Üniversitesi and actively started analyses, stating, “Many scientific studies have been carried out in this field to date. For example, last year alone, approximately 15 master's students completed their thesis work under my supervision. These studies, particularly focusing on neuropsychiatric diseases (neurodegenerative diseases such as bipolar disorder, autism, schizophrenia, Alzheimer's, Parkinson's), investigated the connections between relevant genes and diseases, and the effects of mutations. However, there are still institutional resistances in this field, and the necessary awareness has not been created in some academic circles. Therefore, I believe that this topic needs to be discussed, explained, and popularized in every setting.”
We Have Completed the R&D Process for the SMA Drug
Prof. Dr. Konuk noted that there are currently serious problems with rare diseases in our country and worldwide, and since pharmaceutical companies prioritize profit, they are not keen on developing drugs for rare diseases, stating, “For example, one dose of the SMA drug is currently around 2.5 million dollars. As a university, we have completed the R&D process for this drug. We are moving to the product development and production phase. We anticipate that when this process is completed, the cost will drop to 1/15th of today's price. This situation will provide significant advantages to both the ministry and patients. Our primary goal is for patients to be treated faster, more effectively, and more economically.”
If the State Allocated a Budget to This Field Equal to the Money Wasted in Annual Healthcare Expenditures…
Prof. Dr. Konuk emphasized the necessity for not only scientists but also state administrators to champion this issue, stating, “This work is not as costly as perceived. Analyzing a person's 3.5 billion nucleotide sequence can be done today for only 1000 dollars. This cost is expected to drop to 300 or even 200 dollars in the near future. If the state allocated a budget to this field equal to the money wasted in annual healthcare expenditures, huge gains would be achieved. Because the cheapest treatment is preventive medicine, which takes precautions before a person gets sick. If we adopt this approach, as in Western countries, the burden on hospitals will decrease, and the healthcare system will operate more efficiently.”
Artificial Intelligence Has Enormous Potential to Transform Treatment Processes
Prof. Dr. Konuk stated, “Artificial intelligence has enormous potential to transform treatment processes,” and added, “We have opened the in silico laboratory we established at Üsküdar Üniversitesi. AI-supported drug discoveries will be made in this laboratory. I believe that the solutions for many diseases said to be untreatable already exist in nature, and these hidden treasures will be discovered thanks to artificial intelligence. I particularly believe that we will develop new drug candidates by collaborating with our professors from the Department of Pharmacology at the Faculty of Medicine, along with the Bioengineering and Chemical Engineering departments.”
Prof. Dr. Konuk stated that research is not limited to neuropsychiatric diseases, and every department of medical faculties can work in this field, saying, “Because new hybrid fields are constantly emerging. A student entering this field does not just learn what already exists, but perhaps opens brand new doors.”
Prof. Dr. Konuk also added that approximately 80% of the state's drug expenditures could be prevented thanks to individuals' genetic predisposition profiles to drugs, obtained from just 2 ml of blood.
