Advisor to the Rector of Üsküdar University, Prof. Muhsin Konuk, emphasized the importance of personalized treatment and pharmacogenetics, making significant evaluations in the field of personalized medicine and pharmacogenetics, which is considered the future of medicine. Prof. Konuk stated, “When you give the same drug for the same disease to three people with different genetic structures, you get completely different results.” He added, “When treatment is carried out based on the patients’ genetic profiles, the success rate reaches 99.5%.”
Explaining that Türkiye’s first applied pharmacogenetics laboratory was established at Üsküdar University and that active analyses have already begun, Prof. Konuk said: "Many scientific studies have been conducted in this field to date. Approximately 15 master’s students have completed their theses. In these studies, which particularly focus on neuropsychiatric diseases (such as bipolar disorder, autism, schizophrenia, Alzheimer’s, and neurodegenerative diseases like Parkinson’s), the connections between the relevant genes and diseases, as well as the effects of mutations, have been investigated."
Prof. Konuk highlighted that with just 2 ml of blood, it is possible to determine individuals’ genetic predisposition to drugs, which could potentially reduce about 80% of the government’s drug expenses.
Advisor to the Rector of Üsküdar University and Head of the Molecular Biology Master’s Program, Prof. Muhsin Konuk, made important evaluations on personalized medicine and pharmacogenetics, which are regarded as the future of medicine.
Almost none of the drugs we take are used directly by the body
Explaining that pharmacogenetics is a field of science that studies how individuals’ genetic makeup reacts to drugs taken from outside, Prof. Konuk said:"It is sa id that the human body has approximately 22,000 genes. However, we do not know exactly which of our traits are related to about 25% of these genes. The drugs we take are not used directly by our bodies. Especially the proteins produced by a gene family in the liver called Cytochrome P450 convert these drugs into active molecules that our body can use. The speed at which these proteins work also varies from person to person."
Success rate reaches 99.5% when treatment is based on genetic profiles
"When you give the same drug for the same disease to three people with different genetic structures, you get completely different results," said Prof. Konuk, summarizing the process as follows: "If a person’s enzymes metabolize the drug very quickly, no matter how much dosage you give, the drug will remain ineffective. If they metabolize it at a normal level, even a low dose can create a strong response. If they metabolize it slowly or not at all, the drug will have no effect. That’s why the success rate reaches 99.5% when treatment is based on the patients’ genetic profiles."
Healthcare expenses can be reduced
Stating that the same type of drug is given to all patients with the same disease, Prof. Konuk continued his remarks as follows: "Today’s statistical data show that the success rate of treatment with the same drug for all patients is 20%. Therefore, 80% of our resources are wasted. This is a very serious expense. In fact, the state has a crucial role here. In this context, just as three drops of blood are taken from a newborn’s heel before hospital discharge to screen for three different genetic diseases, it is possible to take this system one step further. If a fourth screening were added to these tests and the genetic predisposition profile of individuals to drugs could be determined from that single drop of blood, approximately 80% of the government’s drug expenditures could be prevented. This is because the effects of drugs on individuals vary significantly depending on genetic differences. Research in this field shows that the main reason for the difference in treatment success rates—ranging from 20% to 100%—is whether the drug is suitable for the person or not. Some Western countries, especially the Netherlands, have already started integrating such pharmacogenetic screenings into their healthcare systems. Implementing this in Türkiye would be a major gain both in terms of patient health and economic efficiency."
The role of genetic tests in personalized treatment has increased
Prof. Muhsin Konuk pointed out that in recent years, the role of genetic tests in personalized (individualized) treatment approaches has been increasing, stating: "The accuracy and reliability rate of these tests is nearly 100%. Especially thanks to studies on gene expression (how the gene works) and the epigenetic factors affecting this expression, much more complex mechanisms such as not only the existence of genes but also when and how they work are starting to be understood. We now have significant knowledge about which genes and which types of mutations should be examined in which disease groups. The most critical point here is not only learning this information but also translating it into clinical practice and shaping disease treatment accordingly."
There is no obstacle from either an ethical or medical perspective
Prof. Muhsin Konuk emphasized that pharmacogenetic analyses are conducted entirely based on patient consent, therefore there are no ethical issues in this field, stating: "The implementation of the test is only possible with the patient’s approval. Moreover, as a result of this analysis, it can be seen that the patient can benefit from treatment at a rate close to 100%, meaning that an effective treatment plan can be developed directly at a 5 out of 5 success rate, unlike the classic approach which achieves 1 out of 5. Therefore, there are no obstacles from either an ethical or medical standpoint. However, if these analyses can be turned into a state policy and if the pharmacogenetic profiles of all individuals in our country can be identified, significant savings in healthcare expenditures can be achieved. In fact, these savings may reduce expenses in certain areas by as much as one-fifth."
A change of mindset in medical education is necessary
Pointing out that the current medical education system does not give this field the attention it deserves, Prof. Konuk said: "Although we use the term ‘modern medicine,’ we see that some academicians who teach medicine are still not open enough to this field. Yet pharmacogenetics is a translational science that goes beyond classical medicine, and this approach must be taught to new medical candidates."
Türkiye’s first applied pharmacogenetics laboratory is at Üsküdar University
Explaining that Türkiye’s first applied pharmacogenetics laboratory was established at Üsküdar University and that active analyses have begun, Prof. Konuk said: "Many scientific studies have been conducted in this field to date. For example, last year alone, about 15 master’s students completed their theses under my supervision. In these studies, which focus particularly on neuropsychiatric diseases (such as bipolar disorder, autism, schizophrenia, Alzheimer’s, and neurodegenerative diseases like Parkinson’s), the connections between the relevant genes and diseases, as well as the effects of mutations, have been investigated. However, there is still internal resistance in this field, and some academic circles have not yet developed the necessary awareness. Therefore, I believe this topic must be discussed, explained, and promoted in every possible setting."
We have completed the R&D process for the SMA drug
Prof. Konuk noted that there are currently serious problems both in Türkiye and globally regarding rare diseases, as pharmaceutical companies generally prioritize profit and are not keen on developing drugs for rare diseases: "For example, a single dose of the SMA drug currently costs around 2.5 million dollars. As a university, we have completed the R&D process of this drug. We are moving into the product development and production phase. Once this process is completed, we anticipate that the cost will decrease to one-fifteenth of the current price. This will provide significant advantages for both the ministry and patients. Our primary goal is to ensure that patients are treated faster, more effectively, and more economically."
If the state allocated a budget equal to the amount wasted annually on healthcare...
Emphasizing that not only scientists but also state administrators must support this issue, Prof. Konuk stated: "This work is not as costly as one might think. Analyzing a person’s 3.5 billion nucleotide sequence can be done today for just $1,000. This cost is expected to drop to $300 or even $200 in the near future. If the state allocated a budget to this area equal to the amount wasted in annual healthcare expenses, there would be immense gains. Because the cheapest treatment is preventive medicine, where precautions are taken before illness occurs. If we adopt this approach, as Western countries do, the burden on hospitals will decrease, and the healthcare system will operate more efficiently."
Artificial intelligence has tremendous potential to transform treatment processes
"Artificial intelligence has tremendous potential to transform treatment processes," said Prof. Konuk, adding: "We have opened the in silico laboratory we established at Üsküdar University. In this laboratory, AI-assisted drug discovery will take place. I believe that the solutions for many diseases that are currently considered untreatable already exist in nature, and that artificial intelligence will help us discover these hidden treasures. Particularly by collaborating with our professors from the Departments of Biomedical Engineering, Chemical Engineering, and the Faculty of Medicine’s Department of Pharmacology, I believe we will identify new drug candidates."
Prof. Konuk added that research is not limited to neuropsychiatric diseases and that every department within medical faculties can conduct studies in this area, stating: "Because new hybrid fields are constantly emerging. A student entering this field will not only learn what already exists but may also open entirely new doors."
Prof. Konuk also reiterated that, thanks to determining individuals’ genetic predisposition to drugs from just 2 ml of blood, approximately 80% of the state’s drug expenditures could be avoided.
Üsküdar News Agency (ÜNA)