Team:KOREA/Human Practices
Human Practices
Introduction
An accurate scientific method is not the only thing required for a successful project. A broad understanding of the real-world situation is also necessary for feasible works. In the same vein, in order for our project to really benefit human society, we must not only overcome the limits of existing therapies but also consider the social discomforts that patients with Parkinson's currently have. The biggest problems with current therapies, represented by chemotherapy and invasive therapy, are resistance and heavy burdensomeness each. No matter how good a drug is, the fundamental limitations of tolerance to mechanisms that treat diseases with chemicals are difficult to overcome. In addition, if the symptoms are alleviated or become severe, the type and dosage of the medicines you take will need to be changed, but the effects of the drugs will not be immediate, which makes you and your doctor really troublesome. In the case of invasive treatment, this discomfort is even greater. The physical modification is hard to restore. Above all, it's extremely scary. No one would want to undergo a procedure that cuts their brains and penetrate the skull. Therefore, we studied through social research to solve the four following problems: tolerance, irreversibility, slow response, and heavy burden. We met with representatives of Aimed Inc. which implement healthcare services for various chronic diseases with mobile applications, and former scientific journalist, Jae-Won Shin, to discuss what the biggest and most realistic problems Parkinson's patients actually have. We also met with Lee Chung-heon, a doctor and medical journalist at KBS, to discuss the potential of our project. Presentations to high school students also revealed public awareness of Parkinson's diseases. Dr. Soo-jin Oh and Dr. Min-ho Nam of KIST helped us deciding how to apply the research.
Beyond The Lab
We made several interactions with stakeholders that directly guided some of the aspects of our project design. Integrated Human Practice was extremely important in framing our project. To begin with, we finalized a decision to cure Parkinson's disease with a synthetic biological approach. Through the understanding of doctors and current researchers in this field, we thought developing existing medication would be a better choice, realizing that our first plan was too invasive. Moreover, in response to conversations with doctors, experts, medical journalists, a medical venture CEO, and Parkinson's Disease patients, we adopted optogenetics in Parkinson's Disease and adjusted our future plan. Despite working on a lab-scale now, we are deeply contemplating how our project will affect the patients and society. We believe that Korea’s gene therapy isn’t as developed; therefore we contacted the KAIST center for Bio-Healthcare Innovation & Policy and questioned about prospective changes in policy.
We started by knowing a problem in an existing treatment. Through a conversation with a doctor, we understand that the problem with conventional medication comes from the problems of off-targeting and levodopa itself.
The most common treatment for Parkinson's disease is medication. However, medication has many side effects such as drug tolerance. Kim, Na Young M.D. (DKM) Doctor
Levodopa is a precursor of dopamine, dopamine is too big that cannot penetrate BBB but levodopa can. But it can lead to Levodopa-induced dyslexia and have a tolerance, we thought something another has to work as dopamine in PD patient's brain. Meanwhile, we heard about optogenetics about experts with an expertise in optogenetics and brain science from the Korea Institute of Science and Technology.
Optogenetics has great spatiotemporal accuracy. Min-Ho, Nam, M.D.(DKM), Ph.D. Researcher
After we talking with experts who expertise in Parkinson's Disease from the Korea Institute of Science and Technology, we decide which receptor we will target.
DRD1 and DRD2 are a dopamine receptor that is primarily involved in Parkinson's Disease. Oh, Soo-Jin, Ph.D. Senior Researcher
Then we contact the experts who have experience in GPCR fusion protein. We get advice on how our chimera protein works.
GPCR protein family can be fused with homologous protein Minsoo Kim, Ph.D. Dean’s Professor of Microbiology & Immunology at Rochester University
We looked at how we could affect society and future medical industry. we met a medical venture CEO and asked how our project can be actualized. He said if we can develop our research to the form that can be treated by light device there would be a lot of advantages. Parkinson disease patient who feels hard going to hospital can be treated at home by telemedicine. He said our research would take several years to develop and get approval from government but has a great potential to change the paradigm of pharmaceutical industry.
Even if this study is only partially successful, it is very meaningful that slow down the starting of levodopa treatment. Shin, JaeWon, M.D. Medical Venture CEO
To consider the influence of our project on society, we interviewed medical journalist Lee ChoongHeon. He said Korea has disbelief about gene therapy because of invossa scandal which is false reporting of an ingredient used. Invosa got its permission to use from Ministry of food and Drug Safety which was consist of chonodrocyte and TGF-β1 transformed cell. However, test after released showed different composition. Invosa was Korea's first gene thrapy drug after going through many difficult clinical trial. Korea encouraged the development of gene therapies before that scandal but has since been wary of gene therapy. Also, people are questioning about its benfit, whether it is worth paying huge about money to medicine which doesn't show distinct change.
At present, the atmosphere toward gene therapy is not so good, so gene therapy needs a dramatic effect Lee, ChoongHeon, M.D. Medical Journalist
We are studying gene therapy and still in the initial stage. So, we concentrated on the perspective of change in gene therapy policy when our research is fully developed rather than the present state of the moment. So we contact the KAIST Center for Bio-Health Innovation and Policy and heard the perspective of gene therapy policy in the future. After that, we visited the National assembly and pondered what the future direction of policy would be.