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Biotechnology in Healthcare

BMJ 1999; 318 doi: (Published 15 May 1999) Cite this as: BMJ 1999;318:1358
  1. Roger Walker, professor of pharmacy practice
  1. Cardiff University, and director of pharmaceutical public health, Gwent Health Authority

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    Ed Gavin Brooks

    Pharmaceutical Press, £19.95, pp 228

    ISBN 085369 372 2

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    “Wrong man, wrong book to review,” I thought on receiving Biotechnology in Healthcare, “What's the relevance of this to a clinician or a health authority bureaucrat like me?” But on the plus side, it was only 228 pages long and had a statement on the cover that it was written for the healthcare profession, so I accepted the invitation to review.

    For those a little rusty on centromeres, telomeres, histones, nonsense DNA, and the general terminology of molecular biology, the introductory chapter could be your last. It is not an easy read, but it is worth making the effort to understand. Comprehension of the terminology and concepts is the key to understanding the remainder of the book and helps develop an appreciation of the impact of molecular biology on health care.

    The book tackles the subject of biotechnology in health care from a predictably scientific basis given the subject matter and the backgrounds of the 10 contributors. There is, however, a concerted effort to make the subject relevant to clinical practice and the search for new drugs: gene therapy, as we are reminded, represents an extension of rational drug design in which the drug is a piece of nucleic acid.

    It is intriguing that, despite the logical scientific base of the text and the work undertaken, most trials of human gene therapy are targeted towards cancer. This is not because cancer is particularly amenable to gene therapy, but, we are told, because there is a large patient population lacking effective and tolerable treatment. I have a lurking suspicion that potential profits may also be a factor. The potential treatment strategies for various cancers make interesting reading and include the use of genetically modified cells as cancer vaccines and the delivery of tumour suppressor genes. The science is fascinating, and perhaps this should have been the sole focus of the text. Unfortunately, there is a superficial discourse of some of the ethical issues: no balanced view of the struggles between ethicists and scientists is presented, and this consequently does little justice to the book.

    Overall, this is not an easy read, and its multiauthor origin does not facilitate a logical flow of material from chapter to chapter. With a little effort, however, readers will find their eyes opened to the potential contribution of biotechnology to health care. For this alone, it is worth reading.

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