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Kyriazis. J Transl Genet Genom 2018;2:7. I https://doi.org/10.20517/jtgg.2018.04 Page 5 of 8

Here, concepts like precision medicine (which considers the variability of individual genetic profiles in
[55]
relation to the environment and lifestyle), as already mentioned, and the “unique disease principle”
become relevant. Essentially these affirm that each individual patient exhibit unique disease profiles based on
an interaction of genetic, epigenetic and other factors such as cell interactions, nutrition, lifestyle, microbial
exposure, social and racial elements, age differences etc. It is therefore essential, if we want the therapy to be
successful, to develop tailor-made interventions for each patient, and not rely on generic treatments. This
may prove to be an impossible task.

TRANSLATION
Traditionally, with regards to the translation of laboratory research into clinical treatments, there has been
excessive reliance on a simplistic model examining the issues relating to “bench to bedside” principle.
However, taking a more “systems thinking” approach, reveals that there are other translational aspects which
we need to take into account. For instance, there are six translational stages of an overlapping continuum that
[56]
must be considered :
T0 - Identification of opportunities, genomic discoveries, biomarkers and basic research;
T1 - The classic “bench to bedside” model, which bridges basic research in the laboratory to possible health
applications. Here, laboratory evidence is transferred into the development of new procedures for therapy or
prevention, and proceeds to human testing;
T2 - The evaluation of clinical usefulness of genomic or other therapeutic applications (i.e., if the particular
product or application performs better than existing therapies in everyday clinical situations);
T3 - The wider integration of genomics or other applications into routine, community based practice (i.e.,
for the public at large, through delivery and dissemination practices), with the purpose of ensuring that the
intervention or application reaches populations whose health can benefit;
T4 - The overall health impact of the particular application at a population level (if the use of the application
has indeed resulted in any appreciable health benefit);
T5 - In the case of aging, which is a continual process, we may also consider a T5-stage, whereby the
continual effectiveness of the application at a population level remains consistently beneficial even after the
passage of long periods of time.

For example, it has been suggested that less than 2% of genomics research funded by the National Cancer
[56]
Institute and less than 0.5% of published cancer genomics research is beyond stage T1 . This is also the case
with rejuvenation biotechnologies and anti-aging medicines which have not yet passed stage T1. Basically, it
is not a matter of making a discovery, or devising a treatment/therapy or application, but it is also a matter
of that application making a clear health impact at a population level. All of the above stages need to be
addressed, otherwise the promise of an effective treatment remains unfulfilled.

This is not to say that the obstacles mentioned here are insurmountable by themselves, however the totality
of these make the effectiveness of any putative antiaging/rejuvenation intervention, less promising and
certainly less imminent.

Treating both the diseases of ageing and age-related degeneration (age-related damage at a preclinical,
preventive stage) is not merely subject to biomedical interventions aiming at “fixing” genetic and cellular
damage, but also depends on behavioural ones, as well as others such as cognitive factors, psychological
elements and environmental influences. In order to improve health outcomes all of these factors need to
[57]
be taken into account . Factors which are specific to the individual may make a huge difference between
[58]
significant therapeutic benefit and little or no benefit .
The rise of personalised medicine, in association with elements from MPE described above, is useful, but