Hello, my name is Lisa Caulley and I'm one of the editorial fellows of the New
England Journal of Medicine. Today, we'll be discussing a new review article
series entitled "Frontiers in Medicine," that showcases the ways in
which new technology is influencing medicine. Over the last year, the New
England Journal of Medicine editorial team has been working with leading
experts to prepare the series that presents the translation of scientific
knowledge into new devices, drugs, and techniques that can improve patient care.
To introduce the series we have Dr. Elizabeth Phimister, who is one of the
deputy editors and one of the editorial leads for the Frontiers in Medicine
series. Dr. Phimister, can you tell us a bit about this series and what readers
can expect. [Dr. Phimister] Absolutely. So, the journal publishes manuscripts covering a very
broad arc of focus, from understanding the mechanisms of disease — for example, the
genetic causes of disease — right through to phase 3 trials of new interventions
to treat disease. This series also follows that same arc. So, on
the one end of the spectrum, in the science space, we have an article on the
extracellular vesicle, which is an area of intense interest and growth right now.
I think it was only six years ago that the International Society for
Extracellular Vesicles initiated. Another article in the science space is an
article on mapping neurologic and psychiatric symptoms to networks of
neurons in the brain, knowledge of which might one day be used to identify new
targets for treatment. At the other end of the spectrum is an article on
oligonucleotide drugs, which are a relatively new form of drug.
I think particularly exciting because it targets protein expression at the level
of messenger RNA, so it can target messenger RNA for degradation and
decrease it of expression of the protein, or it can tweak splicing to ramp up
expression of the protein. Also in the clinical end of the spectrum is an
article on the use of circulating cell-free DNA to screen for fetal trisomies.
This method has been rapidly embraced in the last five
years and now is the screen of choice in many countries. [Dr. Caulley] So why did the Journal
think this topic was important? [Dr. Phimister] Well, we know that our readers are interested not
only in learning about new and better ways to treat their patients but also
the translational research, the science that generated these new drugs and new
devices, new methods to treat disease in the first place.
[Dr. Caulley] As a surgeon, I really appreciate the advances that we've seen in minimally
invasive approaches to surgery. What excited you about the series? [Dr. Phimister] Everything!
I'm a technophile. I handle genetics and genomics research reports for the
Journal, I handle ophthalmology manuscripts, and just taking the field of
ophthalmology and looking back over the past 20 years, one can see how different
technology's approaches have really impacted the field. DNA sequencing has
led to the identification of many disease genes that, when variant, cause
congenital forms of blindness and also vision loss. They've also made it
possible to generate animal models of disease, which, in turn, has made it
possible to develop gene therapy approaches to treating disease. More
recently, new ways to image the retinal vasculature has led to the design of new
types of clinical trial. And, of course, one can't forget the extraordinary
impact that the development of antibody-based drugs to target
angiogenesis has had on prevalent forms of blindness, such as age-related macular
degeneration. So, it is really the technology side of the the series that
excites me. The fact that each article provides a foundation, a clear
explanation of mechanism, and also there's some looking to the future as
well. [Dr. Caulley] The series really is intended for anyone who has an interest in
technology, how it works, and what it can do.
It was really important to us to make sure that the series was accessible to
all readers. Each article is accompanied by an interview with the authors, as well
as an illustrated glossary to explain specialized and uncommon terms. I'd like
to thank Dr. Phimister, as well as our viewers. We hope you've enjoyed this
brief introduction into the Frontiers in Medicine series. Please find the
inaugural article and the accompanying editorial at NEJM.org.