GERO-THERANOSTICS
GERO-THERANOSTICS
Nuclear Medicine & Theranostics
As the 21st century dawned, nuclear medicine faced a bleak outlook. The advent of clinical ultrasonography, computerized tomography, and magnetic resonance seemed to overshadow our field’s relevance, while a dearth of investments in novel radiopharmaceuticals and relying on decades old Anger physics cast a shadow over its future.
Yet, through a series of remarkable developments intertwined with the human genome projects and the explosion of the omics knowledge and technologies, coupled with the relentless determination of pioneers, nuclear medicine has undergone a profound and fantastic resurgence. Today, it stands poised to play a pivotal role in patient management, particularly in oncology, marking a turning point marked by a shortage of nuclear professionals unprecedented in our history.
Central to this renaissance is the discovery and clinical application of a new class of radiopharmaceuticals known as Theranostics. Coined by John Funkhouser in 1998, Theranostics represents a revolutionary fusion of therapeutic and diagnostic modalities. Under Funkhouser’s leadership as CEO of PharmaNetics, this vision crystallized into a paradigm- shifting approach that was intending to blend therapeutics and diagnostics seamlessly.
Nuclear Theranostics, epitomized by the use of a single target binding agent to both diagnose and treat specific diseases, has sparked immense enthusiasm within the nuclear medicine community. With approximately 90 companies currently engaged in developing precision medicine radiopharmaceuticals, market analyses indicate exponential financial growth for the specialty in the years ahead. Forecasts indicate a seismic shift from an imaging-centric specialty to a therapeutic focus, with nuclear medicine projected to transition from an 85 percent imaging specialty to a 60-70% therapeutic specialty.
While Nuclear Theranostics have already made significant inroads in managing neuroendocrine tumors, prostate cancers, and select thyroid cancers, their integration of diagnostic and therapeutic components represents just the beginning of the concept of Theranostics. Across diverse fields, from Nano Theranostics to Magnetic Theranostics and Immuno-Theranostics, researchers are harnessing the power of integrated platforms to tackle a spectrum of diseases, spanning from degenerative and systemic disorders to infectious diseases.
In essence, the revitalization of nuclear medicine through Theranostics heralds not only a renaissance within our field but also a broader revolution in precision medicine and patients management fueled by relentless innovation and collaborative research.
Figure 1. GeroScience: illustration of aging related conditions/diseases
GeroScience
The progress in socioeconomics, living standards, medicine, and public health has heralded a remarkable era of increased lifespan worldwide. Over centuries, life expectancy has nearly doubled from the early 19th century, a testament to humanity’s strides in healthcare and societal development.
While aging itself isn’t a disease, it significantly heightens the risk of various acute and chronic conditions, including cardiovascular disease, diabetes, cancer, arthritis, and degenerative disorders (Figure 1). Gerontology, coined by Ilya Ilyich Mechnikov in 1903, encompasses a broad spectrum of disciplines, addressing the societal, psychological, cognitive, and biological dimensions of aging’s impact on older adults.
Recognizing the pivotal role of aging research, the National Institute on Aging (NIA), established by the
U.S. Congress in 1974, has been at the forefront. In 2012, Drs. Felipe Sierra and Ronald Kohanski catalyzed the NIH-wide Geroscience initiative, consolidating efforts to understand the genetic, molecular, and cellular biology processes that underpins aging.
GeroScience endeavors to unravel the intricate mechanism of aging, viewing it as a primary driver of age-related diseases. Geroscientists delve into the fundamental physiological, pathophysiological and biological processes associated with aging, aiming to develop interventions that mitigate age-related ailments and enhance overall well-being in older populations (Figure 2).
By probing the molecular and cellular intricacies of aging, GeroScience is poised to accelerate our understanding of aging and revolutionize approaches to age-related healthcare. This interdisciplinary pursuit unites researchers across diverse fields, forging pathways to address the multifaceted challenges posed by an aging worldwide population, with the ultimate aim to foster healthier and more fulfilling lives for older adults.
GeroScience,
Nuclear Medicine and Theranostics
The intersection of GeroScience, nuclear medicine, and Theranostics represents a promising frontier in understanding and managing age-related conditions and diseases. As people worldwide are living longer, addressing age-related health challenges becomes increasingly urgent. GeroScience, as a field, seeks to unravel the underlying genetic, molecular, and cellular mechanisms driving aging and age-related diseases.
Nuclear medicine, with its ability to visualize and treat diseases at the molecular level, offers a unique toolset for GeroScientists to delve into the intricacies of aging processes. The development and utilization of nuclear diagnostic and therapeutic Theranostics further enhance this capability, enabling precise detection and targeted treatment of age-related conditions (Figure 3)
Figure 2.GeroScience: aging biology processes snapshot
Figure 3. 18-FDG PET scintigraphy performed on a 62year old patient for suspicion of a pulmonary tumor showing in fact a diffuse joint inflammatory process related to a psoriatic arthritis
By leveraging radiopharmaceuticals and Theranostics, GeroScientists can gain insights into the molecular changes associated with aging, aiding in the identification of biomarkers and pathological pathways. This knowledge not only deepens our understanding of aging but also enables the development of interventions and therapies to mitigate in not curing age-related diseases.
Additionally, nuclear medicine techniques can assist Gerontologists in patient management by providing personalized diagnostic and therapeutic strategies tailored to individual molecular profiles. This targeted approach enhances treatment efficacy and patient outcomes, ultimately improving quality of life for older adults.
Conclusion
As the fields of GeroScience, Nuclear Medicine, and Theranostics continue to evolve, their integration holds great promise for advancing our understanding of aging and transforming the landscape of age-related healthcare. By synergizing these disciplines, researchers and clinicians can pave the way for innovative approaches to promote healthy aging and address the complex health challenges associated with growing older.
