Where lies the future of biomedicine? No price is too high for extending life. All efforts are thus being made, not only to prevent sickness, but also to extend wellness. Some say the future of biomedicine lies in personalised, predictive and preventive medicine. Some see it in nano-medicine, while some others see it in regenerative medicine and stem cell-based therapies. Or does it lie in the virtual man who would take care of all the trials and troubles of man. Wherever the future of biomedicine lies, it is in the safe hands of life scientists and bioengineers, and the good thing is that both are coming closer to each other to change the future of medicine.

Future medical practitioners will recommend therapy based on patient’s unique genetic profile. A combination of genetic and clinical data will make tailor-made drugs to meet the unique needs of a patient. Precise drug targeting will be possible using newly developed tools and concepts of genetics, genomics, and proteomics. Playing with the genes and proteins will be central to drug development. The interplay of genes and proteins with the environment can be more precisely controlled to prevent or minimise disorderly actions that may lead to disease formation.

Magic bullets are very much needed so as to hit only the target cells and sparing the surrounding cells. Nanotechnology-based drug delivery approach is broadening the therapeutic potential of medicine by showing the way to reach previously inaccessible selective sites in the body. Some of the long- term nanomedicine initiatives include (Source: US National Institute of Health): searching out and destroying the very first cancer cells that would otherwise have caused a tumour to develop in the body, ways to remove and replace a broken part of a cell with a miniature biological machine, developing molecular pumps and implanting them inside the body to deliver life-saving medicines precisely when and where they are needed, etc. Besides biocompatibility, another requisite characteristic is the biodegradability of the material used for the production of nanoparticles. Researchers are hoping that the future nanoparticle-based medicine shall fill this void.

The restoration of diseased or damaged tissues or organs will be essential component of future medicine tool box. Developments in tissue engineering and medical devices shall further strengthen regenerative medicine. Tissue engineering involves modifying cells or tissues in some way so that they can repair, regenerate or replace tissue in the body. The common example of tissue engineering is artificial skin. A critical issue for successful regenerative medicine applications is the source from which the cells are harvested. Cell therapies using patients own cells (autologous therapies) as well as using another person’s cells (allogeneic therapies) are possible. The key issue is rejection of the regenerated tissue by the patient’s immune system. The derivation of blood cells from stem cells, the creation of insulin-secreting, glucose-responsive cells for the treatment of diabetes, the constructive functional remodeling of the heart after a myocardial infarction, and the regeneration of nerves after spinal cord injury represent some of the realistic targets for regenerative medicine.

Stem cells have shown many promising possibilities. Some say the era of stem cells has begun. Human embryonic stem cells, adult stem cells, progenitor cells from a variety of tissues, and the induced pluripotent stem cells all represent potential components of a regenerative medicine strategy for tissue and organ reconstruction. The immunogenicity of cell-based tissue replacement, the potential of uncontrolled cell proliferation, the ethical issues, and regulatory hurdles represent significant barriers to stem cell-based regenerative medicine approach.

“In the past, the combination of patients desperate for new treatments, scientists enthusiastic about the advances they are making, clinicians wanting to help their patients, and entrepreneurial commercial organisations has led to unrealistic expectations. This over-hype has not served the community well, and we must, in advocating the potential for the future, be realistic about what is doable today and what can be expected in the short and long term” is how Stephen F Badylak and Robert M Nerem assessed the future of biomedicine Proceedings National Academy of Sciences.