The human genome project and the technological breakthroughs it has produced have moved the field of molecular medicine forward with breathtaking speed. This will impact not only the advance of scientific discoveries and the way science is conducted but also the clinical practice of medicine. In this review we explain the basic principles of these new technologies. Their potential use and impact are demonstrated by using diabetes mellitus as an example of a common and serious medical disorder. Finally, several potentially adverse consequences of "excessive" knowledge are discussed.
Comparative analysis of gene expression levels on a "gene chip." The messenger RNA (mRNA) is isolated from each sample and converted to complementary DNA (cDNA) and labeled with different fluorescent dyes: sample A with Cy3 (*) and sample B with Cy5 (°). Their relative signal at the 2 different wavelengths is then determined for each gene spot.
Comparative proteome analysis of levels of each protein in 2 biological samples. Proteins in the samples are separated by 2-dimensional gel electrophoresis and visualized by a quantitative stain. Image analysis software identifies differentially expressed spots and the proteins in those spots are identified by mass spectrometry. Mr indicates molecular weight; pI, isoelectric point.
Potential therapeutic impact points in molecular medicine approach to type 1 diabetes mellitus. At the stages denoted by the shaded boxes, increasing potential for ultimate clinical disease is predicted by screening at the genome, transcriptome, and proteome levels. Boxes at bottom denote current conventional stages of late preclinical and clinical detection.
Potential therapeutic impact points in molecular medicine approach to type 2 diabetes mellitus. IGT indicates impaired glucose tolerance; IFG, impaired fasting glucose. Legend otherwise corresponds to that of Figure 3.
Evolution of medical diagnostic methods and likely impact of molecular medicine on disease detection. Black boxes denote the presence or suspected presence of overt disease. Shaded box denotes a late preclinical stage in the evolution to overt disease. The gray arrow denotes that the opportunity exists for intervention prior to overt clinical disease. Black arrows represent opportunities for targeted intervention at an early preclinical stage, such as gene therapy, individualized treatment, or environmental manipulation.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 13
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature
All results at
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.