Medicine is changing from selective interventions following the onset of illness to decentralised, personalised and continuous health monitoring.
Thanks to technologies such as ultra-reliable real-time communication and the Internet of Things, remote diagnoses, remote operations and the seamless monitoring of vital data, for example with wearables or smart wound patches, are becoming possible regardless of location.
Human augmentation will not only restore the senses and mobility, but also interact directly with the brain to map and heal neuronal malfunctions.
Biological sensors, produced using biocatalytic approaches, enable constant diagnostics, while synthetic biology programmes therapies directly in the body and tailored to individual genetic characteristics.
The challenge of scaling up to industrial scale, regulatory requirements and ethical and data protection concerns are currently slowing down the widespread introduction despite the technological potential.
Technological developments such as ultra-reliable real-time communication (URLLC) based on the 5G network mean that the geographical distance between medical staff and patients is becoming less important. URLLC is much more than just a fast mobile phone standard. Thanks to minimal latency, the network enables remote diagnoses and in future will also support remote operations, i.e. surgical procedures that are controlled from a distance by a specialised healthcare centre. This could significantly improve access to modern healthcare services even in remote areas.
In addition, the Internet of Things enables the seamless monitoring of relevant health data in real time, including vital signs such as heart rate and pulse, but also specific clinical data such as blood sugar levels and electrocardiograms (ECG), activity and behavioural data as well as information on medication intake and wound healing. This is made possible by wearables and implanted sensors, as well as smart wound plasters. These medical devices continuously monitor patients. The collected data flows into AI-supported diagnostic systems that recognise patterns at an early stage and enable individualised treatment before a critical deterioration in the condition occurs - provided that the associated challenges in terms of data protection are resolved.
Even if this vision of networked, decentralised medicine is technologically feasible, there are still considerable obstacles to its implementation. The biggest challenge for URLLC applications is to achieve nationwide and fail-safe coverage in Switzerland, which is further complicated by the fact that network expansion is slower than technical development due to restrictive environmental regulations and lengthy authorisation procedures.energy efficiency is the focus for the mostly battery-operated implants, as changing the battery requires a surgical procedure with the associated risks. It is therefore a clear goal to develop batteries that are biodegradable in the body. If this succeeds, a generation of implants is conceivable that dissolve in the body once they have fulfilled their task.
What tends to be perceived by the public as science fiction is inexorably finding its way into everyday medical practice: the restoration and enhancement of physical and neurological functions, or human augmentation in all its breadth.
Impressive examples already show how human augmentation approaches can restore sensory performance and mobility. For example, sensory prostheses such as cochlear implants significantly improve the quality of life of people with hearing loss. In addition, intelligent mobility aids such as exoskeletons and prostheses with modern sensors give people with physical limitations new freedom of movement.the advances in spinal cord implants are spectacular, with targeted stimulation of the trunk and leg muscles in combination with AI allowing paralysed patients to walk again.and the implantation of electrodes in the brain to stimulate brain regions is a standard procedure in the treatment of certain neurological and mental illnesses that are triggered by malfunctions in defined areas of the brain.
With increasingly precise stimulation of brain areas, growing knowledge of functional relationships, more efficient, biodegradable implants and the targeted delivery of active substances directly in the brain, new possibilities are emerging for the treatment of neurological and mental illnesses.the researchers' vision extends to a profound interaction with thoughts: not only should the faulty signals of the nerve cells that underlie some neurological and mental illnesses be recorded and mapped more precisely, but the thoughts that result in the corresponding faulty signals should also be mapped and changed for a positive healing process.
Despite the promising prospects, the development of human augmentation still faces numerous challenges. The mapping of the brain is not yet complete, as gaining knowledge about brain regions and their functions are critical bottlenecks in the further development of human augmentation.in addition, there are the medical risks of brain implants, which can be counteracted by improvements in the materials used and a design optimised for long-term stability. And - last but not least - there is potential in terms of the quality and synchronisation of the data generated. Questions regarding data protection and the ethics of mind manipulation also need to be clarified.
Nevertheless, human augmentation is likely to have even more far-reaching consequences than AI, as the approach not only affects medicine, but also the way people live together.
Synthetic biology approaches complement the possibilities of human augmentation, whereby biological systems are specifically modified to fight diseases directly in the body. The best-known example at present is CAR-T cell therapy: immune cells are reprogrammed to recognise and fight cancer cells as foreign bodies.to this end, gene sequences are inserted into the immune cells that are matched to the individual genetic characteristics of the patient and the tumour, i.e. personalised.
The vision of biological circuits directly in the body can be derived from reality. These function as autonomous, small and intelligent monitoring and therapy units. They are programmed to recognise specific signals or markers that indicate an incipient disease or malfunction and trigger a medical response before symptoms appear. Diagnosis and treatment coincide and are highly personalised due to the depth of information.
It is becoming increasingly apparent that the "one size fits all" approach of traditional medicine is reaching its limits. This is because the metabolism and therefore the breakdown and effect of medication differ from patient to patient. A standard dosage does not always correspond to the optimum, and maximum therapeutic success is not always guaranteed. A first starting point lies in diagnostics.
Let's imagine an ideal scenario: a person with a chronic illness wears a "magic plaster" with an integrated nanopore sensor. This constantly measures the concentration of a critical marker in the blood. If this rises above a defined threshold value, the patch sends a warning to the smartphone. The integral components of such a patch are artificial receptors that are embedded in the nanopores and briefly retain the markers flowing through for measurement. Biocatalysis is the precision tool that produces the individual parts for the artificial receptor. Without biological help, many artificial recognition systems would be too expensive or chemically impossible to produce.
The scenarios still remain visions, as the scaling of processes from laboratory scale to industrial production and proof of safety are still pending. In addition, the requirements for the authorisation of such novel medical products and therapies are very high, complex and expensive and represent a challenge for start-ups and SMEs.
The transition from reactive medicine to preventive, permanent support marks a turning point in healthcare. The combination of seamless networking, human augmentation and advanced biological processes creates the tools to bring medical excellence directly to people - regardless of where they live.despite the ethical, regulatory and technical hurdles that still need to be overcome, the goal is clearly defined: a highly efficient healthcare system that detects diseases before they become clinically relevant and tailors therapies to the individual's metabolism. The medicine of the future will be networked, personalised and precise.
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| Text by | Claudia Schärer |
