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InvestigationsChris Hartlove

Investigations (continued)

The Virtual Patient

If mice and rats were fortunetellers, we’d fire them. They only succeed in predicting whether a drug will be found toxic to humans 43 percent of the time—yet animal testing is the backbone of our safety system. Little wonder, then, that adverse drug reactions cause the death of one in a hundred hospitalized patients.

Thomas Hartung, MD, PhD, director of the Hopkins Center for Alternatives to Animal Testing (CAAT), says he’s on to an approach that’s better for people and animals.

The trouble with animals is “they can hardly substitute for the variety of humans,” says Hartung, the Doerenkamp-Zbinden Endowed Chair in Evidence-Based Toxicology. Our sensitivities morph over time, and many people, especially the elderly, take several drugs at once. When vetting a single substance can require $10 million to $20 million with traditional toxicology tests, vetting combinations simply isn’t affordable.

What’s the alternative? Studying human toxicity in human cell systems, one pathway at a time. As a test case, Hartung is exposing induced pluripotent stem cells to chemicals suspected of leading to autism early in life. “We only get one small piece of info,” says Hartung, but his approach—identifying critical molecular interactions—yields insights that apply readily to new challenges.

Ultimately, Hartung’s vision is to compile a catalog of human toxicology to guide therapy decisions. Someday, he says, “[when] you come to the hospital, an avatar will be produced, with all of your genetic background, your disease, your physiology, your body weight.” Doctors will use this computer-based avatar to simulate treatments—heading off adverse drug reactions and fine-tuning dosages.

“The virtual patient project… will be a very big job,” he recently told the Dutch journal Medicines, “but I don’t think it belongs in the world of science fiction.” In fact, CAAT has been working with more than 140 other organizations to create a sophisticated virtual patient.



  • Fehmida Visnegarwala

    India 02/27/2013 01:15:20 AM

    It is very enthusing to see this important piece of research being done by Dr. Wilcox. Understanding he epidemiology and the who, when and how of suicides is the first step towards prevention. Thank you for all the good work!

  • A Schulz

    Wisconsin 02/27/2013 02:35:26 PM

    We need to change the parameters of discussion to seeing that the energy in the bullet, as released by the gun, is the major factor that determines injury and can be regulated just as we regulate other forms of energy. The 2nd A. debate can be avoided if we regulate bullets and guns as energy that is potentially dangerous for the public regardless of whether the triggering activity is anger, mental illness, video games, political disagreement, or simple mistaken identity. We don't allow the energy in a grenade in a pocket, but in many cases would be less dangerous than a handgun or high capacity rapid fire, low recoil rifle. The whole discussion has to change focus. By the way, I am a former Marine, former NRA member, gun owner, hunter, RN,middle aged, middle class, white male, exactly the demographic the NRA claims to represent. They do not represent me. Oh, I also have been assaulted 4 times by people with handguns , and if I had been armed, I would have been shot right away and my gun stolen. I take this issue both personally and professionally very seriously.

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