0:00:02 > 0:00:05Welcome to Bang Goes The Theory, bringing you the science behind the headlines
0:00:05 > 0:00:08and tackling the issues that have a real impact on all our lives.
0:00:08 > 0:00:11Tonight, it's about a revolution in healthcare,
0:00:11 > 0:00:13because medicine is getting personal.
0:00:13 > 0:00:14With the power of the internet
0:00:14 > 0:00:17and a wealth of new technologies at our disposal,
0:00:17 > 0:00:19we're all turning ourselves into our own doctors.
0:00:19 > 0:00:22It's not just that we're raiding the pharmacy.
0:00:22 > 0:00:26We're testing, diagnosing and even treating ourselves at home.
0:00:26 > 0:00:27At the same time, medicine itself
0:00:27 > 0:00:30is becoming more individual than ever before,
0:00:30 > 0:00:34with pioneering treatments now tailored to our very own genes.
0:00:34 > 0:00:37So, tonight on Bang, personal medicine.
0:00:37 > 0:00:41'Coming up, it doesn't get any more personal than our own DNA.
0:00:41 > 0:00:44'I find out how cutting edge gene therapy
0:00:44 > 0:00:46'is helping to save this man's eyesight.'
0:00:46 > 0:00:49I think the most important thing is that there is real hope.
0:00:49 > 0:00:52'Over five million people suffer from asthma,
0:00:52 > 0:00:55'but for many of them, the drugs don't work.
0:00:55 > 0:00:59'Maggie discovers how personalised medication is helping.'
0:00:59 > 0:01:02Within a few days, the symptoms were just completely gone,
0:01:02 > 0:01:05all the coughing was gone, no tightness of chest, nothing.
0:01:05 > 0:01:08'Plus, is prevention better than cure?
0:01:08 > 0:01:12'We meet a family using technology to track their health 24-7.'
0:01:12 > 0:01:14In some cases, it's a little bit frightening.
0:01:14 > 0:01:19I know that, sort of 5,000-odd steps a day really isn't cutting it.
0:01:19 > 0:01:21That's tonight on Bang.
0:01:22 > 0:01:27'Our first port of call in personal medicine is internet self-diagnosis.
0:01:27 > 0:01:31'Online health searches are the third most popular web activity.'
0:01:31 > 0:01:35Is going online something you would do if you didn't feel too good?
0:01:35 > 0:01:36Initially, yes.
0:01:36 > 0:01:39Yes, because they give you an awareness that
0:01:39 > 0:01:42when you do go to see a professional doctor,
0:01:42 > 0:01:45you've got some idea of what he might be talking to you about.
0:01:45 > 0:01:46Would you go on the internet first,
0:01:46 > 0:01:48or would you go and see the doctor first?
0:01:48 > 0:01:51I would probably check the internet first.
0:01:51 > 0:01:54Internet's brilliant, but it's limited because all you can do
0:01:54 > 0:01:57is read and read and read, but you've got to do something about it.
0:01:57 > 0:01:59The first thing I do if I'm not feeling too good
0:01:59 > 0:02:02and I don't know why, is to go online and check out the symptoms.
0:02:02 > 0:02:04So do 70% of us.
0:02:04 > 0:02:09But only 25% of us ever check the source of that information.
0:02:09 > 0:02:10So, how reliable is it?
0:02:12 > 0:02:15We're putting online diagnosis to the test.
0:02:15 > 0:02:18In one corner, we have Dr Ayan Panja
0:02:18 > 0:02:21the product of six years of medical training,
0:02:21 > 0:02:23a further 14 years treating patients
0:02:23 > 0:02:27and countless hours spent keeping up with the latest research.
0:02:28 > 0:02:32In the other corner, we have two kilos of plastic and metal,
0:02:32 > 0:02:35a Wi-Fi connection and the Great British public.
0:02:37 > 0:02:38If they're anything like me,
0:02:38 > 0:02:40their entire medical training consists
0:02:40 > 0:02:44of a one-day first aid course and an episode of Holby City.
0:02:45 > 0:02:47It doesn't really seem like a fair match.
0:02:47 > 0:02:49I mean, even with the weight of the web,
0:02:49 > 0:02:52what chance do our intrepid volunteers have
0:02:52 > 0:02:56against a true medical professional?
0:02:56 > 0:02:58Each patient gets five minutes
0:02:58 > 0:03:01to look up their symptoms on the laptop.
0:03:01 > 0:03:05I get, like a real shooting pain in my right buttock.
0:03:05 > 0:03:07Give me your self-diagnosis.
0:03:07 > 0:03:10I've fractured one of the small bones in the wrist.
0:03:11 > 0:03:15What have you discovered? What's the worst case scenario for your symptoms?
0:03:15 > 0:03:19Deep vein thrombosis, which is a blood clot.
0:03:19 > 0:03:22But will their online diagnosis
0:03:22 > 0:03:25match what the doctor finds from a physical examination?
0:03:25 > 0:03:30191 over 106 now. That is...
0:03:30 > 0:03:31high blood pressure.
0:03:33 > 0:03:35We ought to get that X-rayed.
0:03:35 > 0:03:39This is most likely to be a long term sprain of the wrist.
0:03:39 > 0:03:41That's lovely. Now, what I'm going to do...
0:03:41 > 0:03:45- I can feel a little twitch there. - This is a very common problem
0:03:45 > 0:03:47and it's something called sciatica.
0:03:47 > 0:03:49The itchy patches where I've scratched them.
0:03:49 > 0:03:51But they're also on my hands.
0:03:51 > 0:03:57It looks like a type of infestation, it's a type of parasite.
0:03:59 > 0:04:03So, how did the two consultations compare?
0:04:03 > 0:04:05Well, it was really interesting. I think the internet
0:04:05 > 0:04:07on about half of the occasions,
0:04:07 > 0:04:11correlated quite well with what I diagnosed.
0:04:11 > 0:04:14Occasionally it was completely wrong.
0:04:14 > 0:04:18Um... So, for example, the lady that we saw with sciatica,
0:04:18 > 0:04:20she'd been looking online and it came up with DVT,
0:04:20 > 0:04:23deep vein thrombosis, which is a very serious condition.
0:04:23 > 0:04:27And it really made her worry, so there are pros and cons.
0:04:27 > 0:04:30I think when it comes to things like rashes for example,
0:04:30 > 0:04:33that's going to be pretty hard to diagnose.
0:04:33 > 0:04:35Whereas I think things like back pain,
0:04:35 > 0:04:39you can get generic pieces of advice that are fairly useful.
0:04:39 > 0:04:41I think the really key point
0:04:41 > 0:04:44is knowing where to look for this advice,
0:04:44 > 0:04:47and I would always go to a trusted site, for example, the NHS website.
0:04:47 > 0:04:51Do you think that the way patients do have access to the internet
0:04:51 > 0:04:55and being able to look things up, it's empowering, isn't it?
0:04:55 > 0:04:57It is empowering, the internet is useful.
0:04:57 > 0:05:03It's just knowing how to take this massive beast and tame it
0:05:03 > 0:05:07and use it to our advantage, without making people anxious
0:05:07 > 0:05:09and without being unsafe.
0:05:11 > 0:05:13While internet self-diagnosis
0:05:13 > 0:05:16can't replace a flesh and blood doctor yet,
0:05:16 > 0:05:19online health searches aren't just feeding our cyberchondria.
0:05:21 > 0:05:23They're also helping researchers
0:05:23 > 0:05:26track outbreaks of diseases like flu around the world,
0:05:26 > 0:05:29which could have benefits for all of us.
0:05:30 > 0:05:33But there is another way of making a self-diagnosis,
0:05:33 > 0:05:35which has been around for some time.
0:05:35 > 0:05:38Cholesterol has become something of a buzzword.
0:05:38 > 0:05:41There are small kits like these, which you can buy over the counter
0:05:41 > 0:05:44to test the level of cholesterol in your blood at home.
0:05:44 > 0:05:47Now, that clip is over 20 years old,
0:05:47 > 0:05:50but home testing kits are still as popular as ever.
0:05:50 > 0:05:54And people are taking self-monitoring to new levels,
0:05:54 > 0:05:56as Jem finds out.
0:05:57 > 0:06:00There are some impressive gadgets on the market,
0:06:00 > 0:06:03that record everything, from blood pressure, to stress levels.
0:06:03 > 0:06:08But can self-monitoring 24/7 actually help our health?
0:06:08 > 0:06:13To try and find out, I'm setting up my own life-logging experiment.
0:06:13 > 0:06:14This is the Hutt family.
0:06:14 > 0:06:19Dad Steve, mum Kate, kids Emily and Oliver and grandad Tom.
0:06:19 > 0:06:22They're going to be the first people in the UK
0:06:22 > 0:06:24to trial the Metria sensor,
0:06:24 > 0:06:28a brand new device promising to be the ultimate accessory
0:06:28 > 0:06:31for any serious self-tracker.
0:06:31 > 0:06:34Oh, the guinea pigs, right. Good.
0:06:34 > 0:06:36You guys are in for a surprising week.
0:06:36 > 0:06:40- Yes.- What you're going to be using is a prototype
0:06:40 > 0:06:42unavailable to anybody else.
0:06:42 > 0:06:46Nobody in this country has done this experiment yet.
0:06:46 > 0:06:48- Wow.- OK?
0:06:48 > 0:06:53Now what happens is an incredibly high-tech sensor
0:06:53 > 0:06:58gets stuck on your left hand side, just below your ribs, right?
0:06:58 > 0:07:01This little device will be detecting your heart rate,
0:07:01 > 0:07:03your respiration, your breathing rate
0:07:03 > 0:07:07and the G forces you're being subjected to.
0:07:07 > 0:07:10And then all of that gets blue toothed to these tablets.
0:07:10 > 0:07:13- Oh no. - Right, competition begins here.
0:07:13 > 0:07:15I was worried somebody might say that.
0:07:15 > 0:07:18Because the other thing is, I'm going to have one too.
0:07:18 > 0:07:20- What do you reckon, Oliver? - Hmm. Good.
0:07:20 > 0:07:22Your job is to oversee this.
0:07:22 > 0:07:25Make sure they don't take their sensor off and shake it
0:07:25 > 0:07:29to make out they're incredible athletes or anything like that.
0:07:29 > 0:07:32- OK, now you each get a tablet. Tom.- Thank you.
0:07:34 > 0:07:38We'll wear these sensors 24 hours a day for an entire week.
0:07:40 > 0:07:42- Any signs of life?- Says he's asleep!
0:07:42 > 0:07:44THEY LAUGH
0:07:46 > 0:07:49They'll monitor our activity at work, rest and play.
0:07:51 > 0:07:52Good, right.
0:07:52 > 0:07:56I'm really intrigued to discover, how my life in numbers shapes up
0:07:56 > 0:07:58to how I imagine it being.
0:07:58 > 0:08:00I think it might be a bit of a wake-up call in some ways.
0:08:00 > 0:08:02I think you're probably right.
0:08:04 > 0:08:05So that's it.
0:08:05 > 0:08:08We're now all patched up and connected to computers.
0:08:08 > 0:08:11I guess we just lead our everyday lives and see what we learn
0:08:11 > 0:08:12in the next seven days.
0:08:16 > 0:08:17In the meantime,
0:08:17 > 0:08:20to find out about the benefits of self monitoring,
0:08:20 > 0:08:24I'm meeting with GP and medical gadget expert, Dr Jack Kreindler.
0:08:25 > 0:08:27They all look suitably shiny.
0:08:27 > 0:08:30What do these various gadgets and devices do?
0:08:30 > 0:08:34Well, we've got a whole range here, ranging from medical devices
0:08:34 > 0:08:37through things that can help you monitor your lifestyle.
0:08:37 > 0:08:40The thing that's particularly striking about what's here
0:08:40 > 0:08:41is the size of it all.
0:08:41 > 0:08:43Well, interesting you say that.
0:08:43 > 0:08:46Maybe a few years ago, if you were measuring something
0:08:46 > 0:08:52like your ECG, your heart tracing, you'd have to go to a hospital.
0:08:52 > 0:08:56You'd have to have an expert wire you up to a machine like this.
0:08:56 > 0:09:00But now, I have one of these, which is just a simple
0:09:00 > 0:09:06smart phone cover but in fact it has a clinical grade ECG monitor on it.
0:09:06 > 0:09:10So if you've got an arrhythmia of normal rhythm of your heart,
0:09:10 > 0:09:13you can now check that and you have something that a doctor would
0:09:13 > 0:09:16understand instantly that you can send to him
0:09:16 > 0:09:19that would normally have to be printed out from here.
0:09:19 > 0:09:22What strikes me is, you could almost put a roof over this table
0:09:22 > 0:09:23and that's a hospital.
0:09:23 > 0:09:26We've got an incredible opportunity with this kind of technology
0:09:26 > 0:09:30becoming ever smaller, ever more powerful, ever more accurate
0:09:30 > 0:09:34and ever more useful to the profession, that we can transform
0:09:34 > 0:09:38the way we practise medicine by collecting the data, understanding it
0:09:38 > 0:09:42and acting earlier, making better decisions before we get ill.
0:09:45 > 0:09:48So how about our own trial with high-tech gadgetry?
0:09:51 > 0:09:53For the past seven days, our breathing, movement,
0:09:53 > 0:09:57and every heartbeat has been captured and logged by the sensors,
0:09:57 > 0:10:00while we got on with our everyday lives.
0:10:00 > 0:10:03Your temperature, your blocked nose, it's all yourself,
0:10:03 > 0:10:05trying to get yourself better.
0:10:05 > 0:10:06And cut, great.
0:10:12 > 0:10:15Now the Hutt family and I are back to see Dr Jack
0:10:15 > 0:10:16to analyse our results.
0:10:18 > 0:10:22With our daily lifestyles laid bare, will there be any surprises?
0:10:23 > 0:10:26We've got a whole load of really interesting things
0:10:26 > 0:10:29that your devices have picked up.
0:10:29 > 0:10:30You can see some amongst us
0:10:30 > 0:10:33have been doing a little bit more running around than others.
0:10:33 > 0:10:36So, Jem, you training for a marathon that day?
0:10:36 > 0:10:39No, that's Saturday. I'm looking after the kids on a Saturday.
0:10:39 > 0:10:40Oh, I see. Excellent.
0:10:40 > 0:10:44Nearly 16,000 steps equivalent, so a pretty active day.
0:10:44 > 0:10:47So here are the averages. We've got Tom.
0:10:47 > 0:10:48Nearly 6000 steps a day.
0:10:48 > 0:10:51That's good for me. Probably on the walk down the pub.
0:10:53 > 0:10:57And Kate there, is nearly doing double that amount,
0:10:57 > 0:10:58which is really quite extraordinary.
0:10:58 > 0:11:00I work in a big hospital
0:11:00 > 0:11:02so when I'm actually at work, there's lots of walking around.
0:11:02 > 0:11:03A lot of running around.
0:11:03 > 0:11:05Shall we also have a look at something
0:11:05 > 0:11:08that I found very interesting, which was your sleep?
0:11:09 > 0:11:14Tom, on average over the week, you got about 6.8, nearly 7 hours.
0:11:14 > 0:11:18- Steve, 7.3.- I'll take that.
0:11:19 > 0:11:23Emily had a grand 9.5 hours of sleep, which doesn't surprise me at all
0:11:23 > 0:11:27because you do most of your growing as a child, when you're asleep.
0:11:27 > 0:11:31Now Kate, how many hours of sleep are we meant to get a day?
0:11:31 > 0:11:32About eight, I think.
0:11:32 > 0:11:36Now obviously you're managing a busy job and a big family.
0:11:36 > 0:11:41You're still doing OK. 6.6 hours. You had this thing for a week.
0:11:41 > 0:11:45Did it surprise you, inform you of anything you hadn't known before?
0:11:45 > 0:11:49I never knew that my mum would actually get 10,000.
0:11:49 > 0:11:52I was quite surprised on just a normal day that
0:11:52 > 0:11:54I got that many steps and I thought that I probably
0:11:54 > 0:11:58got the least sleep as well so I kind of feel vindicated.
0:11:58 > 0:12:00All my moaning, "I'm so tired!"
0:12:00 > 0:12:04I think the interesting thing as well with that is, it's factual.
0:12:04 > 0:12:05It's data.
0:12:05 > 0:12:08It's data and in some cases, it's a little bit frightening.
0:12:08 > 0:12:12Now we've been chatting about this I know that sort of 5,000 odd steps
0:12:12 > 0:12:16- a day really isn't cutting it. - Because it's all being recorded,
0:12:16 > 0:12:19did you sort of try to become more active?
0:12:19 > 0:12:21- Yeah, we did. - We tried to be more active.
0:12:21 > 0:12:23Because it was a bit like a competition.
0:12:23 > 0:12:27We thought, instead of Steve getting in the car and going down the shops,
0:12:27 > 0:12:28we'd all walk down the shops.
0:12:28 > 0:12:32It's only a five-minute journey but it's that extra little bit.
0:12:32 > 0:12:35It's like having a sort of a personal coach, you become your own coach.
0:12:35 > 0:12:40It's called bio-feedback. It's the ability for you to see the results
0:12:40 > 0:12:45of what you're doing and then feel what it's like to be more active.
0:12:45 > 0:12:49And you can imagine that those things might become smaller in future.
0:12:49 > 0:12:51More and more invisible.
0:12:51 > 0:12:54Last for a month before you need to recharge the batteries.
0:12:54 > 0:12:58All of these things. I think that they'll become part of life.
0:13:00 > 0:13:04I don't know if I'm ready to become a full time life-logger quite yet,
0:13:04 > 0:13:07but it was fascinating to see an entire week of my life
0:13:07 > 0:13:09reduced to a page full of numbers.
0:13:09 > 0:13:13It was also wonderful to see just how much the Hutt family enjoyed
0:13:13 > 0:13:15the experiment and how,
0:13:15 > 0:13:18it seems the very act of being monitored makes everyone more
0:13:18 > 0:13:21interested and indeed competitive with regard to their health.
0:13:25 > 0:13:29This natural competitiveness we all have can be taken advantage of.
0:13:31 > 0:13:36Across the world, we spend 3 billion people-hours a week on gaming.
0:13:36 > 0:13:39And now medical experts are using that to turn some
0:13:39 > 0:13:41elements of healthcare into games.
0:13:43 > 0:13:46David and Ben have type 1 diabetes
0:13:46 > 0:13:49and need to check their glucose levels up to five times a day.
0:13:50 > 0:13:56How much of a chore is it to constantly monitor your blood sugar?
0:13:56 > 0:13:59It's quite a big one, but you have to do it.
0:13:59 > 0:14:02It's your life, you can't mess it up.
0:14:02 > 0:14:05Although Ben and David know they have to keep a close eye
0:14:05 > 0:14:08on their blood sugar, being kids, they still need a bit
0:14:08 > 0:14:12of motivation sometimes and now there's a game that could help.
0:14:14 > 0:14:16So this is it, Monster Manor. How does it work?
0:14:16 > 0:14:21Basically, you put in your blood sugar after you've just tested
0:14:21 > 0:14:23and you get coins from it.
0:14:23 > 0:14:25And you get prizes.
0:14:25 > 0:14:27And do you find having a game like this that's kind of
0:14:27 > 0:14:30linked in to monitoring your blood sugar, does it make it
0:14:30 > 0:14:34kind of easier, I guess, to remember or to want to do it?
0:14:34 > 0:14:36If you want to play Monster Manor you'll think,
0:14:36 > 0:14:39"I don't have enough coins so, test my blood."
0:14:39 > 0:14:40And now I've get more coins.
0:14:42 > 0:14:45The makers of Monster Manor have found that using
0:14:45 > 0:14:50games as motivation can have very positive results.
0:14:50 > 0:14:53What we've definitely found is the relationship between doing
0:14:53 > 0:14:57a blood glucose check and then having some fun for a short amount
0:14:57 > 0:15:01of time afterwards is very effective at creating the habit
0:15:01 > 0:15:02that you're looking for.
0:15:02 > 0:15:06That small behaviour change, that small amount of fun,
0:15:06 > 0:15:08starts to create the habit.
0:15:08 > 0:15:10And what I find particularly fascinating about that is that
0:15:10 > 0:15:15with type 1 diabetes the real life stakes are incredibly high
0:15:15 > 0:15:19and yet the kind of fun of the game is actually
0:15:19 > 0:15:21more of a draw than that.
0:15:21 > 0:15:24And that's really the whole thing about gamification
0:15:24 > 0:15:25because you do respond.
0:15:27 > 0:15:30The applications of this technology could be far reaching.
0:15:30 > 0:15:35By motivating people and giving them more control over their own health,
0:15:35 > 0:15:39it could be used to tackle a whole range of lifestyle-related illness.
0:15:41 > 0:15:45Biological data of an even more personal nature could allow doctors
0:15:45 > 0:15:49to make treatments more effective than they are at present.
0:15:49 > 0:15:53Despite all of the advances we've made in medicine,
0:15:53 > 0:15:55one of the hard truths that remains
0:15:55 > 0:15:58is that a lot of the time, the drugs just don't work.
0:15:58 > 0:15:59In fact, the vast majority of medications
0:15:59 > 0:16:02are thought to be effective in only 40% of people.
0:16:02 > 0:16:05But all that could be about to change,
0:16:05 > 0:16:07and the key lies in our genes.
0:16:09 > 0:16:13Ten years ago, scientists finished mapping the entire human genome
0:16:13 > 0:16:17and now medicine is on the brink of a genetic revolution.
0:16:18 > 0:16:22Coming up - I find out how cutting-edge gene therapy
0:16:22 > 0:16:25is helping patients to preserve their sight.
0:16:25 > 0:16:27It is genuinely a life-changing event that has happened.
0:16:27 > 0:16:31And Maggie investigates how genetic testing
0:16:31 > 0:16:33can help asthma sufferers like Ewan.
0:16:33 > 0:16:35I could do anything I wanted
0:16:35 > 0:16:38without having this fear of having an attack at any moment.
0:16:40 > 0:16:44But first, how cutting-edge science is tackling ageing.
0:16:47 > 0:16:50Inside this pharmacy, they're going to take a sample of my DNA,
0:16:50 > 0:16:53because they say it can give me a better chance
0:16:53 > 0:16:55of fighting the ageing process.
0:16:56 > 0:17:00We all age differently depending on our genes.
0:17:00 > 0:17:02If we can work out what those genes are,
0:17:02 > 0:17:05can we tailor our skincare accordingly?
0:17:05 > 0:17:08Professor Chris Toumazou from Imperial College
0:17:08 > 0:17:12has invented a portable device that does genetic tests while you wait.
0:17:12 > 0:17:15So what we've done is we've taken your saliva
0:17:15 > 0:17:18and now we're going through a process of what we call DNA extraction,
0:17:18 > 0:17:21it's a very simple process.
0:17:21 > 0:17:23We've taken what would normally happen
0:17:23 > 0:17:25in a very sophisticated laboratory
0:17:25 > 0:17:28and brought it to the counter, effectively.
0:17:28 > 0:17:31So what's going to happen to my DNA now?
0:17:31 > 0:17:34Yes, so your DNA now has been placed onto this microchip.
0:17:34 > 0:17:35And on this chip,
0:17:35 > 0:17:40we basically have the signature DNA of the anti-ageing mutation,
0:17:40 > 0:17:42which is collagen degradation.
0:17:42 > 0:17:46And so we're comparing now the DNA we extracted from you
0:17:46 > 0:17:49to the signature DNA on that chip.
0:17:49 > 0:17:53'My profile is wirelessly pinged to a database in Hong Kong
0:17:53 > 0:17:57'and 30 minutes later my anti-ageing results are in.'
0:17:57 > 0:17:59- So you've got the results now.- Yes.
0:17:59 > 0:18:02Well, what's the story? What are they telling you?
0:18:02 > 0:18:04You've got a sea of ingredients there,
0:18:04 > 0:18:07so that doesn't mean anything to me. What's it telling you?
0:18:07 > 0:18:09What it means to me, by looking at those ingredients,
0:18:09 > 0:18:12is that you are a very fast degrader of collagen.
0:18:12 > 0:18:14No! I refuse to believe this.
0:18:14 > 0:18:17And I refuse to believe it as well! But you are, unfortunately.
0:18:17 > 0:18:19Gosh, I'm ageing before your eyes!
0:18:19 > 0:18:22Based upon your genetic information,
0:18:22 > 0:18:24the database is recommending
0:18:24 > 0:18:29some of the very strong, collagen-boosting actives.
0:18:29 > 0:18:32So what do you think the implications of this technology are?
0:18:32 > 0:18:34Well, I think, if anything,
0:18:34 > 0:18:38it's going to give consumer awareness of this sort of genetic technology.
0:18:38 > 0:18:42Yes, OK, trying to make beautiful people more beautiful,
0:18:42 > 0:18:46but really my major motivation is to make sick people better.
0:18:46 > 0:18:47And if we can drive this forward,
0:18:47 > 0:18:50particularly into the healthcare system,
0:18:50 > 0:18:52then it would mean that you'd see the future GP
0:18:52 > 0:18:55being able to take a saliva sample in his surgery
0:18:55 > 0:18:59and recommend the right drug for that individual.
0:19:00 > 0:19:03In fact, one clinical trial in Dundee
0:19:03 > 0:19:07is already using personalised medicine to change people's lives.
0:19:09 > 0:19:13'Ewan Macintosh is just one of the one million sufferers
0:19:13 > 0:19:16'of childhood asthma in the UK.
0:19:16 > 0:19:20'He's now 18, but has suffered from this debilitating disease
0:19:20 > 0:19:21'since he was born.'
0:19:21 > 0:19:24Sometimes I would wake up coughing in the night,
0:19:24 > 0:19:26giving me really broken sleep,
0:19:26 > 0:19:29so I'd get really tired during the day.
0:19:29 > 0:19:31And while I always had a very good group of friends,
0:19:31 > 0:19:35I would sometimes feel I couldn't join in with their sports things.
0:19:35 > 0:19:37Hearing your child coughing through the night
0:19:37 > 0:19:40and knowing that he's not getting a good night's sleep,
0:19:40 > 0:19:43it's never a good thing for a parent to hear.
0:19:43 > 0:19:46The normal treatment that everyone else who has asthma has -
0:19:46 > 0:19:49a lot of people do - was not working.
0:19:49 > 0:19:55We thought, why was it not working for him and it works for others?
0:19:56 > 0:19:59The standard medication given to children with severe asthma
0:19:59 > 0:20:04is a drug called Salmeterol, but for Ewan, it just didn't seem to work.
0:20:04 > 0:20:06And he's not alone.
0:20:06 > 0:20:08It's thought that one in seven children with asthma
0:20:08 > 0:20:10don't respond to Salmeterol.
0:20:10 > 0:20:14The problem is working out who those children are.
0:20:15 > 0:20:18But a clinical trial run by Professor Somnath Mukhopadhyay
0:20:18 > 0:20:20from Brighton and Sussex Medical School
0:20:20 > 0:20:21may hold the answer.
0:20:23 > 0:20:27One of the main difficulties that we face right now
0:20:27 > 0:20:30is that we do not have a simple test
0:20:30 > 0:20:34to identify which children will not respond to the Salmeterol.
0:20:34 > 0:20:35What you've been doing is,
0:20:35 > 0:20:38you've been using genetics to help you with this.
0:20:38 > 0:20:39That's absolutely right.
0:20:39 > 0:20:44In many of these children there is a faulty gene,
0:20:44 > 0:20:50which means they will not respond as well to the Salmeterol.
0:20:50 > 0:20:52And we've picked up the children
0:20:52 > 0:20:55who have this particular "faulty gene"
0:20:55 > 0:21:00and we've given them Montelukast instead of Salmeterol.
0:21:00 > 0:21:02The results of the trial confirmed
0:21:02 > 0:21:05that a DNA test can easily identify those children
0:21:05 > 0:21:09who will respond better to the alternative drug.
0:21:09 > 0:21:12The asthma trial is one of the UK's first examples
0:21:12 > 0:21:14of personalised medicine,
0:21:14 > 0:21:17something we've been talking about for years
0:21:17 > 0:21:19and researchers have been working towards
0:21:19 > 0:21:22since first mapping the human genome ten years ago.
0:21:24 > 0:21:26And the impact on patients in the trial
0:21:26 > 0:21:29has been nothing short of remarkable.
0:21:29 > 0:21:31Ewan's genetic make-up
0:21:31 > 0:21:33suggested that he could be one of the one in seven
0:21:33 > 0:21:37who would respond better to the substitute drug.
0:21:37 > 0:21:39Within a few days the symptoms were just completely gone,
0:21:39 > 0:21:40all the coughing was gone,
0:21:40 > 0:21:43no tightness of chest, nothing.
0:21:43 > 0:21:44I could do anything I wanted
0:21:44 > 0:21:48without having this fear of having an attack at any moment.
0:21:48 > 0:21:50It was just a complete change.
0:21:50 > 0:21:53The leap at the beginning was quite amazing.
0:21:53 > 0:21:55I thought, "Oh, what?
0:21:55 > 0:21:58"It's gone quiet, there's no coughing."
0:21:58 > 0:22:00Coughing in the night-time had gone.
0:22:00 > 0:22:03- It gave you your freedom back. - Yeah, I could go out.
0:22:03 > 0:22:06I could go and join in with sports at school.
0:22:06 > 0:22:07I joined the Air Cadets,
0:22:07 > 0:22:11so I could go and do all these sporty things,
0:22:11 > 0:22:13which wasn't available to me before.
0:22:15 > 0:22:18Personalised medicine is still at a trial stage,
0:22:18 > 0:22:20but it's hoped that eventually a simple saliva test
0:22:20 > 0:22:24could determine the correct drugs for many diseases.
0:22:26 > 0:22:29Changing your medication to suit your DNA is one thing,
0:22:29 > 0:22:32but what if you could change some of your genes
0:22:32 > 0:22:34so that you didn't need treatment in the first place?
0:22:34 > 0:22:37Genetically modifying people may sound a little Frankenstein,
0:22:37 > 0:22:40but it's real and it's called gene therapy.
0:22:40 > 0:22:42And there could well be a future where the doctor,
0:22:42 > 0:22:44instead of prescribing drugs,
0:22:44 > 0:22:46is prescribing a slight alteration to your DNA.
0:22:48 > 0:22:51I'm meeting a man who suffers from a genetic condition
0:22:51 > 0:22:55called choroideremia, which leads to complete blindness.
0:22:55 > 0:22:58With only tunnel vision remaining,
0:22:58 > 0:23:00his hope lies in a new gene therapy treatment
0:23:00 > 0:23:03being trialled on a handful of people.
0:23:03 > 0:23:05Stanford, how are you feeling today?
0:23:05 > 0:23:07Slightly nervous, slightly apprehensive,
0:23:07 > 0:23:11but obviously looking forward to what the future holds.
0:23:11 > 0:23:14So when did you first know that you had choroideremia?
0:23:14 > 0:23:19I first knew I had choroideremia when I was 27 and I'm now 43,
0:23:19 > 0:23:21so it's been quite a few years.
0:23:22 > 0:23:25I used to be quite active, I was a diver, worked as a carpenter.
0:23:25 > 0:23:28I found over the last few years,
0:23:28 > 0:23:32it's really started to affect my life and what I can do, my mobility,
0:23:32 > 0:23:36my work, it's becoming more difficult.
0:23:36 > 0:23:38If it's left unchecked,
0:23:38 > 0:23:41I have about ten years' vision left in my left eye.
0:23:41 > 0:23:44So for me to be on this trial is an absolutely amazing feeling.
0:23:46 > 0:23:49Stanford is going to be in the expert hands of Professor MacLaren,
0:23:49 > 0:23:53who's leading a groundbreaking new gene therapy trial
0:23:53 > 0:23:56here at the John Radcliffe Hospital in Oxford.
0:23:58 > 0:24:01So, when a patient has choroideremia,
0:24:01 > 0:24:04what exactly is wrong with their eyes?
0:24:04 > 0:24:06These patients have got a faulty gene,
0:24:06 > 0:24:09which encodes a protein known as REP-1,
0:24:09 > 0:24:12and without this gene, the photoreceptor cells,
0:24:12 > 0:24:16the light-sensing cells at the back of the eye undergo degeneration.
0:24:16 > 0:24:19And it begins in childhood and it affects men,
0:24:19 > 0:24:21because the missing gene is on the X chromosome
0:24:21 > 0:24:24and that degeneration starts on the peripheral part of vision
0:24:24 > 0:24:26and gradually comes into the centre
0:24:26 > 0:24:28until finally the last bit of vision disappears.
0:24:28 > 0:24:30So tell me about this trial.
0:24:30 > 0:24:34Tell me how you go about targeting a tiny gene in so much DNA?
0:24:34 > 0:24:37What we do is we commonly use a virus,
0:24:37 > 0:24:39which has evolved to be very effective at going into cells
0:24:39 > 0:24:41and delivering its own DNA,
0:24:41 > 0:24:44only we're putting our DNA into the virus so it does the job for us
0:24:44 > 0:24:47and it does it very, very efficiently.
0:24:47 > 0:24:49So once the correct version of the gene is inserted
0:24:49 > 0:24:53using this virus vehicle, what happens to those cells?
0:24:53 > 0:24:55What we hope to do is, by replacing the missing gene,
0:24:55 > 0:24:58those cells, those light-sensing cells, are then going to survive,
0:24:58 > 0:25:00whereas previously they would have died,
0:25:00 > 0:25:03and that hopefully will preserve the patient's vision for much longer
0:25:03 > 0:25:05than if they have the disease.
0:25:07 > 0:25:08How on earth do you go about
0:25:08 > 0:25:11inserting the virus carrying the correct gene
0:25:11 > 0:25:13into a patient's eye?
0:25:13 > 0:25:16Well, we need to separate the retina from the back of the eye
0:25:16 > 0:25:19so that we can put the virus underneath it.
0:25:20 > 0:25:24Professor MacLaren uses a specialised flexible needle,
0:25:24 > 0:25:27just one tenth of a millimetre in diameter.
0:25:27 > 0:25:29It leaves such a small hole in the retina
0:25:29 > 0:25:33that it prevents the injected viral particles from escaping.
0:25:34 > 0:25:40So that's it - 10 billion viruses have just been injected
0:25:40 > 0:25:44onto the back of Stanford's eye.
0:25:44 > 0:25:48And it sounds like a lot, and it has to be,
0:25:48 > 0:25:53because each virus is carrying a working copy of the REP-1 gene
0:25:53 > 0:25:55and the more viruses you inject,
0:25:55 > 0:25:57the better the chances
0:25:57 > 0:26:00of the photoreceptor cells on the back of the eye
0:26:00 > 0:26:04taking in the DNA when the virus infects them.
0:26:05 > 0:26:08After only 90 minutes, the operation is over
0:26:08 > 0:26:12and the healthy genes have hopefully been delivered
0:26:12 > 0:26:14to the cells in the back of Stanford's eye.
0:26:15 > 0:26:16That was incredible.
0:26:16 > 0:26:18Now Professor MacLaren and his team
0:26:18 > 0:26:21have already operated on six other patients.
0:26:21 > 0:26:23And one of them was operated on over a year ago now,
0:26:23 > 0:26:24so I'm going to meet him
0:26:24 > 0:26:27to see how the gene therapy has impacted on his life.
0:26:29 > 0:26:34So, Toby, tell me about how quickly did you begin to notice a difference?
0:26:34 > 0:26:36When I went for the first sight test,
0:26:36 > 0:26:38which was a month after the op,
0:26:38 > 0:26:41and that's when I saw that I could see more with the left eye,
0:26:41 > 0:26:44which was the eye they operated on, on the sight chart.
0:26:44 > 0:26:47And how did you feel? I mean, it's a silly question, really.
0:26:47 > 0:26:49It was fantastic, it really was,
0:26:49 > 0:26:52because what they had always said to me
0:26:52 > 0:26:58is that the trial is to try and slow down or stop the degeneration,
0:26:58 > 0:27:01and here we have a situation where it seems, in fact,
0:27:01 > 0:27:04that it has slightly reversed the process
0:27:04 > 0:27:06and so I can see that much more.
0:27:06 > 0:27:09So how has your quality of life improved so far, Toby?
0:27:09 > 0:27:12I think the most important thing is that there is real hope.
0:27:12 > 0:27:14I've always said that
0:27:14 > 0:27:17as long as I can read and play tennis I'll be happy.
0:27:17 > 0:27:19And what this has done
0:27:19 > 0:27:22is to enable me to have very real hope that I will be able to do that.
0:27:22 > 0:27:24Forgive the cliche,
0:27:24 > 0:27:27but it is genuinely a life-changing event that has happened,
0:27:27 > 0:27:30purely as a result of the gene therapy,
0:27:30 > 0:27:32Professor MacLaren and his team.
0:27:35 > 0:27:37This gene therapy has huge potential
0:27:37 > 0:27:40for preventing blindness in various eye conditions
0:27:40 > 0:27:43and it's a great example of how modern medicine
0:27:43 > 0:27:46is becoming more and more tailored to the individual.
0:27:46 > 0:27:50And with trials being carried out for more complex diseases,
0:27:50 > 0:27:53like cancer and heart disease and immune disorders,
0:27:53 > 0:27:55it's predicted that gene therapy is going to become
0:27:55 > 0:27:58a much more important part of our healthcare in the future.
0:28:01 > 0:28:04When out in crowds I'm often struck
0:28:04 > 0:28:08by how we're all so unmistakably human, but utterly individual.
0:28:08 > 0:28:09And now medically, it seems,
0:28:09 > 0:28:13we're engineering ways of capturing that and working with it.
0:28:13 > 0:28:16I think there are some very interesting times ahead
0:28:16 > 0:28:20as we learn to manage our health with more and more precision.
0:28:23 > 0:28:25That's it for this programme.
0:28:25 > 0:28:28There's another special film from Jem at our website -
0:28:28 > 0:28:29bbc.co.uk/bang
0:28:29 > 0:28:32And you can follow the links to the Open University
0:28:32 > 0:28:36for information about alternative and complementary medicine.
0:28:43 > 0:28:47Subtitles by Red Bee Media Ltd