Synthetic Biology Parts, Devices and Applications

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Synthetic Biology: Parts, Devices and Applications, First Edition. Edited by Christina Smolke.
© 2018 Wiley-VCH Verlag GmbH & Co. KGaA. Published 2018 by Wiley-VCH Verlag GmbH & Co. KGaA.


17


17.1 The Need for a New Therapeutic Paradigm


The advent of the germ theory of disease in the late nineteenth century marked a
watershed in the history of medicine and heralded the development of modern
pharmaceuticals. The work of Louis Pasteur, Robert Koch, and fellow microbiolo-
gists elucidated the bacterial and viral origins of common and often fatal diseases
such as cholera and puerperal fever and motivated the development of myriad small
molecule-based pharmaceuticals and viral vaccines that specifically targeted infec-
tious agents. As epidemics such as smallpox and polio came under control, new
classes of diseases that do not have simple biological causes gradually took center
stage. Chronic and complex illnesses such as diabetes, cardiovascular diseases, and
cancers supplanted infectious diseases as the dominant scourges in developed
countries after the Second World War. In response to this changing landscape of
medical challenges, pioneers in molecular biology and genetic engineering launched
a new paradigm of pharmaceutical development and, beginning in the 1980s, pro-
duced the first biologics: monoclonal antibodies such as trastuzumab (Herceptin)
[5, 6] and recombinant protein therapeutics such as synthetic insulin and erythro-
poietin [7, 8]. Today, the twin pillars of small molecules and biologics continue to
serve as the pharmaceutical arsenal of modern medicine, complemented by non-
biochemical methods such as medical devices and surgical intervention.
Despite modern advancements in diagnostics and therapeutics, several debili-
tating diseases have remained essentially incurable. In particular, cancer has
steadily risen through the ranks of fatal diseases over the past several decades,
with prominent examples including pancreatic and small cell lung cancers, each
with an overall relative 5-year survival rate of 7% [9]. Glioblastoma, the most
common type of primary brain tumors, has a median survival period of less than
15 months [10, 11]. Unlike well-characterized infectious diseases and metabolic
disorders such as diabetes, the conditions highlighted previously do not present
simple biological causes or deficiencies that can be easily eliminated or compen-
sated by chemical drugs and biologics. Cancer cells are characterized by genomic


Synthetic Biology in Immunotherapy and Stem Cell


Therapy Engineering


Patrick Ho and Yvonne Y. Chen


University of California, Department of Chemical and Biomolecular Engineering, 420 Westwood Plaza, Boelter Hall
5532, Los Angeles, CA 90095, USA

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