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KEY POINTS

Key Points

  • image The biologic sciences have developed drastically in the last 66 years after the uncovering of DNA structure by Watson and Crick.

  • image The completion of the human genome sequence in 2003 represents a great milestone in modern science.

  • image The technology emerging from molecular and cellular biology has revolutionized the understanding of disease and will radically transform the practice of surgery.

  • image The use of genetically modified mouse models and cell lines using gene therapy and RNA interference therapy has greatly contributed to the understanding of the molecular basis for human diseases and targeted therapies.

  • image The sequencing of each individual’s genome has the potential to improve the predication, prevention, and targeted treatment of disease, resulting in precision medicine and surgery.

  • image Fast-developing targeted genome editing tools like the CRISPR-Cas9 system greatly facilitate biomedical research in native conditions and have shown their potential in the treatment of genetic diseases, including cancers, with a high degree of personalization and precision.

  • image The use of functional genomics and modern molecular analyses will facilitate the discovery of actionable genes to guide choice of care, including precision surgery.

OVERVIEW OF MOLECULAR CELL BIOLOGY

The beginning of modern medicine can be traced back to centuries ago when physicians and scientists began studying human anatomy from cadavers in morgues and animal physiology following hunting expeditions. Gradually, from the study of animals and plants in greater detail and the discovery of microbes, scientific principles governing life led to the emergence of the biologic sciences. As biologic science developed and expanded, scientists and physicians began to utilize its principles to solve challenges of human diseases while continuing to explore the fundamentals of life in greater detail. With ever-evolving state-of-the-art scientific tools, our understanding of how cells, tissues, organs, and entire organisms function, down to the level of molecular and subatomic structure, has resulted in modern biology with an enormous impact on modern healthcare and the discovery of amazing treatments for disease at an exponential pace. Significant progress has been made in molecular studies of organ development, cell signaling, and gene regulation. The advent of recombinant DNA technology, polymerase chain reaction (PCR) techniques, and next-generation genomic sequencing, which resulted in the sequencing of the human genome, holds the potential to have a transformational influence on healthcare and society this century by not only broadening our understanding of the pathophysiology of disease, but also by bringing about necessary changes in personalized medicine.

Today’s practicing surgeons are becoming increasingly aware that many modern surgical procedures rely on the information gained through molecular research (i.e., precision surgery). Genomic information, such as deleterious BRCA and RET proto-oncogene mutations, is being used to help direct prophylactic procedures to remove potentially harmful tissues before they do damage to patients. Molecular engineering has led to cancer-specific gene therapy that could serve in the near future as a more effective adjunct to surgical debulking of tumors than radiation or chemotherapy, so surgeons ...

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