In this review, we discuss new emerging medical applications of the rapidly evolving field of mammalian synthetic biology. We start with simple mammalian synthetic biological components and move towards more complex and therapy-oriented gene circuits. A comprehensive list of ON-OFF switches, categorized into transcriptional, post-transcriptional, translational and posttranslational, is presented in the first sections. Subsequently, Boolean logic gates, synthetic mammalian oscillators and toggle switches will be described. Several synthetic gene networks are further reviewed in the medical applications section, including cancer therapy gene circuits, immuno-regulatory networks, among others. The final sections focus on the applicability of synthetic gene networks to drug discovery, drug delivery, receptor-activating gene circuits and mammalian biomanufacturing processes.
Introduction: Up to 80% of deaths related to chronic diseases (CDs) occur in low-middle income countries. Ecuadorian social security implemented a new policy for improving health care to chronic patients by two main strategies: (i) by adopting the frame of the renewed primary health care of the World Health Organization; and (ii) by massive contracting of family physicians into their primary health care centres. In order to improve the care of homebound chronic patients assigned to our healthcare center-insured to the social security health care system-, and as an answer for the mentioned change in institutional policies, we implemented an Integrated Care (IC) approach, by developing a Home Visit (HV) service in the north of Quito. The service was implemented in a real scenario and it is currently ongoing. Objectives: (i) describe the processes of the service and the tasks of different health professionals: nursing, social care, specialists and family physicians; and along different tiers of care: the patients' home, the primary health care centre and the hospital; (ii) verify its adequacy as an Integrated Care (IC) intervention; and, (iii) identify demographic and clinical determinants of the usage of the service, in order to facilitate a comprehensive future assessment of HV service and its impacts on patients' experience of care, workforce satisfaction, effectiveness and costs.
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