Li Ling: Professor and master’s supervisor of biochemistry and molecular biology department, school of Basic Medical Sciences, Southern Medical University, his main research direction is molecular mechanism of bone metastasis in tumor.

Q: A major application direction of our project is microRNA antagonist therapy. What impact do you think it will bring to the basic treatment? And what new challenges will it pose to hospitals and doctors?

A: News showed that the FDA program approved gene therapy technology and the first gene therapy was expected to be approved in January 2018. In addition, an RNAi (RNA interference) drug has entered the main clinical endpoint of phase three clinical trials. MicroRNA and its antagonist therapy is a promising new technique for treating diseases at gene level. With the wide application of this technology in clinic, many clinical drugs and therapies harmful to human body will face elimination. However, new therapies will have their own advantages, and shortcomings, old things cannot fade away immediately, new things will also face many challenges to retain. Hospitals and clinicians should keep up with the breakthrough of medical technology, enrich the knowledge reserve of gene therapy technology and its treatment, and meet the new challenges at any time to serve the human health.

Q: Systematic drug-given method of the current microRNA antagonist therapy may induce adverse consequences, such as complement activation, hepatotoxicity, and so on. Do you think that means that this therapy is still not mature? How about the acceptance of these risks?

A:Obviously, microRNA antagonists can treat diseases from the source by inhibiting the expression of target genes at the gene level, and have shown good efficacy in a large number of clinical studies and clinical trials. As you described, some of the side effects associated with new therapies also exist. There may be individual differences, and there may be some deficiencies need to be improved. When the microRNA antagonist therapy enters clinical trials, FDA (sFDA) approval process, the treatment effect and its risk will be evaluated, and then mature therapy will be approved. For the new treatment, the patient's acceptance may be different, most of them need to be informed before the medication, and it is necessary to sign the informed consent.

Tu Shuo: Teaching assistant of biochemistry and molecular biology department of Nanchang University, her main research direction is tumor cell apoptosis.

Q: what role do microRNAs play in medical treatment nowadays?A: MicroRNAs are more used in early cancer detection at present, they may appear as adjuvant treatment in the future.

Q: What new challenges do you think microRNAs antagonist might pose to future medical scheme design?

A: The most important challenge is personalized care, it would be ideal to design treatments based on the patient's genetic sequence. Gene therapy is nothing more than specificity, so the key is to find the most specific impact factors or biomarkers of disease, and change it to reach the therapeutic effect of disease. Therefore, the effect of antagonist treatment is determined by whether the first stage can find the key target.

Q: Systematic drug-given method of the current microRNA antagonist therapy may induce adverse consequences, such as complement activation, hepatotoxicity, and so on. Do you think that means that this therapy is still not mature? How about the acceptance of these risks?

A: Liver toxicity depends on whether the drug itself is toxic or only after metabolized in vivo, or it is only toxic to the individual populations. If the drug itself is toxic or metabolized to produce toxicity, then it is necessary to control the dosage strictly and conduct periodic blood biochemical examination during the drug use, as for complement activation, make clear whether it is due to individual specificity or universal situation. It can be taken simultaneously with drugs that inhibit complement activation or optimize its structure.so once something unexpected happens, we can stop using the drug or replace therapeutic plan. There are many drugs have liver toxicity, so the drug can still be used in clinic even it has liver toxicity.