Compared to today's medical approaches that focus on "killing off certain things," for many chronic degenerative diseases—such as kidney failure, diabetes, hypertension, arthritis, and others—what we should really be doing is "cultivating something new." Dr. Siddhartha Mukherjee of the United States points out: The future of medicine will transform the way we cure diseases. Soon, we’ll treat illnesses with cell-based therapies instead of pills.

Looking back at the history of medical drugs, our understanding of diseases and drug treatments still remains rooted in a remarkably simplistic model.

This model can be summarized in six English words: Have Disease, Take Pill, Kill Something.

This simple model once dominated the field—until the advent of cell therapy.

Drug therapies once brought about a revolutionary transformation, turning previously incurable diseases like pneumonia, syphilis, and tuberculosis into conditions that can now be cured.

For example, if you have pneumonia, you can take penicillin to kill the microorganisms and cure the illness.

Whether it’s a drug extracted from nature or artificially synthesized in the lab, once taken, it spreads throughout your entire body, locates its target, and then precisely locks onto that target—whether it’s a microorganism or a specific component of one—disabling a particular function of the target through highly sophisticated and unique mechanisms.

This is the model of using drugs to treat diseases. Over the past 100 years, scientists have continuously tried to replicate this model, aiming to apply it to non-infectious conditions—such as chronic illnesses like diabetes, high blood pressure, and heart disease.

However, some work, and some don't.

For a simple example, let’s assume there are 1 million possible chemical reactions in the human body—and out of all the medicinal chemical reactions triggered by drugs, only 250 are truly effective.

In other words, only 0.025% of the chemical reactions in a person’s body align with the mechanisms currently used in drug therapies.

What should we do when drug treatments no longer work as effectively as we’d hoped? Nature offers us a completely different solution.

Life begins with a self-regulating, semi-autonomous unit known as a cell. These self-regulating, semi-autonomous units come together to form organs. And when these organs organically unite, they give rise to a human being—ultimately shaping the intricate ecosystem we know today.

Therefore, treating the disease may not be a matter of function or chemistry—but rather, a cellular issue. Take arthritis as an example: by approaching it from the perspective of stem cells and viewing it as a cellular disorder, the solution becomes remarkably clear.

Arthritis, a common condition, arises from the degeneration or dysfunction of stem cells. Thus, while we’ve been focusing on finding therapeutic drugs to address the issue, the real root of the problem may actually lie in targeting these very cells.

These cells are found right inside the skeleton.

The image shows both a schematic diagram and a real bone. The white areas represent the bone, while the red, tube-like structures and yellow cells you see all originated from a single stem cell—both cartilage and bone tissue develop from this same versatile stem cell.

Compared to simply "killing off certain things" as we do today, for many chronic degenerative diseases—such as arthritis, kidney failure, diabetes, and hypertension—we may actually need to focus on "cultivating something": namely, stem cells.

Stem cell therapy is so remarkable primarily because of its four key characteristics.

First, they exist precisely where we’d expect—either beneath the bone surface or under the cartilage tissue. In biology, location is crucial—these stem cells can migrate to the right spot to facilitate the formation of bone, cartilage, and other essential tissues and organs.

Second, stem cells can be isolated from vertebrate skeletal structures, and even when placed in a laboratory petri dish, they vigorously begin to form cartilage tissue.

Third, stem cells are the fastest repair workers. They act like a kind of cellular glue, filling in at the site of a fracture, mending it up, and then wrapping up their work. In the experiment, the bone marrow stem cells in fractured mice regenerated the bone (yellow area) and repaired the cartilage (white area), restoring it to virtually its original, intact state.

Fourth, and perhaps most regrettable of all, the number of stem cells declines at an accelerating rate with age—decreasing 10-fold, even 15-fold, as we grow older.

Q: In discussions within the tech sphere, personalized medicine is often mentioned—specifically, the idea that by gathering all available data, future drugs could be tailored precisely to your genome and environmental factors. Does this concept align with the model you’ve described?

Siddhartha Mukherjee: This is a fascinating question. We’ve been considering personalized medicine from a genetic perspective for quite some time—largely because genetics itself has become the dominant metaphor. Yet, curiously, it’s this very same term that today leads us to believe the genome will drive the advancement of personalized medicine. But clearly, the concept of the genome is just the most fundamental piece of the entire puzzle.

The most fundamental, truly organized unit in this chain is the "cell." So, if we’re serious about moving toward personalized medicine, we need to start by considering personalized "cell therapies," followed by personalized tissue and organ therapies, and ultimately culminating in personalized, immersive environmental treatments.

Q: So when you say that the drugs of the future will be cells rather than chemicals, are you referring to the possibility of using one’s own cells?

Siddhartha Mukherjee: Absolutely.

Q: Once converted into stem cells, they may also undergo testing with various drugs or other substances—and then be fully prepared.

Siddhartha Mukherjee: "This isn’t just possible—it’s already happening. In fact, we’re slowly making progress. It’s not about moving *away* from the genome; rather, it’s about integrating with it. We’re developing what we call a multi-layered, semi-automated, self-built system—something that mirrors the complexity of cells, organs, and even the environment itself."

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