Concluding Remarks

Faraday Discussion 126—A final impression

The meeting brought together researchers, including world experts in the field, who are working on the application of spectroscopic methods to particular problems in medicine. These ranged from those studying the molecular scale interactions of important signalling molecules, to the real time monitoring of critical functions in patients. It was brought to the attention of the participants of this discussion meeting that this was the first instance of the term “medical” being included in the title of a Faraday Discussion meeting. It was therefore likely that many of those present were at first unfamiliar with the format of the discussion. This however did not prevent lively debate over what was a fascinating collection of papers on biomedical applications.

The current state of play

The papers presented covered a wide range of biomedical applications of spectroscopy, and included areas beginning to break into the clinical field such as near infrared spectroscopy, used for example to monitor patient blood oxygenation. Slightly further from the clinical environment, Raman and FTIR spectroscopy still require much wider study for a proven clinical application to emerge. Within this field, FTIR imaging has in particular benefited in the last five or so years from the development of focal plane array technology allowing large areas of samples such as biopsy tissues, to be examined. If the development of FTIR instrumentation continues at its current pace, it is conceivable that within a further five years a bench top tissue diagnostic instrument of some form might not only become practicable, but more important may also become affordable. A newly emerging area that was discussed was that of terahertz (THz) spectroscopy and imaging, and the potential of the already available instrumentation to image skin lesions was demonstrated in the paper presented. The nature of the contrast observed in the THz region is less clearly understood, with bulk water absorption making the most significant contribution. However ongoing research in this area may reveal further information within the absorption spectrum.

Several papers presented research into the understanding of interactions at the molecular and cellular scale. These included the use of fluorescence correlation spectroscopy, which demonstrated the co-localisation of cell surface receptors where the intermolecular separation precluded the use of FRET. In the discussion of the application of the two related techniques of UV circular dichroism and g-factor spectroscopy, the opportunity for each research group to benefit from the experience of the other was shown. The combination of g-factor spectroscopy with the exploitation of synchrotron radiation as a UV source promises to provide a powerful tool in the understanding of biomolecular function. This example of cross fertilisation was promoted by the open nature of the discussion forum

An important feature of the meeting, which derived from its discussionary nature, was that it highlighted the need to challenge assumptions in the development of techniques for clinical applications. As one speaker commented, just because it is possible to measure something, does not necessarily mean that the measurement is worthy of development into a medical diagnostic tool. It was pointed out that for example in the area of infrared spectroscopy, few examples of real applications have yet to be delivered, in spite of much promise and years of research. It is perhaps therefore important that we should examine more closely the aims of biospectroscopy and what it can provide to the medical field. Spectroscopists have perhaps in the past been guilty of overselling the potential of spectroscopy in disease diagnosis, leading to a perception that a bench top instrument could replace a pathologist. It was clear from those present that the purpose of the research being discussed was in fact to empower the pathologist or surgeon, and that a problem perhaps existed in the way this intent was communicated to clinicians.

The timing of Faraday Discussion 126 was opportune. It fell between two meetings: the 2nd International Conference on Advanced Vibrational Spectroscopy (ICAVS), and a workshop of the Biological Applications of Synchrotron Infrared in Europe network (BASIE). The ICAVS meeting show-cased the latest technological developments in the fields of vibrational spectroscopy, and many of the discussion points concerning the need for more effective communication with clinicians were carried forward to the BASIE meeting.

The way ahead

In describing how the Faraday Discussion has highlighted future directions, I can relate a few pointers from my sphere of experience, namely the application of IR spectroscopy to the analysis of diseased tissue. A more targeted approach, perhaps in the form of a disease-specific research network, might prove beneficial, providing opportunities for cross validation of results between research groups. Certain seemingly fundamental questions also remain open to debate, such as the suitability or otherwise of paraffin embedded material for FTIR analysis. Opportunities for further exploitation also exist in the use of spectroscopic techniques to aid the understanding of drug behaviour through the study of cell receptor binding and tissue distribution.

In summary, the meeting energised many of those present to push forward their research, perhaps in new directions, or with new collaborations. This culminated in a general agreement that a meeting based around a similar theme, with a similar format should be held in the near future.

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Footnote

† On behalf of Prof. M. A. Chesters.

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