Evolution of hepatology practice in Mexico and Latin America: From biochemical markers to genomic medicine

Abstract

Genomic medicine has evolved significantly, merging centuries of scientific progress with modern molecular biology and clinical care. It utilizes knowledge of the human genome to enhance disease prevention, diagnosis, treatment, and potential reversal. Genomic medicine in hepatology is particularly promising due to the crucial role of the liver in several metabolic processes and its association with diseases such as metabolic dysfunction-associated steatotic liver disease, type 2 diabetes mellitus, liver cirrhosis, and cardiovascular conditions. The mid-20^th century witnessed a paradigm shift in medicine, marked by the emergence of molecular biology, which enabled a deeper understanding of gene expression and regulation. This connection between basic science and clinical practice has enhanced our knowledge of the role of gene-environment interactions in the onset and progression of liver diseases. In Latin America, including Mexico, with its genetically diverse and admixed populations, genomic medicine provides a foundation for personalized and culturally relevant health strategies. This review highlights the need for genomic medicine, examining its historical evolution, integration into hepatology in Mexico, and its potential applications in the prevention of chronic diseases. It emphasizes the importance of training in genomic literacy and interdisciplinary education in medical training, particularly in the field of hepatology, with a focus on genomic medicine expertise.

Keywords: Genomic medicine; Hepatology; Liver disease; Gene and environmental interactions; Exposome; Personalized medicine; Training; Latin America; Mexico

Core Tip: Genomic medicine in hepatology studies the gene-environment interactions that lead to the development of liver diseases. The liver expresses numerous genes involved in the physiology and pathophysiology of several comorbidities, such as diabetes, chronic liver disease, and cardiovascular disease. This work aimed to provide an overview of the study of the liver from its early days to genomic medicine, emphasizing its role in chronic diseases and its use in diagnosing and preventing them at early stages. It also highlighted the need to train healthcare professionals in genomic medicine, creating a new approach to medicine in Mexico and other Latin American countries.