Dave Stuart on how drugs can now be created faster than ever

We’ve come a long way with drug development. Rational design which once seemed impossible has become routine, and we’re now able to produce advanced medicine quicker and more effectively than ever.

In 1969, Oxford scientist Dorothy Hodgkin solved the structure of insulin – a hormone that allows the body to process sugar and is used to treat diabetes. This work took her 35 years to complete – today, it could be done within hours.

Now we use this sort of information to improve the drug development process. Within recent decades, technology has opened up opportunities to explore many aspects of biology at the atomic level, allowing a different approach to drug design.

In the past, scientists would develop medicines through trial and error – making small adjustments to the structure of a suitable molecule until it had the desired effect.

The problem with this approach is that we can’t see the interaction between the molecule and its protein target, so we don’t know if it’s hitting the most effective spot. We also can’t predict whether it might interact with other proteins in the body. This happens frequently and is the key reason that drugs often cause side effects.

But now, using the methods pioneered by Dorothy Hodgkin, we have the ability to routinely see down to the individual molecules inside our bodies – particles often millions of times smaller than a pinhead. This means that we can identify exactly how a drug binds to its target and try to design new medicines that fit perfectly.

And it’s not only the body that we understand more of. It’s now possible to study the atomic structure of viruses, bacteria and other pathogens: knowledge that should allow us to design effective vaccines, antimicrobials and clinical therapies.

Working with colleagues from Beijing, Leeds and Innsbruck, my group in Oxford has identified the structure of the hand, foot and mouth disease virus, a pathogen responsible for numerous epidemics and deaths in children, mainly in Asia.

This virus has an outer protein shell which, once inside a host cell, breaks apart releasing the genetic material of the virus into the cell. Our research into the virus’s structure revealed a small pocket inside this shell, so we designed a potent molecule that fits in the pocket and blocks the viral shell from breaking open, thus inhibiting infection.

All of this is only possible because of the tools and techniques that scientists now have at their disposal. Being able to scrutinise nature at the smallest scale can have a huge effect on the drugs we create.

Technology is developing at an astonishing rate, so our response to disease can grow in new and exciting ways. As scientists’ work on the Ebola vaccine demonstrates, we can now carry out advanced diagnostics in the field, not just the lab. We can also test the tiniest shards of molecules to identify whether they interact with a potential drug target, bringing down preliminary testing times from months to about a week.

In the future, technology is likely to expand even further into drug design. With improved diagnostics, we can expect to see the rise of personalised medicine, with treatment options tailored to a patient’s genetic make-up. We also anticipate the increased power of computational modelling allowing aspects of this process to be done via simulation.

With the necessary support, science will continue to drive progress in health and medicine. It’s approaching 50 years since Hodgkin solved the structure of insulin – drug research has changed beyond all measure since then. But the frontier continues to stretch out before us. Looking back in another 50 years, who can say how much we will have achieved.

* Dave Stuart is director of life sciences at the Diamond Light Source and Professor of Structural Biology at Oxford University.