Book Review

Principles of Molecular Medicine

N Engl J Med 1999; 340:1601-1602May 20, 1999

Article

Principles of Molecular Medicine
Edited by J. Larry Jameson. 1123 pp., illustrated. Totowa, N.J., Humana Press, 1998. $175. ISBN: 0-89603-529-8

Debates are taking place in medical schools and on the pages of medical journals about the extent to which medical students need to learn about molecular medicine and about how the subject should be taught. Indeed, the rapid proliferation of modern molecular and genetic techniques and advances in structural biology have made an enormous contribution to our understanding of biologic processes and the mechanisms of disease. Advances in human genetics, immunology, virology, hematology, neurology, drug design, and gene therapy, along with knowledge and applications generated by the Human Genome Project, are converging to create the new interdisciplinary field known as molecular medicine.

Molecular medicine promises to transform medical practice by providing new and more efficient approaches to the diagnosis, prevention, and treatment of a wide spectrum of congenital and acquired disorders. We are already seeing the first fruits of these efforts: several recombinant proteins are on the market, some gene-therapy protocols are undergoing phase 3 clinical trials, and a number of molecular diagnostic kits are now available commercially. Because molecular medicine has already started to become an integral part of medical practice, there is a growing need to integrate it into the medical school curriculum and medical education in general. Principles of Molecular Medicine is well suited to serving this purpose, dealing with the more recent molecular and genetic advances in each major branch of medicine and closing the gap between basic science and the bedside.

The book is organized according to organ systems and comprises more than 120 chapters, each written by outstanding specialists. It opens with a series of chapters that introduce the seminal molecular and cellular concepts of modern biology and genetics — the fundamental principles underlying the organization of the human genome, the transcriptional control of gene expression, and the transmission of human genetic diseases. Other chapters describe the tools and techniques available to characterize genes and mutations and to analyze both their expression and their molecular and cellular pathology. The various facets of human hereditary disorders, including genetic counseling and molecular diagnostic testing, are clearly and comprehensively presented.

The specialty sections are divided into chapters that, in addition to providing information on the molecular mechanisms of the respective diseases and practical applications of molecular biology, attempt to foresee the future implications of recent developments. Each chapter ends with a list of selected references, which, unfortunately, are not cited in the text. Most of the sections contain background or overview chapters that summarize the molecular pathophysiology specific to the relevant organ system and, in some instances, the approaches used to identify disease-related genes.

Although the book is well written and attractive, it has a few shortcomings. Because some of the authors set the stage for their topic by introducing the same basic principles, there is, inevitably, some redundancy. Some of the figures are also redundant. The majority of the illustrations are well chosen and clearly designed, but the exclusive use of monochrome is regrettable. Indeed, many figures suffer from the lack of color, which is not fully compensated for by the use of tones of gray.

Despite these imperfections, Principles of Molecular Medicine is a valuable resource that will certainly appeal to clinicians, researchers, teachers, and students alike. It will also be of value to those involved in a particular area of molecular medicine who need a reference manual in which to find information on aspects of the field with which they are less familiar.

Given the astounding pace of basic and clinical research in molecular medicine, this book will need regular updating. For the time being, it will be a valuable reference for anyone with an interest in the achievements and the potential of molecular medicine.

Michel Goossens, M.D.
Hôpital Henri Mondor, 94010 Créteil, France