110th Anniversary: Process and Systems Engineering Perspectives on Personalized Medicine and the Design of Effective Treatment of Diseases

Abstract

The mammalian organism maintains stable, efficient, and “near-optimal” performance and homeostasis in the face of external and internal perturbations via distinct biological systems ranging from the large-scale physiological (nervous, endocrine, immune, cardiovascular, respiratory, etc.), to the cellular (growth and proliferation regulation, DNA damage repair, etc.), and the subcellular (gene expression, protein synthesis, metabolite regulation, etc.). A control engineering perspective of the function, organization, and coordination of these multiscale biological systems and the control mechanisms that enable them to carry out their functions effectively provides a framework for understanding the occurrence of diseases as a consequence of the malfunction of components of these biological control systems, with implications for the design of effective treatments and the prevention of diseases. This paper provides an overview of how physiological life is made possible by control and argues for the usefulness of a control engineering perspective of pathologies for diagnosis, design, and implementation of effective treatments—especially for personalized (precision) medicine for “optimizing health”. We present a control engineering perspective of this emerging approach to medical practice which we employ to make the case for the role that process systems engineering will play in enabling health care delivery of the future. The highlighted concepts and principles are illustrated with a modest clinical example from the literature involving platelet count control for an immune thrombocytopenic purpura (ITP) patient.