Systems medicine, transformational technologies and the emergence of predictive, personalized, preventive and participatory (P4) medicine

Abstract

The challenge for biology in the 21st century is the need to deal with its incredible complexity. One powerful way to think of biology is to view it as an informational science. This view leads to the conclusion that biological information is captured, mined, integrated by biological networks and finally passed off to molecular machines for execution. Hence the challenge in understanding biological complexity is that of deciphering the operation of dynamic biological networks across the three time scales of lifeevolution, development and physiological responses. Systems approaches to biology are focused on delineating and deciphering dynamic biological networks and their interactions with simple and complex molecular machines. I will focus on our efforts at a systems approach to diseaselooking at prion disease in mice. We have just published a study that has taken more than 5 yearsthat lays out the principles of a systems approach to disease including dealing with the striking signal to noise problems of high throughput biological measurements and biology itself (e.g. polymorphisms). I will also discuss the emerging technologies (measurement and visualization) that will transform medicine over the next 10 yearsincluding next generation DNA sequencing, microfluidic protein chips and single-cell analyses. I will as well discuss some of the computational and mathematical challenges that are fundaments to the revolution in medicineboth those that deal with medical sciences and those that deal in a general way with healthcare. It appears that systems medicine, together with pioneering changes such as next-generation DNA sequencing and blood protein measurements (nanotechnology) and as well as the development of powerful new computational and mathematical tools will transform medicine over the next 5-20 years from its currently reactive state to a mode that is predictive, personalized, preventive and participatory (P4). This will in turn lead to the digitalization of medicinewith ultimately a profound decrease in the cost of healthcare. It will also transform the business strategies for virtually every sector of the health care industry. These considerations have led ISB to begin formulating a series of national and international strategic partnerships that are focused on accelerating the realization of P4 medicine. I will discuss some of these strategic partnerships and discuss the implications for healthcare arising from P4 medicine.