Biology Reference
In-Depth Information
Chapter 23
Systems Medicine and the Emergence
of Proactive P4 Medicine: Predictive,
Preventive, Personalized and Participatory
Leroy Hood
1
, Mauricio A. Flores
2
, Kristin R. Brogaard
1
, and Nathan D. Price
1
1
Institute for Systems Biology, 401 N. Terry Ave, Seattle, WA 98121, USA
2
P4 Medicine Institute, 401 N. Terry Ave, Seattle, WA 98121, USA
Chapter Outline
Introduction
445
Two Big Challenges: Education and Information
Technology for Healthcare
Systems Medicine
447
464
Five Systems' Strategies for Dealing with
Biological Complexity
Impact of P4 Medicine on Society
464
449
How to Bring P4 Medicine to Patients
465
P4 Medicine
460
Acknowledgments
465
References
466
INTRODUCTION
Medicine is undergoing a revolution that will transform
the practice of healthcare in virtually every way. This
revolution is emerging from the convergence of systems
biology
together to cool the temperature of soup. Deciphering the
complexity of this 'soup-cooling system' requires
(1)
defining the components of the soup-cooling system,
(2)
determining how these components interact with one
another, and
(3)
delineating the dynamics of these
components in space and time that are necessary for
carrying out their function of soup cooling. These are
precisely the elements that systems biology attempts to
define when deciphering the complexity of biological
systems. To achieve actionable understandings of biolog-
ical complexity, the analyses must be global (comprehen-
sive), integrative and dynamic.
Systems medicine, the healthcare-focused derivative of
systems biology, is beginning to alter the face of healthcare
through (1) a systems approach to disease, (2) driving the
emergence of technologies that permit the exploration of
new dimensions of patient data space (e.g., sequencing the
individual human genome), (3) the analyses of the quan-
tized units of biological information (single genes, single
molecules, single cells, single organs to provide disease-
relevant information on health or disease for the indi-
vidual), and (4) the resulting explosion of patient data that
is transforming traditional biology and medicine into an
information science
[1
e
and the digital revolution. Systems biology is opening
what has historically been the black box of our individual
biological systems as they change over time. The digital
revolution is vastly expanding our capacity to generate and
analyze 'big data' sets, deploy this information in business
and social networks and create digital consumer devices to
measuring personal information. Both of these new
capabilities will be deployed in systems medicine (see
below).
Systems biology emerged at least partly in response to
the incredible complexity of biological systems, both
normal and diseased
[1,2]
. This complexity arises from the
natural process of Darwinian evolution
e
a holistic approach to biology (and medicine)
random muta-
tions followed by natural selection generated in large part
by the environment. Darwinian evolution is a random and
chaotic process
e
building new complexities on top of
e
previously
evolved
complexities.
Indeed,
biological
systems
resemble Rube
Goldberg devices. Consider
e
a Rube
Goldberg device that attaches 14 different gadgets
11]
.
e
e
