Textbook of Personalized Medicine - Second Edition [2015]

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Systems Medicine


The concept of systems biology is applied to systems medicine and is relevant to
personalized medicine. Computational and mathematical tools have enabled the
development of systems approaches for deciphering the functional and regulatory
networks underlying the behavior of complex biological systems. Further concep-
tual and methodological developments of these tools are needed for the integration
of various data types across the multiple levels of organization and time frames that
are characteristic of human disease. Because of the complexity of cellular net-
works that are perturbed in human disease development and progression as well as
complex interactions between different cells of the human body, it is diffi cult to
determine the molecular cause of disease in an individual patient. Even though
considerable data has accumulated from “omics” studies in different tissues of
large patient cohorts, systems medicine approach is needed for integration of these
data and simulation of biological networks to study their dynamic behavior
(Nielsen 2012 ).
Medical genomics has attempted to overcome the initial limitations of genome-
wide association studies and has identifi ed a limited number of susceptibility loci
for many complex and common diseases. Systems approaches are starting to pro-
vide deeper insights into the mechanisms of human diseases, and to facilitate the
development of better diagnostic and prognostic biomarkers for cancer and many
other diseases. Systems approaches will transform the way drugs are developed
through academic-industrial partnerships that will target multiple components of
networks and pathways perturbed in diseases. In addition to better insight into
mechanism of action of existing drugs, new drug targets will be identifi ed, and
development of drugs unlikely to be successful can be terminated at an early stage
before expensive clinical development.
Advances in genomics and other -omics during the last decade have resulted in
unprecedented volumes of complex data, which can enable physicians to provide
their patients with more personalized care. Some of the expertise needed for under-
standing and management this data is lies outside the scope of conventional medi-
cal practice; therefore multidisciplinary collaboration coupled to a systems
approach is important for exploiting its potential. Systems medicine builds on the
successes in the fi eld of systems biology by recognizing the human body as a mul-
tidimensional network. Systems medicine provides a conceptual and theoretical
basis with the goal to provide physicians the tools necessary for translating the
rapid advances in basic biomedical science into their routine clinical practice
(Vandamme et al. 2013 ).
Major non-communicable diseases (NCDs) – cardiovascular diseases, cancer,
chronic respiratory diseases, diabetes, rheumatologic diseases and mental health –
represent the predominant health problem of the twenty-fi rst century. Trend in the
management of NCDs is a holistic integrative approach. A health system built
around systems medicine and strategic partnerships has been proposed to combat
NCDs (Bousquet et al. 2014 ).


1 Basic Aspects
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