Wednesday, January 23, 2013

Systems Medicine A Reality

Systems medicine is the application of systems biology approaches to medical research and medical practice. Its objective is to integrate a variety of biological and medical data at all relevant levels of cellular organization using the power of computational and mathematical modeling, to enable understanding of the pathophysiological mechanisms, prognosis, diagnosis and treatment of disease.

The clinical needs should be the driver for the applications of systems biology methods in medicine and for the evolution of the essential new technologies. The possible actions required are, systems biology approaches could guide clinical trial design, shortening times and costs. Re-defining clinical phenotypes based on molecular and dynamic parameters, discovering effective biomarkers of multiple nature for disease progression; clinically useful for risk, prognosis, diagnosis. Combinatorial therapy approach would be useful to find out a combination and lower doses of effective drugs, in particular in the case of co-morbidity, where more than one disease is affecting the patient, upgrading of drug development; optimizing drug efficacy, safety and delivery, timing and dosage of therapy. Finally, healthy individual are to be addressed in the long term.

Scientific areas for partnership in Systems Medicine includes understanding the pathophysiology of chronic diseases, multifactorial diseases like cancer, diabetes, obesity, metabolic disorders, aging through network analysis of disease processes, and the recognition of biomarkers for early diagnosis and prognosis and personalized treatment, combinatorial therapies and combinatorial drug screening and mixing of personalized genomics with personalized metabolomics, endocrinomics, proteomics and clinical phenotyping.

The major confrontation is for systems biology to furnish a change in the medical model in order to build the foundation for a prospective medicine that will be predictive, personalized, preventive and participatory. In order for systems medicine to become a reality, one needs coordinated vision of all relevant stakeholders and a field guide at the same level of ambition as the Human Genome project. In addition, the creation of a strong networking effort among funded systems biology projects is essential, in order to share information and resources on successful methodological approaches and tools with the broader systems biology and clinical community.

Recent years have seen the rapid emergence of systems biology as a new discipline. In the biomedical sciences, this trend is very apparent as research moves from a reductionist approach to a systems understanding model that attempts to understand biology and pathophysiology in an integrative manner, making use of the rapidly increasing amounts of novel (-omics) data and other relevant quantitative biological and medical data that are becoming available.

However, despite the spectacular advances in the post-genomic era, there exists a hiatus between experimental data and medical knowledge, and even a greater gap exists when we evaluate new knowledge in terms of clinical utility and benefit to patients. As a result, despite major technological advances, there are still obstacles that separate systems biology from medical applications. Systems medicine, a newly emerging area should aim the bridging of this gap.

Experts in a wide range of relevant disciplines from clinical, diagnostics and pharmaceutical areas, to high throughput –omics technologies, and computational and systems biology, including representatives from academia, industry, and funding agencies should get together to explore opportunities and challenges for the development of systems medicine. The aims are to analyze the state-of-the-art of systems biology for medical applications, identify key opportunities and bottlenecks for the translation of systems biology to medicine and the clinic, and identifying key research and policy areas for joint research in the short, medium and long term in order to make systems medicine a reality.



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