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Personalized medicine: Leroy Hood, founder of the Institute for Systems Biology, in Seattle, has a vision of the future of medicine that he calls the “P4” approach.
Institute for Systems Biology
Genomics pioneer Leroy Hood says a coming revolution in medicine will bring enormous new opportunities.
Leroy Hood has been at the center of a number of paradigm shifts in biology. He helped to invent the first automated DNA sequencing machine in the 1980s, along with several other technologies that have changed the face of molecular biology. And in 2000, he founded the Institute for Systems Biology, a multidisciplinary institute in Seattle dedicated to examining the interactions between biological information at many different levels, and to moving forward a new perspective for studying biology. The next revolution he plans to help shape is in medicine, using new technologies and new knowledge in biology and informatics to make its practice more predictive, preventative and personal.
Hood says that with each of the major transitions he's been a part of, he has faced skepticism. The human genome project, for example, had many naysayers. But he says the best way to overcome doubts is with results. To that end, Hood has founded a startup called Integrated Diagnostics, which is developing cheap diagnostics that could be used to detect diseases at earlier, more treatable stages. He has also developed a partnership between the Institute for Systems Biology and Ohio State Medical School, where he hopes to show how combining existing medical and genomics technologies can affect the practice of health care today.
Hood contends that digitizing medical records--the health-care industry's major push at the moment--is just one small part of the informatics overhaul the field needs to undergo. And pharmacogenomics--the practice of using an individual's genetic makeup to choose drugs --provides only a limited example of the potential power of personalized medicine.
TR: How do you see the future of personalized medicine?
LH: I think personalized medicine is too narrow a view of what's coming. I think we'll see a shift from reactive medicine to proactive medicine. I define it as "P4" medicine--powerfully predictive, personalized, preventative--meaning we'll shift the focus to wellness--and participatory. That means persuading the various constituencies that this medicine is real and it's here. Physicians will have to learn a medicine they didn't learn in medical school.
TR: What new technologies will drive the revolution in medicine?
LH: Individual genomes will become a standard of medical records in 10 years or so, and we will have the power to make inferences [about an individual's health] when combined with phenotypic information. Then we can begin to plan strategies for individual health care in ways we have never done before.
Nanotechnology approaches to protein measurement--such as measuring 2,500 proteins from a drop of blood--will also be important. We want to develop tests to asses 50 organ-specific proteins from 50 organs as way of interrogating health rather than disease.
The third technology that is going to be transformational is the ability to get detailed analysis from a single cell. We can analyze transcriptomes and RNAomes, proteomes and metabolomes [the collection of transcribed genes or messenger RNA, total RNA, proteins and metabolites, respectively, in the cell]. That information will reveal quanti cellular states that will say lots about normal mechanisms and disease mechanisms. For example, we are doing an experiment now where we take 1,000 cells from glioblastomas [a type of brain tumor] and select transcripts from each of those cells. We're discovering interesting new things about what constitutes a tumor.
The final driver is going to be what I generally call computational and mathematical tools, the ability to deal with data dimensionality that is utterly staggering. If we have patients in 10 years with billions of data points, being able to compare that with individual genotype-phenotype correlations will give us deep and fundamental new insights into predictive medicine. But the challenge is, where will we get the cycles to make those computations and where will we get storage for all this data?
"absolutely transform the business plans of every sector of health care"
I laugh when our government makes budgets for ten years out. Are they counting on this stuff to save their asses?
Dr. Chu, Secretary of Energy, has debated Ray Kurzweil about the Technology Singularity. So I know the administration is aware of this kind of super-advancing possibilites.
Perhaps they want to gain as much power as possible before the inevitable happens so they can take credit. Digitizing medical records will continue to happen with or without the gov. It's just good business.
Also, in the process of digitizing medical records, I hope we can develop simple (non-corrupt) laws to protect privacy without hampering the great promise of this technology.
Sorry to talk of politics in the face of such pure and wonderful science, but health care must be political to a degree these days.
Yes. I'm sure the current administration understands that if they are able to make this healthcare 'land grab', they'll be able to take credit for the changes that are already in progress. That happened when Clinton was the beneficiary of 'deregulation' that happened many years before in the Reagan years. So what could have been a reinforcement of the free markets ability to provide what the public desires will be seen by the general public as a 'great new program' that government came up with to solve our problems. Just what we need:( Another slam on the private sector that drives innovation, and our economy.
Outstanding and hints a new role for doctors
Currently, physicians are rebelling a lot against what they see as a dilution of their role in health care as physician assistance and nurse practitioners pick up roles which used to be filled by them. For health care cost to be reduced and the vision of personal care as outlined here to be realized, a new class of para professionals will likely be created who rely on technology rather than years of abusive education to diagnose and treat. Better, the incidence of treatment should decline significantly with better overall preventive care. I'm not holding my breath on that one though as preventive care is actually proven to be more expensive currently. New tech could, hopefully, change that.
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54 Comments
Desktop Personalized Health Care
Today we have desktop engineering as a given and are skirting desktop manufacturing. It is very encouraging to note that very soon we will have desk top health care. Then desk top surgery could not be far off.We will soon realize the holy grail of affordable health care of the universe. It is great to be alive and part of a great world with positive advances in science.
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Pellionisz
6 Comments
Re: Desktop Personalized Health Care
P4 is not just for desktops (e.g. Personal Genome Computer) - but, especially in Asia but also in the US it is on mobile, see Personal Genome Assistant YouTube
We better call P4 in longhand "Personalized Health Care" (rather than "Personalized Medicine"), since according to Dr. Hood, the challenge is to embrace Information Technology. "Medicine" is a monopoly that is mush slower to embrace Information Technology than e.g. the yuppie generation of techie students, eager to practice Predictive, Personalized, Participatory Prevention as the core of future health care.
pellionisz_at_junkdna.com
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