Integra(on of different perspec(ves in medicine Jan Schroën MSc, OMD
Transcript
1. Integra(on of dierent perspec(ves in medicine Jan Schron
MSc, OMD
2. As the 20th century was the centuryof the revolution of
physics, the 21stcentury will be the century of therevolution of
life science.For medicine it will mean a shiftfrom primarely
curative to primarelypreventive and from generaltreatments to
personalizedmedicine Prof. Dr. Jan van der Greef Universiteit
Leiden
3. Systems Biology, towards personalized fingerprints Systems
Biomarkers Transcripts InformaticsTissue Proteins Proteins Pathways
System Metabolites Knowledge Cell Organism Measurement Analysis
Interpretation Systems cannot be understood by studying fundamental
constituents, the properties of the parts are not intrinsic but can
be understood within the context of the whole Slide 3
4. Preven(ve What is health?
5. Are there opportunities to bring the system back in
homeostasis? Health Reversible pathology Irreversible pathology
Disease management Symptom focus Disease Health Promotion Improve
resilience Healthy Changes in pathway dynamics to maintain
homeostasis
6. Personalized We need to get the right drugs to the right
pa(ents(right route, right dose, right (me)
7. Treating the right patients with the right medicine Approach
: Current drugs + improved diagnosisEmpirical Medicine Treatment a
Treatment b Treatment cBiomarker-Guided Medicine Treatment b
Treatment a Biomarker-guided therapy Treatment c Slide 7
8. Dynamic Systems Theory In studying self-organizing systems a
shi5 in focus occurs: From objects to rela(onships Mapping of
paIerns From quan(ty to quality of rela(onships
9. How to design an intervention for a complex system? Current
paradigm: Monotherapy 1 disease 1 target 1 drug fits all
Blockbuster approach Systems Theory : The scale and complexity of
the problem and solution should match Prof. Dr. Yaneer Bar-Yam New
England Complex Systems Institute New paradigm : Integrated
Intervention Life style, nutrition, medicine (multi-dimensional
pharmacology) and psychology Slide 9
10. John N. Wareld professor Emeritus, George Mason University,
USA basis for stopping some of the bad pracGces in systems science
community Underscoping the Systems Domain Unimagina(ve Workspaces
Mismatched Media Linguis(c Pollu(on Premature Quan(ca(on
Insensi(vity to Discovered Behavioral Pathologies Inadequacy of
Comparisons of Alterna(ves Blindness to History Monotonous
Bifurca(on
11. Blindness to History Some people thought about systems long
ago. There seems to be a strongly entrenched belief that systems
thinking originated in the last half of the twen(eth century.
Virtually every important concept that backs up the key ideas
emergent in systems literature are found in ancient literature and
in the centuries to follow. It is (me to recognize the contribu(ons
of these elder scholars and factor them into systems science where
their presence is absolutely essen(al to a mature science. an
introduc(on to systems science
12. 3 tradi(onal systems Ayurveda Tradi(onal Chinese Medicine
Unani
13. If the only tool you have is a hammer, you tend to treat
everything as if it were a nail.Abraham Maslow (1908-1970)
14. New Medicine based on systemofbiology! New theoretical and
clinical approach medicine! Sciences Western Chinese Sciences
Medicine Medicine Western Chinese philosophy philosophy of Science
of Science Western philosophy Chinese philosophy Western culture
Chinese culture Origin of Man
15. The Binocular dilemma of Master Yuen Yongli
16. Diagnosis development stepwise strategy ? One-size-fits-all
Stratified/Individualized Care Symptom/Signs Molecular pathology
Personalized Health Care Ecosystem Symptom/Signs Molecular
pathology fingerprint @ Life style @ Psychology/Consciousness
Environment, Nutrition Medicine Subtype B Subtype ADisease -
symptom management Targeted care disease phenotype focus Patient
Wellness focus1 disease -1 target 1 (block buster) drug
theranostics related to efficacy and adverse effects Integrated
systems approach Slide 17
17. Systems biology guided byTraditional Chinese
Medicinereveals new diagnostic markersfor rheumatoid arthritis A
China Dutch joint project of the Sino-Dutch center for Personalized
and Preventive Medicine Herman van Wietmarschen LACDR, Analytical
Biosciences 18
18. The ongoing sub-typing of MSX/Diabetes2 project- System
Biology based development ofdiagnostic biomarkers for Diabetes type
2 A China Dutch joint project of the Sino-Dutch center for
Personalized and Preventive Medicine Koko Wei PhD student
Sino-Dutch Centre, TNO 19
19. Acknowledgment Acknowledgment Jan van der Greef Wang Mei
Wei Koko Jan van der Wietmarschen Mei, Koko Wei, Carina Rubingh,
Herman van Greef, Wang Eduard vanPasman, Nicole Cnubben, Herman van
Wilrike Wijk Everine van der Kraats Kistemaker of the Sino-Dutch
Wietmarschen, Cor Roel van Wijk Centre for Preventive and
Personalized ResearchWang Xinlu and TNO MedicineMaster Yuen
YongliAnd Yang Yifang Ph.D.; Albert van Dinteren M.D.