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Endobiogeny Systems Theory

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This is a summary of the big research article of the same name that was published in two parts. This lecture was given at UCSD Center for Integrative Medicine's Journal Club on 6/27/13.
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ASEMIP Endobiogeny: A global approach to systems biology Kamyar M. Hedayat, MD (c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology
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Page 1: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Endobiogeny: A global approach to systems biology

Kamyar M. Hedayat, MD

Page 2: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Goals

• Discuss general concepts presented in Endobiogeny: A Global Approach to systems biology, part 1 (Glob Adv Health Med. 2013:2(1):64-78) and part 2 (Glob Adv Health Med. 2013:2(2):32-56)

• Discuss research opportunities• Discuss training opportunities

Page 3: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

INTRODUCTION

““Living systems are organized in such a way that they form multi-leveled structures, each level consisting of subsytems which are wholes in regard to their parts, and parts with respect to the larger wholes ”--Fritjof Capra, The turning point: science, society and the rising culture, p. 43

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ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Reductionism and Holism

• Reductionism: explaining complex phenomena by the properties individual components

• Naïve reductionism: belief that reductionism leads to a complete understanding of living organisms

• Holism: evaluating complex phenomenon that arise from individual components

• Naïve Holism: qualitative, subjective evaluation can sufficiently explain complex phenomenon

• Systems Theory: Complex systems are composed of individual sub-systems that are both independent and inter-dependent on other sub-systems as well as the whole

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ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Differing views

REDUCTIONISM HOLISM

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ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Systems Theory“Systems theory looks at the world in terms of the interrelatedness and interdependence of all phenomenon, and in this framework an integrated whole whose properties cannot be reduced to those of its parts is called a system.” Fritjof Capra, The turning point: science, society and the rising culture, p. 43

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ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Determining level of studyBiological information is encoded in a multi-scale information hierarchy: DNA, RNA, proteins, interactions, biological networks, cells, tissues and organs, individuals and, finally, ecologies. The important point is that the environment impinges upon each of these levels of the hierarchy and modulates the digital informational output from the genome. Thus, systems-level investigations demand the collection of data at each relevant level of the hierarchy between the phenotypic measurement (features of the cell) and the core digital genome—Leroy Hood et al., Institute for Systems Biology39

Page 8: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Implications in Nosology

Human disease network and Disease Gene Networks reveal the complex polygenetic basis of disease and proposes a classification of disease based on complex physiologic activity, rather than on phenotypic expression of symptoms. From Goh KI, Cusick ME, Valle D, Childs B, Vidal M, Barabasi AL. The human disease network. Proc Natl Acad Sci U S A. May 22 2007;104(21):8685-8690.

Figure 1: Human Disease Network

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ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

OVERVIEW OF ENDOBIOGENY

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ASEMIP

Endobiogeny: A theory of terrain

• Presented by French physician Christian Duraffourd, MD in the early 1980’s

• Terrain: functional expression of structural constitution in its internal equilibrium– Dynamic and Ceaseless– Consists of Inductive and Reactive elements

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ASEMIP

Endobiogeny: A theory of terrain

• Terrain– Constitution: Genetic heritage, potential capacity

of the structure– Structure: materialized constitutive elements that

assure life. The achievement of constitution– Function: all the biologic and metabolic mechanics

that assure functioning of structure and dynamics of the organism

Page 12: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Manager of the System

• In order to ensure the integrity of the system, the manager must possess 3 qualities: 1) Ubiquity of interaction with each structural

element2) Constancy of relationship with those elements3) Auto-regulation.

Page 13: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Elements of the Endobiogenic Method

• Theory of Terrain• History• Physical Exam• Systems-based biomarker interpretation• Rational clinical phytotherapy• Allimentation• Lifestyle

Page 14: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

A false dichotomy

Reductionism• Quantitative

• Smallest functioning part at expense of big picture• Hierarchy• Categorical• Separate• Unrelated• Static• Control

Holism• Qualitative

• Big picture at expense of the part

• Relationships• Individualized• Interconnected• Inter-related• Dynamic

• Creative chaos

ENDOBIOGENY

Page 15: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

THE BIOLOGY OF FUNCTIONS

"The new mathematics...is one of relationships and patterns. It is qualitative rather than quantitative and thus embodies the shift of emphasis that is characteristic of systems thinking—from objects to relationships, from quantity to quality, from substance to pattern." Fritjof Capra

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ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Need to use biomarkers

Advantages• Objective• Quantitative• Accurate• Reproducible• Minimally invasive

Short-comings• Binary• Reductionist• Confusion of

– Cause vs. Effect– Cause vs. Effect vs.

Mechanism

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ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Cause, Mechanism, Effect

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ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Rational for use biomarkers

• Endocrine management: – Endocrine system is true manager of the terrain– Endocrine activity cannot be accurately evaluated by direct serum

measurement. • Biomarkers and the endocrine system

– Known for nearly 100 years that changes in biomarkers associated with specific endocrinopathies

– Changes in biomarkers result of endocrine management of metabolism

• Systems analysis and relative relationships– Body is a true system– Blood-based biomarkers will be most informative of system activity

when applied in a qualitative manner using ratios

Page 19: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Biomarkers used in the biology of functions

Page 20: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

CBC: Biomarker-NeuroEndocrine relationships

Biomarker Neuro-Endocrine

RBC Androgens at tissue level

WBC Estrogens at tissue level

PMN Estrogens with respect to immunity, inflammation, anabolism

Monocytes FSH activity within gonadotropic axis (direct), relative efficiency of estrogens during adaptation (inverse), peripheral androgen activity relative to that of estrogens (direct), immune dysregulation.

Eosinophils Intensity of ACTH solicitation adrenals (direct), relative efficiency of cortisol activity (inverse). Risk of Inflammation, thrombosis, immune and other activities due to insufficient cortisol activity

Basophils Intensity of ACTH solicitation adrenals

Page 21: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

CBC (cont.)Biomarker Neuro-Endocrine relationship

Lymphocytes Related to three factors: cortisol, estrogen, and TSH. Cortisol (inverse): reduces circulating lymphocytes, augments destruction; Estrogen (inverse): augment infiltration of lymphocytes into tissues; TSH (direct): metabolic needs of body, degree to which TSH used to modulate thyroid activity.

Platelets Mobilized by adrenaline; adsorber, transporter of calcium, serotonin; participates in thrombosis, wound healing, inflammation (via histamine)

Hemoglobin Marker of the degree of alpha-sympathetic activity in adaptation.

Page 22: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Bone Stroma biomarkersBiomarker Relationship

Osteocalcin Glucose regulation (insulin sensitivity), Fat regulation (adipocyte growth), ATP production (number and efficiency of mitochondria), Endocrino-metabolic efficacy of estrogens

Alkaline phosphatase Related to effects of intracellular growth factors, cell turnover and energy demand

Page 23: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Systemic Enzyme BiomarkersBiomarker Neuro-Endocrine relationship

Creatine Kinase Thyroid metabolic efficiency (inverse): Ultra-acute energy demand, Mitochondrial efficiency (inverse),

Lactate dehydrogenase Thyroid metabolic efficiency (direct): oxidation of glucose relative to demands of the organism, as seen in: cardiac ischemia,405, 406 muscle turnover,389 rapid cell and tissue growth,407 hemolysis,408, 409 and cancer.410-412

Page 24: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Endocrine biomarker

Bio-marker

Relationship

TSH responsiveness of the thyroid to stimulation (inverse), immune demand of body, anabolic solicitation by estrogens

Figure 8: TSH relationship to T4

From Hoermann R, Eckl W, Hoermann C, Larisch R. Complex relationship between free thyroxine and TSH in the regulation of thyroid function. Eur J Endocrinol. Jun 2010;162(6):1123-1129.

Page 25: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Ratios in medicine

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ASEMIP

Direct and Indirect ratios

Direct Indices• Direct relationship of

biomarkers• Genital Ratio (GR)

– RBC/WBC

• Adaptation Index – Eosinophils/Monocytes

Indirect Indices• Indirect relationship of

direct indexes and other indirect indexes

• Genital ratio corrected=GR × Starter Index

GR=RBC/WBC

=(RBC × Starter)/WBC

Page 27: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Thrombotic index=Thrombogenic x Evoked Histamine x Genital Ratio

– Thrombogenic: 10 x (Bone remodeling x Apoptosis x Necrosis)/Metabolic yield

= (Bone remodeling x Apoptosis x Necrosis)(Evoked Histamine x Genital Ratio)/Metabolic yield

• Relationships in index: risk of thromboembolism is result of triad of factors, necessary but not sufficient: – 1) Risk of thrombus formation (due to necrosis206-208 or apoptosis205)– 2) Histamine activity,209-211 – 3) Elevated androgens212-220

• Consistent with known pathophysiologic mechanisms of thromboembolic phenomenon.

Page 28: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

RESEARCH, LEARNING AND PRACTICE

Page 29: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Endobiogeny around the world

• Europe– France: Home of Endobiogeny– UK: taught in conjunction with Middlesex University– Lithuania: Taught through affiliation with medical school

(starting 2014)• Americas– US: Fellowship underway– Mexico: Official form of medicine, used by public health

system• North Africa– Tunisia: Masters degree in endobiogeny

Page 30: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Areas of research

• Cancer• Autoimmune disorders• Neuro-psychiatric disorders• Cardiovascular disorders• Septic Shock• PTSD

Page 31: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Opportunities for learning

• US, France, Lithuania, Tunisia• 2 year fellowship, 260 learning hours– History– Physical examination– Biology of Functions– Integrative, clinical use of medicinal plants

Page 32: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

CONCLUSIONS

Page 33: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Conclusions

• There is nothing new in the tendency to take obvious things for granted and to postpone logical thought…For many centuries we were satisfied to accept life itself without questioning and without inquiring as to its beginnings, variations and potentialities. Now we have some desire of understanding how life began, of its continuation and limitations

Manfred Sakel, MD, 1938

Page 34: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

Conclusions

• Endobiogeny is a theory of terrain• Offers a Global systems approach to biology– Quantitative– Qualitative– Humanistic– Clinical solutions open to all forms of treatment,

prefers medicinal plants, diet, lifestyle

Page 35: Endobiogeny Systems Theory

ASEMIP

(c) 2013 American Society of Endobiogenic Medicine and Integrative Physiology

DISCUSSION

Huichol Indian thread work


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