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How Would a Systems Approach to Future Predictive, Preventive, and Personalized Medicine Work?

"A systems approach to medicine is predicated upon several concepts: 1) health is mediated by a series of interlocking intracellular and intercellular networks that mediate the normal physiological and developmental functions of life, whereas disease arises from one or more genetic and/or environmental perturbations of one or more of these networks; 2) disease-perturbed networks alter their patterns of gene expression and these altered gene products lead to the disease manifestations; 3) some of the altered gene products (mRNAs) encode proteins secreted into the blood and there their levels of expression constitute a molecular fingerprint reporting health and disease states; and 4) some of these blood fingerprint proteins, if appropriately analyzed, will lead back to the primary disease-perturbed networks and, hence, provide a new approach to the discovery of drug targets. Thus, powerful new approaches to disease diagnostics and therapeutics will arise from these systems approaches." -Leroy Hood (2005)

What Impact will Such Work Bring to the Health Care Industry?

"The entire health care industry will be transformed over the next 10-20 years—drug companies, medical instrumentation companies, biotechnology companies, diagnostic companies, health care companies, insurance companies, HMOs, medical schools, etc. For example, the drug companies are failing in their quest to discover new drugs effectively. Indeed, about 80 billion dollars worth of drugs are coming off patent by 2008 and the pipeline has little to replace these drugs. It is my belief that a systems approach to drug target discovery will revolutionize this process. The question is whether it will be the drug companies or new companies that take this new approach. Where there is disruption transformation, there is enormous opportunity—scientifically, industrially and economically." -Leroy Hood (2005)

How Would Systems Biology Transform Current Practice of Teaching Biology?

"A [related] question is how to teach the undergraduates, graduate students, postdoctoral fellows and even senior scientists who interested in this new systems biology. All biology should be taught as an informational science—for this is the most fundamental unifying theme of all biology. Undergraduates clearly must have a cross-disciplinary training—an excellent background in mathematics and statistics is essential, as is a fundamental understanding of computer science and the basic technical tools of systems biology. A dual major (and mentorship) should be considered. Short courses can be offered to cover many of the important topics—with lots of problems for the students to solve. Learning to think analytically and with an inquiry-based focus is essential. The key lesson is that learning never ceases, especially in an immature field. Senior scientists should get used to the idea that it may be important for them to go back and take courses again." -Leroy Hood (2005)

How Would Systems Biology and Personalized Medicine Transform Future Education for Medical School Students?

"We are teaching today the physicians who will be practicing this new medicine in 20 years. We are not beginning to give them the understanding and insights that they will need for this revolution. Two questions are central. How should the teaching be changed? How can we effect these changes? As to the first, it is clear that medical students must understand biology as an informational science; they must understand the systems view of biology and medicine; they must acquire the computational/mathematical skills to be able to understand the new medicine; they must understand the acquisition and analysis of large amounts of data; they must understand how the molecular fingerprints of the blood can distinguish health from disease; they must understand the nature of the intra-cellular and inter-cellular networks, the disease perturbation of these networks and how drugs may normalize disease perturbed networks or prevent their disease perturbations; they must understand in a deep sense human genetics and the complexities of their polymorphisms; they must learn how to think analytically; they must learn how to explain the new medicine to patients—in the face of the enormous misinformation that will emerge from the internet; they must learn how to use the internet effectively; and so on." -Leroy Hood (2005)

How Would Personalized Medicine Create New Ethical, Social, and Legal Challenges?

"The transition from predictive to preventive medicine will take time. During this gap, a host of questions emerge about prediction without the ability to prevent. Issues surrounding genetic privacy as well as those surrounding the question of whether prediction without prevention is appropriate, etc. My prediction is that, over the next 20 years, there will be perhaps a 10-20% increase in the productive life span of the average individual. This means that individuals in their 80s and 90s could be productive and creative. Society does not treat the older well. How will society adjust to these new opportunities? What about retirement funding? How will new jobs be made available for the young? This raises a host of social questions. The question of intellectual property in medicine is going to become increasingly thorny. This is part of a global concern with the question of intellectual property and how it is treated in some of the emerging societies. These are but a few of the many ethical, social and legal challenges that will arise from the new medicine. We should deal with them proactively." -Leroy Hood (2005)