SEBM Symposium
at
Experimental Biology 2010

This symposium will highlight the emerging field of personalized, “systems” medicine. With the sequencing of the human genome and availability of high power computational methods and various high throughput technologies, biomedical sciences and medicine will be undergoing revolutionary change. The new technologies and approaches have already spawned the field of systems biology; the new field of systems medicine is the integration and application of biologic and informational sciences, allowing a complex approach to biomedical problems. In medicine, complex computational tools will become essential for deriving personalized assessments of disease risk and management including individualized diagnosis, prognosis, and treatment options. This change, involving the use and analysis of enormous quantities and variety of data, will require new types of physicians and researchers - ones with a grasp of modern computational sciences, “-omic” technologies (genomics, proteomics, metabolomics, etc.), and a systems approach to medicine. The objective of this symposium is to put forth not only the vision of personalized medicine, as eloquently described by Leroy Hood, a leader in this emerging field, but to give examples of the scientific application of these principles in current research, as well as the legal, ethical, and educational implications of using a systems medicine approach.

 

3:15 PM            Systems Medicine and the Emergence of Proactive Medicine—Predictive, Personalized, Preventive and Participatory
Lee Hood, MD, PhD, Institute for Systems Biology

The challenge for biology and medicine in the 21st century is the need to deal with its incredible complexity.  One powerful way to think of biology is to view it as an informational science requiring systems approaches.  This view leads to the conclusion that biological information is captured, mined, integrated by biological networks and finally passed off to molecular machines for execution. Systems approaches are holistic rather than atomistic—and employ both hypothesis-driven as well as discovery-driven approaches. Hence the challenge in understanding biological complexity is that of using systems approaches to deciphering the operation of dynamic biological networks across three time scales of life—development, physiological and disease responses. I will focus on our efforts at a systems approach to disease—looking at prion disease in mice. We have just published a study that has taken more than 5 years—that lays out the principles of a systems approach to disease including dealing with the striking signal to noise problems of high throughput biological measurements and biology itself (e.g. polymorphisms).  I will also discuss the emerging technologies (measurement and visualization) that will transform medicine over the next 10 years—including next generation DNA sequencing, microfluidic protein chips and single-cell analyses. It appears that systems medicine, together with pioneering changes such as next-generation DNA sequencing and blood protein measurements (nanotechnology) and as well as the development of powerful new computational and mathematical tools will transform medicine over the next 5-20 years from its currently reactive state to a mode that is proactive or predictive, personalized, preventive and participatory (P4).  

3:45 PM            A systems medicine approach for neurological diseases
Howard Federoff, MD, PhD, Georgetown University Medical Center

Many neurological disorders are systemic but such peripheral features, typically that those that antedate brain involvement, often elude detection.  Thus current clinical approaches are initiated only at the time of symptomatic disease presentation. We hypothesize that pre-symptomatic manifestations revealed as systems alterations in non-CNS compartments are discoverable.  Their recognition may reveal new opportunities to diagnose earlier and deploy disease-modifying agents before substantive damage has occurred. Herein we describe a systems strategy to define the peripheral characteristics of neurological disorders by analyzing blood. The presentation will focus on Alzheimer’s and Parkinson’s disease as illustration of the approach. The scientific and clinical impact of this paradigm, systems neuromedicine, will be discussed.

4:15 PM            A systems medicine approach to treating cancer
Michael Cusick, PhD, Dana Farber Cancer Institute, Harvard University

4:45 PM            Why should we train clinicians in systems biology?
Robert Clarke, PhD, Georgetown University

The new technologies and applications associated with systems medicine will create many new challenges for the physicians of the future. It will soon become essential for physicians to understand and apply new approaches to prevention, diagnosis, and prediction, with the goals of more effectively preventing or delaying disease manifestation and/or improving clinical outcomes for patients. Moreover, the knowledge contained within the results of such analyses has legal, social, and ethical implications for clinical practice. Few medical school curricula are adequately developed to educate students in these emerging technologies, their application or the implications of their use. The challenges in appropriately adapting existing curricula, while maintaining the requirements for academic accreditation, require careful consideration.

5:10 PM            Legal, ethical and policy implications of systems medicine
Elenora E. Connors, JD, MPH, O’Neill Institute for National and Global Health Law,
Georgetown University Law School

Despite the potential for improved preventive and personalized care, a shift to systems medicine raises critical legal, ethical, and policy issues. Encompassing concerns expressed by the clinical applications of genomics, pharmacogenomics, and personalized medicine, systems medicine adds new dimensions of apprehension based on the multidimensional information collected.  Therefore, a paradigm shift to systems medicine requires carefully conducted research alongside ethical and socio-legal considerations. Although it is difficult to determine the exact legal and policy issues that will come into play, further research and discussions are necessary to ensure appropriate implementation measures, privacy protections, and equal access.  The areas of legal and ethical focus can be broken into five distinct categories that require further exploration: cost, privacy, discrimination, justice, and civil liberties.