Omics approaches to individual variation: modeling networks and the virtual patient.

Abstract:

:Every human is unique. We differ in our genomes, environment, behavior, disease history, and past and current medical treatment-a complex catalog of differences that often leads to variations in the way each of us responds to a particular therapy. We argue here that true personalization of drug therapies will rely on "virtual patient" models based on a detailed characterization of the individual patient by molecular, imaging, and sensor techniques. The models will be based, wherever possible, on the molecular mechanisms of disease processes and drug action but can also expand to hybrid models including statistics/machine learning/artificial intelligence-based elements trained on available data to address therapeutic areas or therapies for which insufficient information on mechanisms is available. Depending on the disease, its mechanisms, and the therapy, virtual patient models can be implemented at a fairly high level of abstraction, with molecular models representing cells, cell types, or organs relevant to the clinical question, interacting not only with each other but also the environment. In the future, "virtual patient/in-silico self" models may not only become a central element of our health care system, reducing otherwise unavoidable mistakes and unnecessary costs, but also act as "guardian angels" accompanying us through life to protect us against dangers and to help us to deal intelligently with our own health and wellness. :Cada ser humano es único, Nos diferenciamos en nuestros genomas, ambiente, conductas, historia de enfermedades y, tratamiento médico actual y pasado; un complejo catálogo de diferencias que a menudo conducen a variaciones en la forma cómo cada uno responde a una terapia específica. En este artículo se argumenta que la verdadera personalización de las terapias farmacológicas se basará en modelos de “pacientes virtuales” de acuerdo a una detallada caracterización del paciente individual mediante técnicas moleculares, de imágenes y de sensores, Los modelos se basarán, siempre que sea posible, en mecanismos moleculares de los procesos patológicos y la acción de fármacos, pero también se pueden expandir a modelos híbridos que incluyan elementos basados en la inteligencia artificial, el aprendizaje automático (o de máquinas) y las estadísticas a partir de los datos disponibles para abordar áreas terapéuticas o terapias para las cuales no se dispone de suficiente información sobre esos mecanismos.Dependiendo de la enfermedad, sus mecanismos y la terapia, los modelos de paciente virtual se pueden implementar en un nivel bastante alto de abstracción, con modelos moleculares que representen células, tipos celulares u órganos relevantes para la pregunta clínica, que puedan interactuar no solo entre sí, sino que también con el ambiente. A futuro, los modelos de “paciente virtual/realizado in-silico (en computadora)” pueden no solo llegar a ser un elemento central de nuestro sistema de atención de salud, reduciendo de alguna manera los errores inevitables y los costos innecesarios, sino también actuar como “ángeles guardianes” que nos acompañen a través de la vida para protegernos contra los peligros y ayudar a manejarnos inteligentemente con nuestra propia salud y bienestar. :Chaque être humain est unique. Nous différons dans nos génomes, notre environnement, notre comportement, nos antécédents médicaux et dans notre traitement médical, passé et actuel et ce catalogue complexe de différences mène souvent à des variations sur la façon de chacun de répondre à un traitement particulier. Dans cet article, nous expliquons que pour réellement personnaliser les traitements médicamenteu. Il faudra s'appuyer sur des modèles de « patients virtuels », basés sur une caractérisation détaillée de chaque patient par des techniques moléculaires, d'imagerie et de capteurs. À chaque fois que cela sera possible, les modèles se fonderont sur les mécanismes moléculaires des processus pathologiques et de l'action du médicament mais ils pourront aussi s'étendre à des modèles hybrides y compris des éléments basés sur l'intelligence artificielle, les appareils d'apprentissage et les statistiques. Ces éléments sont formés sur des données disponibles pour traiter des domaines thérapeutiques ou des traitements pour lesquels les informations sur les mécanismes sont lacunaires. Selon la maladie, ses mécanismes et le traitement, les modèles de patient virtuel peuvent être concrétisés avec un niveau assez élevé d'abstraction, les modèles moléculaires représentant les cellules, les types cellulaires, ou les organes se rapportant au problème clinique, interagissant non seulement entre eux mais aussi avec l'environnement. À l'avenir, les modèles « patient virtuel/in silico » seront non seulement au centre de notre système de santé en diminuant les erreurs inévitables en situation réelle et les coûts superflus, mais aussi des « anges gardiens »nous accompagnant au cours de notre vie pour nous protéger des dangers et nous aider à gérer intelligemment notre santé et notre bien-être.

authors

Lehrach H

subject

Has Abstract

pub_date

2016-09-01 00:00:00

pages

253-265

issue

3

eissn

1294-8322

issn

1958-5969

journal_volume

18

pub_type

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