Metabolomics and Microbiomics

Personalized Medicine from the Fetus to the Adult

Vassilios Fanos

• Publisher: Academic Press
• Year: 2016
• Print ISBN: 9780128053058
• eBook ISBN: 9780128054505
• Topic: Medicine
• Subtopic: Pharmaceutical, Biotechnology & Healthcare Industry

Metabolomics and Microbiomics: Personalized Medicine from the Fetus to the Adult encompasses the most recent advances on the usage of metabolomics and microbiome research to improve disease diagnosis and healthcare. Medicine is changing from epidemiologic, descriptive, reductionist, and reactive approaches to individualized, predictive, and holistic ones by applying microbiomics to understand the functionality of the human body. The book discusses topics such as systems biology approaches, omics technologies, perinatal programming, and personalized medicine. It also discusses the ethical implications of microbiomics research and new pathways of research, such as renal regenerative medicine, gender medicine in perinatology, and animals and the science of healing. The book is a valuable resource for medical professionals and researchers in metabolomics, nutrition, microbiology, and personalized-predictive medicine. The book also will appeal to non-specialized professionals who may take advantage of its captivating and simple language. - Covers the latest scientific discoveries in order to improve health and early diagnosis of diseases - Brings a holistic and perinatal programming approach—from fetus to adulthood—to early and long-term prevention of diseases - Provides illustrations and diagrams to facilitate understanding for readers - Discusses the ethical implications of microbiomics research and new pathways of research, such as renal regenerative medicine, gender medicine in perinatology, and animals and the science of healing

1

Medicine centered on the person

Abstract

The risk of medicine in the future will be that of appearing as miraculous and infallible since it is based on scientific evidence and supported by sophisticated technology. In the next few years an overpowering evolution in medicine will be represented by the development and interrelations of four technologies: nanotechnologies, biotechnologies, information and communications technology, and cognitive sciences. But if all this is disconnected from patients and their needs, medicine will run the risk of ignoring the knowledge of its limits, which will objectively continue to exist in the light of the extreme complexity of the human being. There is no project, architecture, design, or product, whether material or intellectual, that can be compared to the complexity of human beings and their lives.

Keywords

medicine

scientific evidence

technology

nanotechnologies

biotechnologies

information and communications technology

cognitive sciences

human complexity

Through the patient’s eyes

There is a great difference between medicine centered on the person and that focused on disease. In recent years we have witnessed radical changes in the world of medicine and, to sum up what has come about, we can say that observing things through the patient’s eyes appears today to be the only possible way to meet the challenges of medicine. To be more specific, we have gone from paternalism to a therapeutic alliance, from curing patients to caring for them, from the concept of sickness connected to a disease of the body to that of illness which considers patients in the wholeness of their beings with bodies and minds, from compliance of patients who “tolerate” what the doctor proposes to adherence of patients who accept the doctor’s proposal. This itinerary marks the passage from a physician-centered system to a patient-centered one. This sees patients as being less and less passive, more and more active and assuming a leading role in their improvement (empowerment). Furthermore, communication has assumed a growing importance in the relationship between doctors and patients: it is increasingly important to communicate “with” patients rather than simply communicating “to” them. Good communication is the key to arriving at patients’ agreement with the physician’s opinion. It is sometimes necessary to have a good relationship with patients’ families as well. In the case of the pediatrician, contact with the patient is mediated by the parents, but also in the case of adult patients the family can provide valid support. In any case, in the relationship between physician and patient, an authoritarian attitude is becoming less and less acceptable. Readiness to explain to patients what is happening and the reasons behind therapeutic choices with a language that can be understood, especially by those with no medical training, leads to a shared plan for action. To establish a relationship of this kind with patients it is above all necessary to know how to listen.

Table 1.1 illustrates today’s new tendencies which are changing the panorama of health care; however, other profound changes will take place in the next few years, when the significant improvements in basic biological research, associated with the impact of technological advances and the possibility of analyzing enormous amounts of data, will bring about revolutionary changes in medicine, with immediate and positive fallout for our health and a rapid increase in life expectancy.

Table 1.1

Relationship between physicians and patients: a scenario being profoundly altered

Past physician–patient relationship	Future physician–patient relationship
Paternalism	Therapeutic alliance
Treatment	Care
Disease	Illness
Compliance	Adherence
Patient passive	Patient active (empowerment)
Physician-centered medicine	Medicine centered on patients and their families
Communicate to…	Communicate with…

Modified from Fanos (2008).

An irresistible evolution in medicine

An irresistible evolution in medicine, which will go far beyond the limits of our imaginations, will be represented by the development and interrelation of four technologies: nanotechnologies, the area of technology “... concerned with manufacturing to dimensions or tolerances in the range of 0.1 and 100 nm [that plays] a key role in many areas...” in Albert Franks’ words; biotechnologies, information and communications technology, and cognitive sciences. Although we are not yet fully aware of it, the human race is about to enter a new stage in its evolution, a true revolution that begins with today’s reality in an ongoing metamorphosis.

But we must be careful, and it is not by chance that I say this at the beginning of this book, not to lose sight of the quite special nature of the coming together of physicians and their patients. The risk of future medicine will be that of appearing as miraculous and infallible since it is based on scientific evidence supported by sophisticated technology; but if it is separated from patients and their needs, medicine will run the risk of losing sight of its limits, which will objectively continue to be present in consideration of the extreme complexity of the human being. It must be clear that there is no project, architecture, design, or product, whether material or intellectual, that can be compared to the complexity of human beings and their lives.

2

The five great ideas of biology and medicine

Abstract

The cell is the biological foundation of life and every cell possesses a genome, an individual’s genetic inheritance that regularly interacts with the surrounding environment. Health depends on the capacity to resist and maintain an equilibrium when faced with an element of stress; everything that takes place in every living organism is functional to the production, maintenance, and increase of energy through biochemical processes. Systems biology studies the complexity of living organisms and their interaction with the environment, thanks to the possibility of analyzing enormous amounts of data provided by modern technologies. Systems biology is expressed through the “-omics” disciplines, such as metabolomics, which succeed in photographing the complexity of biological systems with the simultaneous and often noninvasive sampling and analysis of enormous amounts of data. Thus, it is a candidate to replace traditional laboratory methods, which are less sensitive and less specific in diagnosing diseases.

Keywords

cell

genome

biochemistry

evolution

systems biology

What is life?

What is life? A very simple question, an impossible answer. The Nobel laureate Erwin Schrödinger delivered a renowned series of lectures in 1943 entitled with these very words. It was followed by publication of a short book that sparked a lively scientific debate.

In recent years giant steps have been taken compared to the past and now we are immersed, as Craig Venter says, in the digital age of biology. But life is extraordinarily complex and we are still far from answering the question: what is life?

In the history of medicine an enormous number of theories, hypotheses, and opinions have been put forward. But if we were in a hot-air balloon with everything that has been written over the centuries and were in danger of falling, we would be forced to throw overboard most of the proposed answers. We would keep the important ones to the last, those which according to the Nobel laureate Paul Nurse are the five great ideas of biology and medicine: genome, cell, biochemistry, evolution, and systems biology (Table 2.1).

Table 2.1

The five great ideas of biology and medicine

• Genome

• Cell

• Biochemistry

• Evolution

• Systems biology (or systemic biology)

What are we talking...

Table of contents

• Cover
• Title page
• Table of Contents
• Copyright
• Author’s biography
• Introduction
• 1: Medicine centered on the person
• 2: The five great ideas of biology and medicine
• 3: The medicine of the future
• 4: The “-omics” technologies
• 5: Perinatal programming
• 6: From birth to the miracle of mother’s milk
• 7: The fetus, the preterm baby, and the term baby: the good and the not so good
• 8: We are an ecosystem: in our bodies only one cell out of ten is human
• 9: Microbiomics: from the clinic... to the chocolate
• 10: Personalized medicine
• 11: The new approaches of research
• 12: The medical humanities
• 13: Scientific debate in the Internet age
• 14: Messages to take home
• Bibliography
• Author Index
• Subject Index