From Systems Biology to The Clinics
Anurag Agrawal MD PhD FCCP, Center of Excellence for Translatioal Research in Asthma and Lung disease, CSIR-Institute of Genomics and Integrative Biology, India
Background. Systems medicine is an application of systems biology that is aimed at diagnostic, predictive, and therapeutic utility. This emphasizes the translational purpose and relevance of complex models, but correspondence between biological complexity and medical impact is intricate. A common feature is the necessary use of multi-scale models, which may be molecules, organelles, cells and tissues, for systems biology; and symptoms, physiologic variables, biomarkers, disease states, individuals, societies, for systems medicine. Here we discuss a systems-analytics based approach to clinical problems such as detection of airway disease in individuals and detection of interrelationships of symptoms and diseases in societies.
Study 1. Early detection of airway disease in reversible stages is an important need that is not met by current tests that condense detailed physiologic information into singular variables. We used machine-learning methods to extract highly predictive frequency-domain patterns in time-scale data from a standard Impulse Oscillometry (IOS) machine that is already in clinical practice. These patterns were sufficient to reliably identify asymptomatic asthmatics, who were in clinical remission and indistinguishable from normals by other methods, including conventional IOS analysis.
Study 2. Understanding the patterns of disease burden across varying social groups and ages in a diverse society is challenging but necessary. We attempted to understand the interrelationships between symptoms, diseases, lifestyle, gender and age, in more than 200,000 patients seen in a single day across India by over 8000 doctors representing every major region. To this end, we used relevance network mapping of the global association matrix and were able to visualize a modular structure of the health wiring of India.
Message. Systems Medicine is an exciting new frontier of science and translational applications of analytical concepts from systems biology to physiological or clinical data is rewarding.