Integra(on	  of	  different	  perspec(ves	  in	  medicine	                             Jan	  Schroën	  MSc,	  OMD	  
As the 20th century was the centuryof the revolution of physics, the 21stcentury will be the century of therevolution of l...
Systems Biology, towards personalized fingerprints        Systems                                                         ...
Preven(ve	  What	  is	  health?	  
Are there opportunities to bring the system back in homeostasis?  Health                Reversible pathology   Irreversibl...
Personalized	   We	  need	  to	  get	  the	  right	  drugs	  to	  the	  right	  pa(ents(right	  route,	  right	           ...
Treating the right patients with the right medicine                                  Approach : Current drugs + improved d...
Dynamic Systems Theory	  	  	  In	  studying	  self-­‐organizing	  systems	  a	  shi5	  in	  focus	  occurs:	  	  	  	  	 ...
How to design an intervention   for a complex system?                                          Current paradigm: Monothera...
John	  N.	  Warfield	                             professor	  Emeritus,	  George	  Mason	  University,	  USA	              ...
Blindness	  to	  History 	  	         	  	  Some	  people	  thought	  about	  systems	  long	  ago.	            There	  se...
3	  tradi(onal	  systems                                 	  • Ayurveda	  • Tradi(onal	  Chinese	  Medicine	  • Unani	  
If the only tool you                             have is a hammer,                               you tend to treat        ...
New Medicine based on systemofbiology!    New theoretical and clinical approach medicine! Sciences	          Western	     ...
The Binocular dilemma of  Master Yuen Yongli
Diagnosis	  development	  stepwise	  strategy	  ?	  	              One-size-fits-all                                      ...
Systems biology guided byTraditional Chinese Medicinereveals new diagnostic markersfor rheumatoid arthritis          A Chi...
The ongoing sub-typing of MSX/Diabetes2 project- System Biology based development ofdiagnostic biomarkers for Diabetes typ...
Acknowledgment	              Acknowledgment                           	ª  Jan van der Greef	ª  Wang Mei 	ª  Wei Koko 	ª...
9 juni - Vision Dinner Chronische Zorg - Jan Schroen TNO
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9 juni - Vision Dinner Chronische Zorg - Jan Schroen TNO

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9 juni - Vision Dinner Chronische Zorg - Jan Schroen TNO

  1. 1. Integra(on  of  different  perspec(ves  in  medicine   Jan  Schroën  MSc,  OMD  
  2. 2. As the 20th century was the centuryof the revolution of physics, the 21stcentury will be the century of therevolution of life science.For medicine it will mean a shiftfrom primarely curative to primarelypreventive and from generaltreatments to personalizedmedicine Prof. Dr. Jan van der Greef Universiteit Leiden
  3. 3. Systems Biology, towards personalized fingerprints Systems Biomarkers Transcripts InformaticsTissue Proteins Proteins Pathways System Metabolites Knowledge Cell Organism Measurement Analysis Interpretation Systems cannot be understood by studying fundamental constituents, the properties of the parts are not intrinsic but can be understood within the context of the whole Slide 3
  4. 4. Preven(ve  What  is  health?  
  5. 5. Are there opportunities to bring the system back in homeostasis? Health Reversible pathology Irreversible pathology Disease management Symptom focus Disease Health Promotion Improve resilience Healthy Changes in pathway dynamics to maintain homeostasis
  6. 6. Personalized   We  need  to  get  the  right  drugs  to  the  right  pa(ents(right  route,  right   dose,  right  (me)  
  7. 7. Treating the right patients with the right medicine Approach : Current drugs + improved diagnosisEmpirical Medicine Treatment a Treatment b Treatment cBiomarker-Guided Medicine Treatment b Treatment a Biomarker-guided therapy Treatment c Slide 7
  8. 8. Dynamic Systems Theory      In  studying  self-­‐organizing  systems  a  shi5  in  focus  occurs:              From  objects  to  rela(onships     Mapping  of  paIerns        From  quan(ty  to  quality   of  rela(onships  
  9. 9. How to design an intervention for a complex system? Current paradigm: Monotherapy 1 disease – 1 target – 1 drug fits all Blockbuster approach Systems Theory : The scale and complexity of the problem and solution should match Prof. Dr. Yaneer Bar-Yam New England Complex Systems Institute New paradigm : Integrated Intervention Life style, nutrition, medicine (multi-dimensional pharmacology) and psychology Slide 9
  10. 10. John  N.  Warfield   professor  Emeritus,  George  Mason  University,  USA    basis  for  stopping  some  of  the  bad  pracGces  in  systems  science  community   •  Underscoping  the  Systems  Domain   •  Unimagina(ve  Workspaces   •  Mismatched  Media   •  Linguis(c  Pollu(on   •  Premature  Quan(fica(on   •  Insensi(vity  to  Discovered  Behavioral  Pathologies   •  Inadequacy  of  Comparisons  of  Alterna(ves   •  Blindness  to  History   •  Monotonous  Bifurca(on  
  11. 11. Blindness  to  History        Some  people  thought  about  systems  long  ago.   There  seems  to  be  a  strongly  entrenched  belief  that   systems  thinking  originated  in  the  last  half  of  the   twen(eth  century.  Virtually  every  important  concept   that  backs  up  the  key  ideas  emergent  in  systems   literature  are  found  in  ancient  literature  and  in  the   centuries  to  follow.  It  is  (me  to  recognize  the   contribu(ons  of  these  elder  scholars  and  factor  them   into  systems  science  where  their  presence  is   absolutely  essen(al  to  a  mature  science.          “an  introduc(on  to  systems  science”  
  12. 12. 3  tradi(onal  systems  • Ayurveda  • Tradi(onal  Chinese  Medicine  • Unani  
  13. 13. If the only tool you have is a hammer, you tend to treat everything as if it were a nail.Abraham Maslow (1908-1970)
  14. 14. New Medicine based on systemofbiology! New theoretical and clinical approach medicine! Sciences   Western   Chinese   Sciences   Medicine   Medicine   Western   Chinese   philosophy   philosophy   of  Science   of  Science   Western  philosophy   Chinese  philosophy   Western  culture   Chinese  culture   Origin  of  Man  
  15. 15. The Binocular dilemma of Master Yuen Yongli
  16. 16. Diagnosis  development  stepwise  strategy  ?     One-size-fits-all Stratified/Individualized Care Symptom/Signs Molecular pathology Personalized Health Care Ecosystem Symptom/Signs Molecular pathology fingerprint @ Life style @ Psychology/Consciousness Environment, Nutrition Medicine Subtype B Subtype ADisease - symptom management Targeted care – disease phenotype focus Patient Wellness focus1 disease -1 target – 1 (block buster) drug theranostics related to efficacy and adverse effects Integrated systems approach Slide 17
  17. 17. Systems biology guided byTraditional Chinese Medicinereveals new diagnostic markersfor rheumatoid arthritis A China Dutch joint project of the Sino-Dutch center for Personalized and Preventive Medicine Herman van Wietmarschen LACDR, Analytical Biosciences 18  
  18. 18. The ongoing sub-typing of MSX/Diabetes2 project- System Biology based development ofdiagnostic biomarkers for Diabetes type 2 A China Dutch joint project of the Sino-Dutch center for Personalized and Preventive Medicine Koko Wei PhD student Sino-Dutch Centre, TNO 19  
  19. 19. Acknowledgment Acknowledgment ª  Jan van der Greef ª  Wang Mei ª  Wei Koko ª  Jan van der Wietmarschen Mei, Koko Wei, Carina Rubingh, Herman van Greef, Wang ª  Eduard vanPasman, Nicole Cnubben, Herman van Wilrike Wijk ª  Everine van der Kraats Kistemaker of the Sino-Dutch Wietmarschen, Corª  Roel van Wijk Centre for Preventive and Personalized Researchª Wang Xinlu and TNO Medicineª Master Yuen Yongli ª And … Yang Yifang Ph.D.; Albert van Dinteren M.D.

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