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Personalized/precision/individualized (i) Medicine
Jacob Iasha Sznajder MDJacob Iasha Sznajder MD
Feinberg School of Medicine,Feinberg School of Medicine,
Northwestern UniversityNorthwestern University
Disclosures:
•NHLBI funding
•Stipend as Editor of AJRCCM
Behavior
Diseases
Environment
Genetics
Infectious
diseases
Medicine
One size fits all
The era of personalized/precision
“iMedicine”
Predictive
Preventive
Participatory
Personalized
The period of incidental discoveries
up to the 1960s
Bacteria, Disease, and Pasteurization
Established methods to
discover how a specific
germ caused a disease.
Robert Koch Paul Ehrlich
Discovered staining of Bacteria
and Salvarsan to treat Syphilis
and contributed to antiserum
for diphteria.
Louis Pasteur
Pasteurization process,
microbiology, led the way to
vaccinations
Koch‘s postulates
Aspirin and COX inhibition
From Hippocrates to Charles Gerhard and Felix Hoffman
Insulin
From Langerhans to Frederick Banting
Eli Lilly and Company, and mass production
Insulin
Penicillin
The era of high throughput
1970s-2000s
screening of chemical
compounds libraries
Statins
Akira Endo
HMG-CoA reductase
Velcade® (bortezomib)
23andMe and the FDA.
Annas GJ, Elias S.
N Engl J Med. 2014 2014;370:985-988.
SNP technology to identify markers of 254 diseases
“change what you can manage what you can’t”
Government paternalism vs. individual empowerment
The FDA is overcautious on consumer genomics
Robert C. Green and Nita A. Farahany 15 January 2014. Nature 505, 286-287.
R.C. Green. Older patients and ε4 allele of the APOE genotype.
Am J Psychiatry 2014, 171:137-9.
S. Fairclough. Physiological data must remain
confidential. Nature January 15th
2014.
Uncovering and tackling Europe's hidden respiratory
illness
Klaus Rabe and Brian Ward
Lancet. 2012 Aug 18;380(9842):623-
4.
Figure. Differences in life expectancy of men in a small area of
London, Travelling east from Westminster, 1 year of life
expectancy is lost with every two tube stops. Data are for the
period 2004–08. Reproduced from London Health Observatory
The era of
Personalized/precision/individualized
“iMedicine”
Predictive,
Preventive,
Participatory
Personalized,
Programmatic

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