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How Scientific Wellness will
Drive the Future of Health
Nathan Price, PhD
Institute for Systems Biology
Seattle, WA
Hyper Wellbeing
November 13, 2016
@ISBNathanPrice
Disclosures
• Dr. Price is a Co-Founder of Arivale, which
partially funded and may license discoveries
resulting from the Hundred Person Wellness
Project (to be described).
• Dr. Price serves on Scientific Advisory Board of
Habit, a new personalized nutrition company
Founders
Clayton Lewis, CEO and Co-founder
Maveron, MarketLeader, Harborview Medical Center, Capitol
Hill
Lee Hood, MD, PhD, Co-founder, SAB Chair
ISB, Amgen, National Academies, Presidential Medal
Nathan Price, PhD, Co-founder, Board of Directors
ISB, University of Illinois, Urbana-Champaign, UCSD, UW
86% of Healthcare Costs Treat Chronic Disease
Determinants of Health in U.S.
60%
30%
10%
Genetics
Behavior &
environment
Health
Care
Steven Schroeder et al.
New England J Medicine, 2007
U.S.
Healthcare
Spending
$3.8 Trillion
(2014)
Wellness
Industry
Scientific Wellness → A New Industry
U.S.
Healthcare
Spending
$3.8 Trillion
(2014)
Wellness
Industry
Scientific
Wellness→ ↔
Conceptual Themes of P4 Medicine
Disease DemystifiedWellness Quantified
P4 Medicine
Predictive
Preventive
Personalized
Participatory
Scientific Wellness Industry Disease Industry
Proposing the 100K Wellness Project
Nature,
News
piece,
(2014)
Hood and Price, Science Translational Medicine (2014)
Hood and Price,
Clinical Omics,
(2014)
Scientific Wellness:
Two Integrated Directions
Arivale
• A consumer facing
scientific wellness
company
• 5,000 individuals in the
first 18 months
• Transform how biotech
industry operates
ISB-Providence
• Dense, dynamic, personal data clouds
• Research to validate wellness metrics
• Research for better assays
• Optimize wellness
• Study wellness to disease transitions
• Study disease [progression, response
to therapy and transition to wellness
PIONEER 100 PROJECT
Principal Investigators: Lee Hood and Nathan Price
The 100K Wellness Project was initiated in 2014 with the generation of dynamic data clouds for 108
individuals. These data provided spectacular insights into what it is to be well and the nature of
wellness to disease transitions (and vice versa).
• 108 participants
• Age range: 20s to 88+
• 9-month study
launched March 2014
• IRB approved
• Evaluation / insights
for next phase
• Whole genome sequence
• Detailed blood, urine, saliva
measurements 3x
• Gut microbiome 3x
• Continual self-tracking and lifestyle
monitoring
• Data integration & correlations
• Monthly coaching sessions on
actionable data
• Discovery research
• Events and education
Assays / Measurements—108 Pioneers
Database
of actionable
possibilities that
will grow over
time
GENOME
Whole Genome
Sequencing.
SNPs Millions
LABS
Detailed lab tests 3x
(blood, urine, saliva)
Clinical chem. 150
Metabolites 700
Proteins 400
SELF-
TRACKING
Continual
self-tracking
& lifestyle
monitoring
MICROBIOME
Gut Microbiome
3x
Creating dense and dynamic personal data clouds
Wellness coaching for participants
Sandi Kaplan, MS, RD Craig Keebler, MD
Wellness Coach Study Physician
Clinical Labs Discovery:
Improvements in blood health with behavioral coaching
50%
55%
60%
65%
70%
75%
80%
85%
90%
95%
100%
Cardiovascular Diabetes Inflammation Nutrition
%changeinout-of-rangemeasurements
Baseline 3 months 6 months
Improved by 33%Improved by 6% Improved by 12% Improved by 21%
Clinical Labs Discovery:
Significant pre-diabetes improvements
Seven participants with pre-diabetes were completely normalized in six months
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
HbA1c
(Glycated hemoglobin)
Fasting glucose HOMA
(Insulin resistance)
Insulin
%changeinout-of-rangemeasurements
Baseline 3 months 6 months
Improved by 19%Improved by 38% Improved by 55% Improved by 56%
A wellness to disease transition—genetics
plus environment—an actionable
possibility
• Blood + Genetics illuminated the effects of increasing copies of the Hemochromatosis variant
• Left untreated, this disorder could lead to cartilage damage, liver cancer, diabetes, and heart
disease: Easily treated by regular blood donations to reduce the iron stores
• One participant ALREADY had cartilage damage from his undiagnosed disease
• Subsequent family genetic testing detected other family members at risk
0.0
50.0
100.0
150.0
200.0
250.0
Zero copies of rare
variant
(86 individuals)
One copy of rare
variant
(12 individuals)
Two copies of rare
variant
(2 individuals)
Ferritinlevels
Baseline 3 months
Genetics and Clinical Labs: Hemochromatosis
Detected risk of a deadly disease in two participants
Deriving Insights from Data: New Frontiers
C
Identifying inter-related molecular modules
• Cholesterol is positively
associated with alpha-
tocopherol (Vitamin E)
• Cholesterol is negatively
associated with
endogenous thyroxine
• A beneficial side effect of
the drug thryroxine
(Synthroid) is lowering LDL
cholesterol
Total cholesterol
community
The largest molecular community: related
to cardiometabolic health
We can determine
your genetic risk for
at least 60 diseases.
Estimated risk for the
disease or trait relative
to a population
GWAS variants have been determined for about 60
diseases and traits
Variant
rs6827
Variant
rs8572
Variant
rs68883 Variant
rs0994
Variant
rs9769
Variant
rs14445
Var
iant
Variant
rs111393
Variant
rs6837
Variant
rs5837
Variant
rs68279
Variant
rs59583
Variant
rs1352
Variant
rs6827
Variant
rs68883
Variant
rs9769
Variant
rs14445
Variant
rs5837
Detrimental VariantBeneficial Variant
0
20
40
60
80
100
120
140
Cumulative Risk
Below average
Distribution from 2000 Genomes
ADHD COPD Myopia
Alzheimer's disease Crohn's disease Obesity
Anorexia Esophageal cancer Osteoarthritis
Asthma Gout Osteoporosis
Atrial fibrillation Grave's disease Ovarian cancer
Breast cancer Hematocrit Pancreatic cancer
Bipolar disorder Hypertension Parkinson's disease
Blood pressure Hypothyroidism Primary biliary cirrhosis
Bone mineral density Inflammatory bowel disease Prostate cancer
Inflammation Iron levels Psoriasis
Calcium Lung Cancer Rheumatoid arthritis
Cardiovascular disease Lupus Schizophrenia
Celiac disease Macular degeneration Stroke
Cholesterol levels Magnesium levels Type 1 Diabetes
Chronic kidney disease Metabolic syndrome Type 2 Diabetes
Colorectal cancer Migraine Ulcerative colitis
Coronary heart disease Multiple sclerosis Urate levels
Nutrient measurements correlated
with genetic predisposition for IBD
cystine
(plasma)
glutathione
(cytosol)
Sido, B., Hack, V., Hochlehnert, A., Lipps, H., Herfarth, C., and Dröge, W.
(1998). Impairment of intestinal glutathione synthesis in patients with
inflammatory bowel disease. Gut 42, 485–492.
Ulcerative colitis
activity
Pilot Study Correlation
Network
cysteine
(cytosol)
-2
0
2
4
6
-4
plasmacystine
-4 -2 0 2 4
Inflammatory bowel disease genetic
score
N = 107
rho = -
0.44
p =
2.3e-6
q = 0.03
Dense, Dynamic Personal
Data Clouds
These personalized data clouds are the foundation
of what Precision Medicine should be.
Enabling Individuals to take Responsibility for
their Own Wellness (and Disease)
Individuals taking responsibility for their own health
will dramatically reduce the cost of healthcare
Project Leadership
• Leroy Hood, MD, PhD
• Nathan Price, PhD
• Sean Bell, Business Director
Data Analytics
• Nathan Price, PhD – Analytics Lead
Gustavo Glusman, PhD, Genomics
• Andrew Magis, PhD, Multi-omics
• John Earls, Data integration
Project Management
• Kristin Brogaard, PhD Project Manager
• Sara Mecca, Project Assistant
• Mary Brunkow, PhD, Project Coordinator
Medical Advisory Board
• Robert Green, MD
• Jane Guiltinan, ND
• Michael Raff, MD
• Sarah Speck, MD
Communications
• Gretchen Sorenson, Consultant
• Hsiao-Ching Chou, Commun. Director
Participant Engagement
• Jennifer Lovejoy, PhD, VP Clinical Affairs
• Sandi Kaplan, Wellness Coach
• Craig Keebler, MD, Study Physician
ISB Hundred Person Wellness Project: Team
Special thanks to our funders: Robert Wood Johnson Foundation and
M.J. Murdock Charitable Trust
@ISBNathanPrice
"How Scientific Wellness will Drive The Future of Health" - Nathan Price (Professor, Institute of Systems Biology)

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"How Scientific Wellness will Drive The Future of Health" - Nathan Price (Professor, Institute of Systems Biology)

  • 1.
  • 2. How Scientific Wellness will Drive the Future of Health Nathan Price, PhD Institute for Systems Biology Seattle, WA Hyper Wellbeing November 13, 2016 @ISBNathanPrice
  • 3. Disclosures • Dr. Price is a Co-Founder of Arivale, which partially funded and may license discoveries resulting from the Hundred Person Wellness Project (to be described). • Dr. Price serves on Scientific Advisory Board of Habit, a new personalized nutrition company Founders Clayton Lewis, CEO and Co-founder Maveron, MarketLeader, Harborview Medical Center, Capitol Hill Lee Hood, MD, PhD, Co-founder, SAB Chair ISB, Amgen, National Academies, Presidential Medal Nathan Price, PhD, Co-founder, Board of Directors ISB, University of Illinois, Urbana-Champaign, UCSD, UW
  • 4. 86% of Healthcare Costs Treat Chronic Disease
  • 5. Determinants of Health in U.S. 60% 30% 10% Genetics Behavior & environment Health Care Steven Schroeder et al. New England J Medicine, 2007
  • 6. U.S. Healthcare Spending $3.8 Trillion (2014) Wellness Industry Scientific Wellness → A New Industry U.S. Healthcare Spending $3.8 Trillion (2014) Wellness Industry Scientific Wellness→ ↔
  • 7. Conceptual Themes of P4 Medicine Disease DemystifiedWellness Quantified P4 Medicine Predictive Preventive Personalized Participatory Scientific Wellness Industry Disease Industry
  • 8. Proposing the 100K Wellness Project Nature, News piece, (2014) Hood and Price, Science Translational Medicine (2014) Hood and Price, Clinical Omics, (2014)
  • 9. Scientific Wellness: Two Integrated Directions Arivale • A consumer facing scientific wellness company • 5,000 individuals in the first 18 months • Transform how biotech industry operates ISB-Providence • Dense, dynamic, personal data clouds • Research to validate wellness metrics • Research for better assays • Optimize wellness • Study wellness to disease transitions • Study disease [progression, response to therapy and transition to wellness
  • 10. PIONEER 100 PROJECT Principal Investigators: Lee Hood and Nathan Price The 100K Wellness Project was initiated in 2014 with the generation of dynamic data clouds for 108 individuals. These data provided spectacular insights into what it is to be well and the nature of wellness to disease transitions (and vice versa).
  • 11. • 108 participants • Age range: 20s to 88+ • 9-month study launched March 2014 • IRB approved • Evaluation / insights for next phase • Whole genome sequence • Detailed blood, urine, saliva measurements 3x • Gut microbiome 3x • Continual self-tracking and lifestyle monitoring • Data integration & correlations • Monthly coaching sessions on actionable data • Discovery research • Events and education
  • 12. Assays / Measurements—108 Pioneers Database of actionable possibilities that will grow over time GENOME Whole Genome Sequencing. SNPs Millions LABS Detailed lab tests 3x (blood, urine, saliva) Clinical chem. 150 Metabolites 700 Proteins 400 SELF- TRACKING Continual self-tracking & lifestyle monitoring MICROBIOME Gut Microbiome 3x Creating dense and dynamic personal data clouds
  • 13. Wellness coaching for participants Sandi Kaplan, MS, RD Craig Keebler, MD Wellness Coach Study Physician
  • 14. Clinical Labs Discovery: Improvements in blood health with behavioral coaching 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100% Cardiovascular Diabetes Inflammation Nutrition %changeinout-of-rangemeasurements Baseline 3 months 6 months Improved by 33%Improved by 6% Improved by 12% Improved by 21%
  • 15. Clinical Labs Discovery: Significant pre-diabetes improvements Seven participants with pre-diabetes were completely normalized in six months 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% HbA1c (Glycated hemoglobin) Fasting glucose HOMA (Insulin resistance) Insulin %changeinout-of-rangemeasurements Baseline 3 months 6 months Improved by 19%Improved by 38% Improved by 55% Improved by 56%
  • 16. A wellness to disease transition—genetics plus environment—an actionable possibility
  • 17. • Blood + Genetics illuminated the effects of increasing copies of the Hemochromatosis variant • Left untreated, this disorder could lead to cartilage damage, liver cancer, diabetes, and heart disease: Easily treated by regular blood donations to reduce the iron stores • One participant ALREADY had cartilage damage from his undiagnosed disease • Subsequent family genetic testing detected other family members at risk 0.0 50.0 100.0 150.0 200.0 250.0 Zero copies of rare variant (86 individuals) One copy of rare variant (12 individuals) Two copies of rare variant (2 individuals) Ferritinlevels Baseline 3 months Genetics and Clinical Labs: Hemochromatosis Detected risk of a deadly disease in two participants
  • 18. Deriving Insights from Data: New Frontiers C
  • 20. • Cholesterol is positively associated with alpha- tocopherol (Vitamin E) • Cholesterol is negatively associated with endogenous thyroxine • A beneficial side effect of the drug thryroxine (Synthroid) is lowering LDL cholesterol Total cholesterol community
  • 21. The largest molecular community: related to cardiometabolic health
  • 22.
  • 23. We can determine your genetic risk for at least 60 diseases.
  • 24. Estimated risk for the disease or trait relative to a population GWAS variants have been determined for about 60 diseases and traits Variant rs6827 Variant rs8572 Variant rs68883 Variant rs0994 Variant rs9769 Variant rs14445 Var iant Variant rs111393 Variant rs6837 Variant rs5837 Variant rs68279 Variant rs59583 Variant rs1352 Variant rs6827 Variant rs68883 Variant rs9769 Variant rs14445 Variant rs5837 Detrimental VariantBeneficial Variant 0 20 40 60 80 100 120 140 Cumulative Risk Below average Distribution from 2000 Genomes ADHD COPD Myopia Alzheimer's disease Crohn's disease Obesity Anorexia Esophageal cancer Osteoarthritis Asthma Gout Osteoporosis Atrial fibrillation Grave's disease Ovarian cancer Breast cancer Hematocrit Pancreatic cancer Bipolar disorder Hypertension Parkinson's disease Blood pressure Hypothyroidism Primary biliary cirrhosis Bone mineral density Inflammatory bowel disease Prostate cancer Inflammation Iron levels Psoriasis Calcium Lung Cancer Rheumatoid arthritis Cardiovascular disease Lupus Schizophrenia Celiac disease Macular degeneration Stroke Cholesterol levels Magnesium levels Type 1 Diabetes Chronic kidney disease Metabolic syndrome Type 2 Diabetes Colorectal cancer Migraine Ulcerative colitis Coronary heart disease Multiple sclerosis Urate levels
  • 25. Nutrient measurements correlated with genetic predisposition for IBD cystine (plasma) glutathione (cytosol) Sido, B., Hack, V., Hochlehnert, A., Lipps, H., Herfarth, C., and Dröge, W. (1998). Impairment of intestinal glutathione synthesis in patients with inflammatory bowel disease. Gut 42, 485–492. Ulcerative colitis activity Pilot Study Correlation Network cysteine (cytosol) -2 0 2 4 6 -4 plasmacystine -4 -2 0 2 4 Inflammatory bowel disease genetic score N = 107 rho = - 0.44 p = 2.3e-6 q = 0.03
  • 26. Dense, Dynamic Personal Data Clouds These personalized data clouds are the foundation of what Precision Medicine should be.
  • 27. Enabling Individuals to take Responsibility for their Own Wellness (and Disease) Individuals taking responsibility for their own health will dramatically reduce the cost of healthcare
  • 28. Project Leadership • Leroy Hood, MD, PhD • Nathan Price, PhD • Sean Bell, Business Director Data Analytics • Nathan Price, PhD – Analytics Lead Gustavo Glusman, PhD, Genomics • Andrew Magis, PhD, Multi-omics • John Earls, Data integration Project Management • Kristin Brogaard, PhD Project Manager • Sara Mecca, Project Assistant • Mary Brunkow, PhD, Project Coordinator Medical Advisory Board • Robert Green, MD • Jane Guiltinan, ND • Michael Raff, MD • Sarah Speck, MD Communications • Gretchen Sorenson, Consultant • Hsiao-Ching Chou, Commun. Director Participant Engagement • Jennifer Lovejoy, PhD, VP Clinical Affairs • Sandi Kaplan, Wellness Coach • Craig Keebler, MD, Study Physician ISB Hundred Person Wellness Project: Team Special thanks to our funders: Robert Wood Johnson Foundation and M.J. Murdock Charitable Trust @ISBNathanPrice

Editor's Notes

  1. Actionable big data for systems medicine and proactive healthcare
  2. Steven Schroeder et al. New England J Medicine, 2007 McGinnis JM, Williams-Russo P, Knickman JR. Health Aff (Millwood) 2002
  3. Growth will be driven primarily by preventive health and wellness categories such as vitamins, nutrition, weight management and fortified foods and beverages; fitness and mind; alternative medicine and workplace wellness The global POC market was worth $13.8 billion in 2011. By 2018, the market is expected to grow to $24 billion in the U.S. alone. Thu Mar 26, 2015 12:13am EDT By Sharon Begley from a survey of 121 representative U.S. employers by Fidelity Investments and the National Business Group on Health   NEW YORK (Reuters) - Employers have ratcheted up the financial incentives they offer workers to participate in wellness programs to a record $693 per employee, on average, this year from $594 in 2014 and $430 five years ago, found a report released on Thursday (Companies with more than 20,000 employees are offering an average of $878
  4. Arivale-a wellness sciences company—consumer facing —generate 10,000 dense and dynamic individual data clouds in next 18 months—may really lead the large-scale adoption of P4 medicine and the democratization of healthcare—one of the first companies in the scientific wellness sector The 100,000 person wellness project—academic—discovery science at ISB—pioneer assays (to the smart phone) and pioneer the integrative and modeling analytics—seek Precision Medicine funding—focus on both wellness and early disease transitions and on following disease to therapy to wellness transitions.
  5. 100 participants 9 month study starting in March They will get:  there whole genome sequenced Detailed Blood measurements 3 times detailed urine and saliva measurements 3 times Gut microbiome 3 times Continual activity and lifestyle monitoring discovery research on their samples Coaching component to focus on actionable information for the participants and help guide them through the study Regulatory: We are IRB approved Multiple events with guest speakers held throughout the 9 months to foster community and educations For bio-sample collection participants will go to blood draw centers for will be given kits to collect samples at home
  6. Transition to Jennifer
  7. Green no highlights
  8. Remove highlights Spell out numbers
  9. Optional Title Slide
  10. What might this mean: paint the picture for the board Have a summary slide: arivale research portal can provide the genetic risk of populations for specific diseases Patent: idea that we can identify the genetic risk for a given population and use that risk disposition to identify molecules that are relevant to those disease associations What about the guy that was diagnosed during the study, is he low