Cancer Epidemiology Program, Dana-Farber/Harvard Cancer Center, 450 Brookline Ave., Room JF-215C, Boston, MA 02215, USA.
Am J Epidemiol. 2012 Oct 15;176(8):659-67. doi: 10.1093/aje/kws226. Epub 2012 Aug 30.
In recent decades, epidemiology, public health, and medical sciences have been increasingly compartmentalized into narrower disciplines. The authors recognize the value of integration of divergent scientific fields in order to create new methods, concepts, paradigms, and knowledge. Herein they describe the recent emergence of molecular pathological epidemiology (MPE), which represents an integration of population and molecular biologic science to gain insights into the etiologies, pathogenesis, evolution, and outcomes of complex multifactorial diseases. Most human diseases, including common cancers (such as breast, lung, prostate, and colorectal cancers, leukemia, and lymphoma) and other chronic diseases (such as diabetes mellitus, cardiovascular diseases, hypertension, autoimmune diseases, psychiatric diseases, and some infectious diseases), are caused by alterations in the genome, epigenome, transcriptome, proteome, metabolome, microbiome, and interactome of all of the above components. In this era of personalized medicine and personalized prevention, we need integrated science (such as MPE) which can decipher diseases at the molecular, genetic, cellular, and population levels simultaneously. The authors believe that convergence and integration of multiple disciplines should be commonplace in research and education. We need to be open-minded and flexible in designing integrated education curricula and training programs for future students, clinicians, practitioners, and investigators.
近几十年来,流行病学、公共卫生和医学科学日益分化为更窄的学科。作者认识到整合不同科学领域的价值,以创造新的方法、概念、范式和知识。本文描述了分子病理流行病学(MPE)的最新出现,它代表了人群和分子生物学科学的整合,以深入了解复杂多因素疾病的病因、发病机制、演变和结果。大多数人类疾病,包括常见癌症(如乳腺癌、肺癌、前列腺癌和结直肠癌、白血病和淋巴瘤)和其他慢性疾病(如糖尿病、心血管疾病、高血压、自身免疫性疾病、精神疾病和某些传染病),都是由基因组、表观基因组、转录组、蛋白质组、代谢组、微生物组和上述所有成分的相互作用组的改变引起的。在个性化医学和个性化预防的时代,我们需要整合科学(如 MPE),可以同时在分子、遗传、细胞和人群水平上破译疾病。作者认为,多学科的融合和整合应该在研究和教育中普遍存在。我们需要在为未来的学生、临床医生、从业者和研究人员设计综合教育课程和培训计划时保持开放和灵活的态度。