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终生经历、大脑与个性化医疗:综合视角。

Lifetime experiences, the brain and personalized medicine: an integrative perspective.

机构信息

Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY 10065, USA.

出版信息

Metabolism. 2013 Jan;62 Suppl 1:S20-6. doi: 10.1016/j.metabol.2012.08.020. Epub 2012 Sep 23.

Abstract

The aim of personalized medicine is to base medical prevention and therapy on the unique health and disease susceptibility profile of each individual. Starting from this idea, we briefly discuss the meaning of the word 'personalized' before analyzing the practical content of personalized healthcare. From a medical perspective, knowledge of a person encompasses both biological and biographical perspectives. The latter includes significant events and experiences throughout the person's lifespan, from conception to the present, in which epigenetic influences play an important role. In practice, we believe personalized medicine should emphasize the development and maintenance of a healthy nervous system. The neurobiological processes involved here depend heavily on the psychosocial environment, in particular the presence of responsible, caring adults and integration in a reasonably fair society. A healthy brain subsequently promotes good health throughout life, both through direct, favorable influences on the body's intrinsic biological pathways, and indirectly by enabling the person to engage in supportive relationships, make wise decisions and take good care of him/herself. From a public health perspective, we conclude that hi-tech personalized medicine based on detailed bio-molecular mapping, monitoring and tailored drug interventions holds promise only as part of a wider, socio-culturally informed approach to the person.

摘要

个性化医学的目的是根据每个人独特的健康和疾病易感性来进行医疗预防和治疗。从这个想法出发,我们先简要讨论一下“个性化”这个词的含义,然后再分析个性化医疗保健的实际内容。从医学角度来看,一个人的知识既包括生物学方面,也包括传记方面。后者包括一个人从受孕到现在一生中的重大事件和经历,其中表观遗传的影响起着重要作用。在实践中,我们认为个性化医学应该强调发展和维持健康的神经系统。这里涉及的神经生物学过程在很大程度上取决于心理社会环境,特别是有负责、关爱的成年人的存在和融入一个相当公平的社会。一个健康的大脑随后会通过直接对身体内在的生物途径产生有利影响,以及间接地使人能够建立支持性的关系、做出明智的决策和照顾好自己,从而促进一生的健康。从公共卫生的角度来看,我们的结论是,基于详细的生物分子图谱、监测和定制药物干预的高科技个性化医学只有作为对人的更广泛的、社会文化知情的方法的一部分才有希望。

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