AXA Research Fund & Sorbonne Université Chair, Paris, France.
Sorbonne Université, AP-HP, GRC n° 21, Alzheimer Precision Medicine (APM), Hôpital de la Pitié-Salpêtrière, Boulevard de l'hôpital, Paris, France.
J Alzheimers Dis. 2018;64(s1):S47-S105. doi: 10.3233/JAD-179932.
The Precision Neurology development process implements systems theory with system biology and neurophysiology in a parallel, bidirectional research path: a combined hypothesis-driven investigation of systems dysfunction within distinct molecular, cellular, and large-scale neural network systems in both animal models as well as through tests for the usefulness of these candidate dynamic systems biomarkers in different diseases and subgroups at different stages of pathophysiological progression. This translational research path is paralleled by an "omics"-based, hypothesis-free, exploratory research pathway, which will collect multimodal data from progressing asymptomatic, preclinical, and clinical neurodegenerative disease (ND) populations, within the wide continuous biological and clinical spectrum of ND, applying high-throughput and high-content technologies combined with powerful computational and statistical modeling tools, aimed at identifying novel dysfunctional systems and predictive marker signatures associated with ND. The goals are to identify common biological denominators or differentiating classifiers across the continuum of ND during detectable stages of pathophysiological progression, characterize systems-based intermediate endophenotypes, validate multi-modal novel diagnostic systems biomarkers, and advance clinical intervention trial designs by utilizing systems-based intermediate endophenotypes and candidate surrogate markers. Achieving these goals is key to the ultimate development of early and effective individualized treatment of ND, such as Alzheimer's disease. The Alzheimer Precision Medicine Initiative (APMI) and cohort program (APMI-CP), as well as the Paris based core of the Sorbonne University Clinical Research Group "Alzheimer Precision Medicine" (GRC-APM) were recently launched to facilitate the passageway from conventional clinical diagnostic and drug development toward breakthrough innovation based on the investigation of the comprehensive biological nature of aging individuals. The APMI movement is gaining momentum to systematically apply both systems neurophysiology and systems biology in exploratory translational neuroscience research on ND.
精准神经医学的发展过程采用系统理论,将系统生物学和神经生理学结合起来,形成平行、双向的研究路径:在动物模型和不同疾病以及不同病理生理进展阶段的不同亚组中,对特定分子、细胞和大规模神经网络系统内的系统功能障碍进行联合假设驱动的研究,同时对这些候选动态系统生物标志物的有用性进行测试。这种转化研究路径与“组学”为基础、无假设、探索性的研究路径平行,后者将从不断发展的无症状、临床前和临床神经退行性疾病(ND)人群中收集多模态数据,涵盖 ND 的广泛连续生物学和临床谱,应用高通量和高内涵技术,结合强大的计算和统计建模工具,旨在识别与 ND 相关的新功能障碍系统和预测标记特征。目标是在病理生理进展的可检测阶段,在 ND 的连续体中识别共同的生物学特征或区分分类器,描述基于系统的中间表型,验证多模态新型诊断系统生物标志物,并通过利用基于系统的中间表型和候选替代标志物,推进临床干预试验设计。实现这些目标是开发 ND 早期和有效个体化治疗的关键,如阿尔茨海默病。阿尔茨海默病精准医学倡议(APMI)和队列计划(APMI-CP),以及巴黎索邦大学临床研究组“阿尔茨海默病精准医学”(GRC-APM)的核心最近成立,以促进从常规临床诊断和药物开发向基于个体全面生物学性质的突破性创新的转变。APMI 运动正在稳步推进,系统地将系统神经生理学和系统生物学应用于 ND 的探索性转化神经科学研究。