Fioranelli Massimo, Sepehri Alireza, Roccia Maria Grazia, Linda Cota, Rossi Chiara, Dawodo Amos, Vojvodic Petar, Lotti Jacopo, Barygina Victoria, Vojvodic Aleksandra, Wollina Uwe, Tirant Michael, Van Thuong Nguyen, Lotti Torello
Department of Nuclear Physics, Sub-nuclear and Radiation, G. Marconi University, Rome, Italy.
Clinic for Psychiatric Disorders "Dr. Laza Lazarevic", Belgrade, Serbia.
Open Access Maced J Med Sci. 2019 Sep 14;7(18):3053-3060. doi: 10.3889/oamjms.2019.775. eCollection 2019 Sep 30.
Increasing incidence and poor outcome of chronic non-communicable diseases in western population would require a paradigm shift in the treatments. Guidelines-based medical approaches continue to be the standard rule in clinical practice, although only less than 15% of them are based on high-quality research. For each person who benefits from the 10 best-selling drugs in the USA, a number between 4 and 25 has no one beneficial effect. The reductionist linear medicine method does not offer solutions in the non-manifest preclinical stage of the disease when it would still be possible to reverse the pathological progression and the axiom "a drug, a target, a symptom" are still inconclusive. Needs additional tools to address these challenges. System Medicine considers the disease as a dysregulation of the biological networks that changes throughout the evolution of the pathological process and with the comorbidities development. The strength of the networks indicates their ability to withstand dysregulations during the perturbation phases, returning to the state of stability. The treatment of dysregulated networks before the symptomatological manifestation emerges offers the possibility of treating and preventing pathologies in the preclinical phase and potentially reversing the pathological process, stopping it or preventing comorbidities. Furthermore, treating shared networks instead of individual phenotypic symptoms can reduce drug use, offering a solution to the problem of ineffective drug use.
西方人群中慢性非传染性疾病发病率的上升和不良预后,将需要治疗模式的转变。基于指南的医学方法仍然是临床实践中的标准规则,尽管其中只有不到15%是基于高质量研究。在美国,每一个从10种畅销药物中受益的人,有4到25个人没有任何有益效果。还原论的线性医学方法在疾病的非明显临床前期无法提供解决方案,而此时仍有可能逆转病理进展,并且“一种药物、一个靶点、一种症状”的公理仍然没有定论。需要额外的工具来应对这些挑战。系统医学将疾病视为生物网络的失调,这种失调在病理过程的演变以及合并症发展过程中会发生变化。网络的强度表明它们在扰动阶段承受失调并恢复到稳定状态的能力。在症状出现之前对失调的网络进行治疗,为在临床前期治疗和预防疾病以及潜在地逆转病理过程、阻止其发展或预防合并症提供了可能性。此外,治疗共享网络而非个体表型症状可以减少药物使用,为药物使用无效的问题提供解决方案。