The Shmunis School of Biomedicine and Cancer Research, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel.
Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
Elife. 2021 Jan 28;10:e61710. doi: 10.7554/eLife.61710.
Human diseases arise in a complex ecosystem composed of disease mechanisms and the whole-body state. However, the precise nature of the whole-body state and its relations with disease remain obscure. Here we map similarities among clinical parameters in normal physiological settings, including a large collection of metabolic, hemodynamic, and immune parameters, and then use the mapping to dissect phenotypic states. We find that the whole-body state is faithfully represented by a quantitative two-dimensional model. One component of the whole-body state represents 'metabolic syndrome' (MetS) - a conventional way to determine the cardiometabolic state. The second component is decoupled from the classical MetS, suggesting a novel 'non-classical MetS' that is characterized by dozens of parameters, including dysregulated lipoprotein parameters (e.g. low free cholesterol in small high-density lipoproteins) and attenuated cytokine responses of immune cells to ex vivo stimulations. Both components are associated with disease, but differ in their particular associations, thus opening new avenues for improved personalized diagnosis and treatment. These results provide a practical paradigm to describe whole-body states and to dissect complex disease within the ecosystem of the human body.
人类疾病产生于由疾病机制和全身状态组成的复杂生态系统中。然而,全身状态的确切性质及其与疾病的关系仍不清楚。在这里,我们在正常生理环境中对临床参数进行了相似性映射,包括大量代谢、血液动力学和免疫参数,然后使用映射来剖析表型状态。我们发现全身状态由定量的二维模型准确表示。全身状态的一个组成部分代表“代谢综合征”(MetS)——一种确定心脏代谢状态的传统方法。第二个组成部分与经典的 MetS 脱钩,表明存在一种新的“非经典 MetS”,其特征是数十个参数,包括脂蛋白参数失调(例如小而高密度脂蛋白中的游离胆固醇低)和免疫细胞对外源刺激的细胞因子反应减弱。这两个组成部分都与疾病有关,但它们的特定关联不同,因此为改进个性化诊断和治疗开辟了新途径。这些结果提供了一个实用的范例,可用于描述全身状态,并剖析人体生态系统中的复杂疾病。