Gilcrease Winston, Manfredi Luca, Sciascia Savino, Ricceri Fulvio
Department of Clinical and Biological Sciences, Centre for Biostatistics, Epidemiology, and Public Health, University of Turin, Turin, Italy.
University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net, ERN-Reconnect and RITA-ERN Member) With Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley, ASL Città Di Torino and Department of Clinical and Biological Sciences, University of Turin, 10154, Turin, Italy.
Rheumatol Ther. 2025 Feb;12(1):1-24. doi: 10.1007/s40744-024-00724-8. Epub 2024 Nov 27.
The transition from a comorbidity-based to a multimorbidity-focused to ultimately a network medicine approach in people with rheumatic diseases might mark a significant shift in how we understand and manage these complex conditions. Multimorbidity expands on the concept of comorbidity by encompassing the presence of multiple diseases, which results in further individual and societal impacts. This approach, while valuable, often leads to fragmented care focused on individual diseases rather than the patient as a whole.Network medicine, on the other hand, offers a more integrated perspective. It is an emerging concept that leverages the understanding of biologic networks and their interactions within the human body to gain insights into disease mechanisms. In the context of rheumatic diseases, network medicine involves examining how different diseases interconnect and influence each other through shared pathways, genetic factors, and molecular mechanisms.This paradigm shift allows for a more holistic understanding in how we manage rheumatic diseases. For instance, rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus are not just a collection of symptoms affecting various organs but are also interconnected through underlying systemic inflammatory processes, immune system dysregulation, and genetic predispositions.
在风湿性疾病患者中，从基于共病的方法转变为关注多重疾病，最终发展为网络医学方法，这可能标志着我们理解和管理这些复杂病症方式的重大转变。多重疾病通过涵盖多种疾病的存在扩展了共病的概念，这会对个人和社会产生进一步的影响。这种方法虽然有价值，但往往导致专注于个别疾病而非患者整体的碎片化护理。另一方面，网络医学提供了更综合的视角。它是一个新兴概念，利用对生物网络及其在人体内部相互作用的理解来深入了解疾病机制。在风湿性疾病的背景下，网络医学涉及研究不同疾病如何通过共享途径、遗传因素和分子机制相互连接和相互影响。这种范式转变使我们能够更全面地理解如何管理风湿性疾病。例如，类风湿性关节炎和系统性红斑狼疮等风湿性疾病不仅仅是影响各个器官的一系列症状，还通过潜在的全身性炎症过程、免疫系统失调和遗传易感性相互关联。
