Boquet-Pujadas Aleix, Anagnostakis Filippos, Yang Zhijian, Tian Ye Ella, Duggan Michael R, Erus Guray, Srinivasan Dhivya, Joynes Cassandra M, Bai Wenjia, Patel Praveen J, Walker Keenan A, Zalesky Andrew, Davatzikos Christos, Wen Junhao
medRxiv. 2025 Aug 13:2025.08.09.25333350. doi: 10.1101/2025.08.09.25333350.
Disease heterogeneity and commonality pose significant challenges to precision medicine, as traditional approaches frequently focus on single disease entities and overlook shared mechanisms across conditions . Inspired by pan-cancer and multi-organ research , we introduce the concept of "pan-disease" to investigate the heterogeneity and shared etiology in brain, eye, and heart diseases. Leveraging individual-level data from 129,340 participants, as well as summary-level data from the MULTI consortium, we applied a weakly-supervised deep learning model (Surreal-GAN ) to multi-organ imaging, genetic, proteomic, and RNA-seq data, identifying 11 AI-derived biomarkers - called Multi-organ AI Endophenotypes (MAEs) - for the brain (Brain 1-6), eye (Eye 1-3), and heart (Heart 1-2), respectively. We found Brain 3 to be a risk factor for Alzheimer's disease (AD) progression and mortality, whereas Brain 5 was protective against AD progression. Crucially, in data from an anti-amyloid AD drug (solanezumab ), heterogeneity in cognitive decline trajectories was observed across treatment groups. At week 240, patients with lower brain 1-3 expression had slower cognitive decline, whereas patients with higher expression had faster cognitive decline. A multi-layer causal pathway pinpointed Brain 1 as a mediational endophenotype linking the FLRT2 protein to migraine, exemplifying novel therapeutic targets and pathways. Additionally, genes associated with Eye 1 and Eye 3 were enriched in cancer drug-related gene sets with causal links to specific cancer types and proteins. Finally, Heart 1 and Heart 2 had the highest mortality risk and unique medication history profiles, with Heart 1 showing favorable responses to antihypertensive medications and Heart 2 to digoxin treatment. The 11 MAEs provide novel AI dimensional representations for precision medicine and highlight the potential of AI-driven patient stratification for disease risk monitoring, clinical trials, and drug discovery.
疾病的异质性和共性给精准医学带来了重大挑战,因为传统方法通常只关注单一疾病实体,而忽视了不同疾病间的共同机制。受泛癌和多器官研究的启发,我们引入了“泛疾病”的概念,以研究脑部、眼部和心脏疾病的异质性和共同病因。我们利用来自129,340名参与者的个体水平数据以及MULTI联盟的汇总水平数据,将弱监督深度学习模型(Surreal-GAN)应用于多器官成像、基因、蛋白质组和RNA测序数据,分别为脑(Brain 1-6)、眼(Eye 1-3)和心脏(Heart 1-2)识别出11种人工智能衍生的生物标志物——称为多器官人工智能内表型(MAE)。我们发现Brain 3是阿尔茨海默病(AD)进展和死亡的危险因素,而Brain 5对AD进展具有保护作用。至关重要的是,在一种抗淀粉样蛋白AD药物(索拉鲁单抗)的数据中,各治疗组的认知衰退轨迹存在异质性。在第240周时,Brain 1-3表达较低的患者认知衰退较慢,而表达较高的患者认知衰退较快。一条多层因果路径确定Brain 1为将FLRT2蛋白与偏头痛联系起来的中介内表型,这为新型治疗靶点和途径提供了例证。此外,与Eye 1和Eye 3相关的基因在与癌症药物相关的基因集中富集,与特定癌症类型和蛋白质存在因果联系。最后,Heart 1和Heart 2具有最高的死亡风险和独特的用药史特征,Heart 1对抗高血压药物显示出良好反应,Heart 2对地高辛治疗有良好反应。这11种MAE为精准医学提供了新的人工智能维度表征,并突出了人工智能驱动的患者分层在疾病风险监测、临床试验和药物发现方面的潜力。