The speed of innovation in research & technology has made our understanding of the human body richer than ever. The progress we have made means that our capacity to accurately “map” the lives of individual patients is well within our reach.
In his book “The Patient Will See You Now” Dr. Eric Topol suggests that this “human mapping” process can and should be viewed in the same way as geographic mapping, where a map of any kind can be drawn as a series of layers. As far as human mapping is concerned, Topol suggests that there are 10 layers in which data can be gathered and studied:
Let’s look at each of these layers in more detail.
Exposome, environmental impact on individual health
This is about data gathering on how each individual’s health is affected by the wider environment, whether this is the local or non-local world. This may include the impact of radiation, pollution, pollen count, or pesticides.
Epigenome, cellular impact on individual health
This layer relates to the so-called “side-chains” of DNA (in medicine there are 3 of these: methylation, histone modifications and chromatin). In practical terms means we are mapping how the 20 cells in the human body interact and affect one another.
Microbiome, microbial impact on individual health
Much in the news recently, we are 9 parts microbe (most of which are bacteria, followed by viruses, and then fungi) and 1 part human. As there are 10,000 different species of microbe alone, understanding this ecosystem is critical to our overall health.
Metabolome, the metabolic impact on individual health
This relates to the compounds in the human body and how they metabolize. This is manly concerned with the interaction of proteins and RNA, which has significant affects on how efficiently and effectively we process food, drink, and medications.
Proteome, the impact of proteins on individual health
This specifically relates to how the many proteins in our body interact with and affect one another and in particular how antibodies are formed or not formed, and why this is the case.
Transcriptome, DNA efficiency’s impact on individual health
It was not long ago that RNA was thought to be “wasted matter” in the body. However, although our understanding is still evolving, we now know that the way DNA transcribes to RNA is critical to our health.
Genome, the DNA sequence’s impact on individual health
Also much in the news recently, especially as costs have come down, this concerns our specific DNA letter sequence (combinations of A, C, T and G) and the extent to which there are “gaps and patterns” from which we can learn much about our own/our family’s health.
Anatome, how the body’s size and shape impacts individual health)
This relates to the shape and size of an individual’s bones, other body parts and features (hair, eyes etc.) and how this individually and in combination can have an affect on health.
Physiome, the impact of blood and breath on individual health
This concerns how effectively a person’s blood and breath in particular is operating in the body. These days, it is measured quite readily by bio-sensors or even wearables and smartphones, which can track heart rate, blood pressure, temperature, et cetera.
Phenome (the impact of contextual traits/characteristics on individual health)
This concerns a person’s age, gender, height, weight, eye or skin color and other ways in which an individual looks physically to others. It also concerns less tangible factors such as relative social connection to friends and family and history.
Every one of these “layers” (or in total what Topol calls a “Panoromic”) is critical in and of itself, but cannot stand alone as an indicator or predictor of an individual’s health.
As we said at the outset, although we are not there yet in assembling all the data we need in every layer, we are well on the way to capturing more and more data in each of these layers, making it increasingly possible to study not only how they interact but how one individual is different from another.
Such data gathering is not without its challenges. Besides huge cost, perhaps one of the most significant challenges to this practice is the sheer scale of the data to be collected, stored and analyzed from just one person. For example, we know that just one individual’s microbiome layer alone generates around 3 Terabytes of data – the equivalent to 3,000 copies of the entire Encyclopedia Britannica.
We may need between 15-20 Terabytes to capture data from all 10 layers, and remember, that’s every time we gather it. Individuals naturally change over time, and we may want to collect data at several life stages from “womb to tomb”.
The implications of future capacity to digitize human bodily data are many and far reaching when it comes not only to healthcare interventions, but in preventions helping them stay well for longer.
Clearly the data can help suggests ways to eat, drink, exercise, socialize and adopt a given lifestyle in other ways. It is also hugely significant in terms of crafting individualized medicine regimes in the future, including taken steps ahead of time to prevent disease and using only drugs that are a complete and appropriate “fit” with the patient when he or she does fall ill.
It should be noted that we should not forget the brain and its nervous system’s role in our overall health over a lifetime – or perhaps what we might call the “neurome”, which may have its own multi-layer system that we need to consider separately. But that’s perhaps the subject of a future article.
CEO-RX4 Group-The Business of Healthcare
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