Transcript Health, Disease, and Treatment, a Systems Perspective

Mattie Robinson, MS, MA
INCOSE – Orlando Chapter
Feb 18 2016
• Overview of Medical Doctrines
• Genetics Terms
• A Systems View of Sickle Cell Disease
• A Systems View of Cancer
Microflora (gut, skin)
Environment
Nutrients
Lifestyle
Western
(United States)
Traditional
Medicine
Folk
Medic
Holistic
(Europe)
Ayurveda
(India)
Western Medicine (United States)
•Comparatively new system of medical education and practice
•Used throughout North America, Europe, and a growing number of developing
countries
Ayurveda (Traditional Indian Medicine)
•Individualized treatment based on the balance of body fluids and other factors within
each patient.
•Interventions are primarily herbal, dietary, and lifestyle interventions.
Eastern Medicine (Traditional Chinese Medicine)
•Ancient systems of integrated medical practice
•Used throughout Asia, Chinese medicine is most well known
Folk Medicine
•Community-based models, rely on spiritual as well as herbal and lifestyle treatments*
•Practiced in a variety of socioeconomic settings, from remote tribes to enclaves within
large cities (New Orleans)
Minimized the preceding models to pinpoint individual
symptoms and syndromes for treatment
•Practitioners see hundreds to thousands of patients with
whom they have little to no personal relationship
•In US, primarily focused on pharmaceutical intervention
• Diagnostics and treatments are highly standardized
•Only individual differences with an immediate impact are considered when
prescribing treatment (ie: allergies, drug intolerances)
•Metrics are used to quantitatively track therapeutic progress
•Even patient responses are gauged in a quantitative fashion
“The greatest mistake in the treatment of
diseases is that there are physicians for the
body and physicians for the soul, although the
two cannot be separated.”
Plato
• The rise of molecular genetics brought a new
understanding of the human system.
• The current trend shifts the focus to molecular
medicine
• Genetic testing is relied on to:
•
•
Characterize a patient
Predict successful therapies
Different sequences, same meaning
11 Molecules
Hemoglobin
T
11
BCL11A
HS1L &
MYB
TOX
SAR1A
FCPL
•A single base can be crucial to the function of a
gene
•Each person with SCD is genetically unique
•The HbS allele only tells part of the story
•Variation at other locations in the genome can
alter the severity of a disease mutation
•Many cancers have genetic alterations that
ramp up growth signaling pathways
•Because of the rapid, uncontrolled growth of
cancer cells, tumors accumulate replication
errors over time
Many cancers have genetic alterations that ramp
up growth signaling pathways
Because of the rapid, uncontrolled growth of
cancer cells, tumors accumulate replication
errors over time
Previously the only therapies available for
cancer patients were
•Chemotherapy
•Radiation therapy
•Surgery
• A growing knowledge of the molecular basis of
cancer paved the way toward targeted therapies.
• Functions that are crucial to cancer cells are shut
down, thereby sparing the patient’s healthy cells.
•
•
Populations of cancer cells continue to evolve as they
replicate.
With time, cancer cells may even “outsmart” a previously
effective therapy
• Cancer is a collection of genetically unique
diseases
• Cancer starts with one mutated cell, but
continues to evolve over time
• Cell signaling is often altered in cancer cells;
new cancer drugs are being developed to target
these alterations
Johns Hopkins Hospital
National Institutes of Health