P4 Medicine Revolution
Diseases requiring medication
“P4” stands for powerfully predictive, personalized, preventative – meaning physicians will shift the focus to wellness–and participatory in medicine. Individual genomes will become a standard of medical records, and we will have the power to make inferences [about an individual’s health] when combined with phenotypic information. Then we can begin to plan strategies for individual health care in ways we have never done before. Nanotechnology approaches to protein measurement–such as measuring 2,500 proteins from a drop of blood–will also be important. We want to develop tests to asses 50 organ-specific proteins from 50 organs as way of interrogating health rather than disease.
The third technology that is going to be transformational is the ability to get detailed analysis from a single cell. We can analyze transcriptomes and RNAomes, proteomes and metabolomes [the collection of transcribed genes or messenger RNA, total RNA, proteins and metabolites, respectively, in the cell]. That information will reveal quanti cellular states that will say lots about normal mechanisms and disease mechanisms. For example, we are doing an experiment now where we take 1,000 cells from glioblastomas [a type of brain tumor] and select transcripts from each of those cells. We’re discovering interesting new things about what constitutes a tumor.
The final driver is going to be computational and mathematical tools, the ability to deal with data dimensionality that is utterly staggering. If we have patients with billions of data points, being able to compare that with individual genotype-phenotype correlations will give us deep and fundamental new insights into predictive medicine. But the challenge is, where will we get the cycles to make those computations and where will we get storage for all this data?
the P4 medicine revolution has two enormous societal consequences. It will absolutely transform the business plans of every sector of health care. It will lead to digitization of medicine, the ability to get relevant data on a patient from a single molecule, a single cell. In time, the costs of health care will drop to the point where we can export it to the developing world.