System Medicine Approaches for the Definition of Complex Phenotypes in Chronic Diseases and Ageing. From Concept to Implementation and Policies

System Medicine Approaches for the Definition of Complex Phenotypes in Chronic Diseases and Ageing. From Concept to Implementation and Policies

Bousquet J; Jorgensen C; Dauzat M; Cesario A; Camuzat T; Bourret R; Best N; Anto JM; Abecassis F; Aubas P; Avignon A; Badin M; Blain H; Bourdin A; Bringer J; Camu W; Cayla G; Costa DJ; Courtet P; Cristol JP; Demoly P; de la Coussaye JE; Fesler P; Gouzi F; Gris JC; Guillot B; Hayot M; Jeandel C; Jonquet O; Journot L; Mathieu G; Morel J; Ninot G; Pelissier JY; Picot MC; Rabier-Pontal F; Robine JM; Rodier M; Sultan A; Wojtusciszyn A; Auffray C; Balling R; Barbara C; Cambon-Thomsen A; Chavannes NH; Chuchalin A; Crooks G; Dedeu A; Fabbri LM; Garcia-Aymeric J; Hassan J; Gomes EM; Palkonen S; Piette F; Pison C; Price D; Samolinski B; Schunemann HJ; Sterk PJ; Yiallouros P; Roca J; Perre PV; Mercier J

Current Pharmaceutical Design

2014

Chronic diseases are diseases of long duration and slow progression. Major NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, rheumatologic diseases and mental health) represent the predominant health problem of the Century. The prevention and control of NCDs is the priority of the World Health Organization 2008 Action Plan, the United Nations 2010 Resolution and the European Union 2010 Council. The novel trend for the management of NCDs is evolving towards integrative, holistic approaches. NCDs are intertwined with ageing. The European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has prioritised NCDs. To tackle them in their totality in order to reduce their burden and societal impact, it is proposed that NCDs could be considered as a single expression of disease with different risk factors and entities. An innovative integrated health system built around systems medicine and strategic partnerships is proposed to combat NCDs. It includes (i) understanding the social, economic, environmental, genetic determinants, molecular and cellular mechanisms underlying NCDs; (ii) primary care and practice-based interprofessional collaboration; (iii) carefully phenotyped patients; (iv) development of unbiased and accurate biomarkers for co-morbidities, severity and follow up of patients; (v) socio-economic science; (vi) development of guidelines; (vii) training; and (viii) policy decisions. The results could be applicable to all countries and adapted to local needs, economy and health systems. This paper reviews the complexity of NCDs intertwined with ageing. It gives an overview of the problem and proposes two practical examples of system medicine applied (MeDALL) to NCD co-morbidities (MACVIA-LR).

2014-03

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