Precision/personalized medicine is a hot topic in health care. Often presented with the motto "the right drug, for the right patient, at the right dose, and the right time," precision medicine is a theory for rational therapeutics as well as practice to individualize health interventions (e.g., drugs, food, vaccines, medical devices, and exercise programs) using biomarkers. Yet, an alien visitor to planet Earth reading the contemporary textbooks on diagnostics might think precision medicine requires only two biomolecules omnipresent in the literature: nucleic acids (e.g., DNA) and proteins, known as the first and second alphabet of biology, respectively. However, the precision/personalized medicine community has tended to underappreciate the third alphabet of life, the "sugar code" (i.e., the information stored in glycans, glycoproteins, and glycolipids). This article brings together experts in precision/personalized medicine science, pharmacoglycomics, emerging technology governance, cultural studies, contemporary art, and responsible innovation to critically comment on the sociomateriality of the three alphabets of life together. First, the current transformation of targeted therapies with personalized glycomedicine and glycan biomarkers is examined. Next, we discuss the reasons as to why unraveling of the sugar code might have lagged behind the DNA and protein codes. While social scientists have historically noted the importance of constructivism (e.g., how people interpret technology and build their values, hopes, and expectations into emerging technologies), life scientists relied on the material properties of technologies in explaining why some innovations emerge rapidly and are more popular than others. The concept of sociomateriality integrates these two explanations by highlighting the inherent entanglement of the social and the material contributions to knowledge and what is presented to us as reality from everyday laboratory life. Hence, we present a hypothesis based on a sociomaterial conceptual lens: because materiality and synthesis of glycans are not directly driven by a template, and thus more complex and open ended than sequencing of a finite length genome, social construction of expectations from unraveling of the sugar code versus the DNA code might have evolved differently, as being future-uncertain versus future-proof, respectively, thus potentially explaining the "sugar lag" in precision/personalized medicine diagnostics over the past decades. We conclude by introducing systems scientists, physicians, and biotechnology industry to the concept, practice, and value of responsible innovation, while glycomedicine and other emerging biomarker technologies (e.g., metagenomics and pharmacomicrobiomics) transition to applications in health care, ecology, pharmaceutical/diagnostic industries, agriculture, food, and bioengineering, among others.

中文翻译：

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深入研究精密/个性化医学：破解糖法，生命的第三个字母和细胞的社会重要性。

精准/个性化医学是医疗保健领域的热门话题。精确医学常常以“为合适的患者，合适的剂量，合适的时间为合适的患者提供合适的药物”为座右铭，它是合理治疗的理论，也是个性化健康干预措施（例如药物，食品，疫苗）的实践。 ，医疗器械和锻炼程序）。但是，一个外星球的访客阅读现代诊断学教科书时可能会认为，精确医学只需要文献中不存在的两种生物分子：核酸（例如DNA）和蛋白质，分别被称为生物学的第一和第二个字母。但是，精密/个性化医学界往往对生命的第三个字母“糖代码”（即存储在聚糖中的信息，糖蛋白和糖脂）。本文汇聚了精密/个性化医学科学，药物糖组学，新兴技术治理，文化研究，当代艺术和负责任的创新方面的专家，以对三个生命字母的社会物质性进行批判性评论。首先，研究了目前使用个性化糖医学和聚糖生物标志物进行靶向治疗的转变。接下来，我们讨论为什么解开糖代码可能落后于DNA和蛋白质代码的原因。尽管社会科学家从历史上就注意到了建构主义的重要性（例如，人们如何解释技术并将其价值，希望和期望建立到新兴技术中），生命科学家依靠技术的材料特性来解释为什么某些创新迅速出现并比其他创新更受欢迎。社会物质性的概念通过强调社会与知识的内在纠缠和物质对知识的内在纠缠以及从日常实验室生活中呈现给我们的现实而融合了这两种解释。因此，我们提出一个基于社会材料概念的假说：因为聚糖的重要性和合成不是直接由模板驱动的，因此比有限长度基因组的测序更为复杂和开放，因此对社会的期望得到了社会建构。糖代码与DNA代码的发展可能有所不同，分别是未来不确定性和前瞻性，因此有可能解释“糖滞后” 在过去的几十年中从事精密/个性化医学诊断。最后，我们向系统科学家，医生和生物技术行业介绍负责任创新的概念，实践和价值，而糖医学和其他新兴生物标记技术（例如宏基因组学和药物微生物组学）已过渡到医疗保健，生态学，药物/诊断学领域工业，农业，食品和生物工程等等。