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Facing multimorbidity in the precision medicine era.
Mechanisms of Ageing and Development ( IF 5.3 ) Pub Date : 2020-06-17 , DOI: 10.1016/j.mad.2020.111287
Graziano Onder 1 , Roberto Bernabei 2 , Davide L Vetrano 3 , Katie Palmer 4 , Alessandra Marengoni 5
Affiliation  

The clinical picture of multimorbidity is heterogeneous and it is characterized by great complexity. Precision medicine is an innovative approach to provide personalized care focused on individual characteristics and to deliver the right treatments, at the right time, to the right person. The precision medicine approach, which represents an epochal change in the field of chronic diseases, has been poorly implemented in patients with multimorbidity. Several factors can limit this application. First, the precision medicine approach has been successfully applied in the treatment of mono-factorial diseases while multimorbidity is multifactorial. Second, there is lack of understanding of risk factors in the development and evolution of multimorbidity. Third, precision medicine is mainly focused on understanding genetic aspects of diseases and neglects other characteristics contributing to the definition of individual profiles. Finally, individual pathways may lead to the development of different multimorbidity phenotypes. A possible solution to simplify the application of precision medicine to this condition is to reduce its complexity and to find homogeneous patterns of chronic diseases that may work as targets of preventive and therapeutic strategies. This approach can lead to better understanding how these factors interact at individual level and to define interventions that might target multimorbidity.



中文翻译:

面对精准医疗时代的多发病。

多发病的临床表现是异质的,其特点是非常复杂。精准医疗是一种创新方法,可提供针对个人特征的个性化护理,并在正确的时间为正确的人提供正确的治疗。代表慢性病领域划时代变革的精准医疗方法在多发病患者中的实施效果不佳。有几个因素会限制这种应用。首先,精准医学方法已成功应用于单因素疾病的治疗,而多发病是多因素的。其次,对多发病的发展和演变中的风险因素缺乏了解。第三,精准医学主要侧重于了解疾病的遗传方面,而忽略了有助于定义个体特征的其他特征。最后,个别途径可能导致不同的多发病表型的发展。简化精准医学在这种情况下的应用的一个可能解决方案是降低其复杂性,并找到可能作为预防和治疗策略目标的慢性疾病的同质模式。这种方法可以更好地了解这些因素如何在个体层面相互作用,并确定可能针对多种疾病的干预措施。简化精准医学在这种情况下的应用的一个可能解决方案是降低其复杂性,并找到可能作为预防和治疗策略目标的慢性疾病的同质模式。这种方法可以更好地了解这些因素如何在个体层面相互作用,并确定可能针对多种疾病的干预措施。简化精准医学在这种情况下的应用的一个可能解决方案是降低其复杂性,并找到可能作为预防和治疗策略目标的慢性疾病的同质模式。这种方法可以更好地了解这些因素如何在个体层面相互作用,并确定可能针对多种疾病的干预措施。

更新日期:2020-06-23
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