Personalized health care or PHC is a structure of care that uses predictive technologies together with a patient-centered approach to health care. Unlike the current care structure, it focuses on the patient including shared decision-making through patient engagement. Such a system may seem to be one of a distant future from the perspective of the medical community. However, from a technological point of view, we are already there and are simply waiting for the medical community to catch up with the progress. The biggest change towards personalized health care is to change the perception of health care as a whole. This perception is one that changes the approach from ‘one-fits-all’ to investigating personalized approaches that benefit every patient individually based on their unique biology.
Such a system will also bring changes to the methodology of treatment by addressing the cause rather than addressing the symptoms of the condition. And lastly, gives the opportunity to view the patient in a holistic manner. For many decades, the medical practice has grown more and more specific. You find a specialist for every inch of the body, yet less importance is given to the overall system of the patient. Technological advancements have given us the opportunity to become aware of just how crucial it is for the body to be a balanced working organism. Technology is non-bias, not commercially driven, and surpasses the capabilities of any human. These advancements, unlike before, can open doors to restructuring the current system which is broken and outdated.
Personalized Health Care
Viewpoints on human beings & health care
Before going into the specifics of what personalized health care has to offer, it is important to understand the viewpoints or perceptions of human beings from experts working in different fields of science. Whilst medical professionals are known for their very niche knowledge on specific parts of the human anatomy, biologists and microbiologists by profession, focus on a holistic view of organisms within an ecosystem. The two perceptions play a crucial role in understanding how a pathogen or condition is addressed.
In the majority of cases, medical professionals present the human being as a very complex organism, resulting in many knowing a lot about something specific, and a little about the holistic system of the human body. Microbiologists do not single out the human being from the rest of the organisms living on the planet. If anything, they acknowledge that all life forms follow a common plan or program, whether they are referring to a microbe or a human. They also recognize that balance is key and in order to achieve balance, one must look at what the potential repercussions may be on the whole ecosystem (the human body) if certain actions are taken in eliminating or replacing a member of the existing ecosystem. This viewpoint alone changes the way one addresses pathogens that cause disbalance and discomfort to an individual.
They also view an individual as an entire ecosystem of its own eliminating the ‘one-fit-all’ approach, taken on by the medical community. The acknowledgment that every human being has their unique microbiome, introduces the concept of a personalized approach towards every human being. The only concept which is a rule for all humans and other organisms alike is that balance is key to a healthy being. However, the achievement of that balance is entirely dependent on each organism individually.
Prediction in personalized health care
From October 1990 till April 2003, the Human Genome Project was able to map out the first blueprint of a human being, the genome. The estimated cost of the initial ‘draft’ is said to be approximately $300 million and the refined ‘finished’ human genome sequence had an approximate cost of $150 million.
With today’s technological advancements, not only has the cost of sequencing a whole genome dropped significantly but there are several services anyone can choose from to sequence their own DNA. Although genome sequencing is indeed complicated, little research can supply anyone with a lot of information.
Some of the main reasons someone would opt into sequencing their genome are:
- To get a blueprint of who they are and find out which genes are present to be prepared or prevent certain medical conditions.
- To get a deeper understanding of rare genetic conditions.
- To get insights into their unique makeup and ancestry.
Genome sequencing can help anyone get a better understanding of themselves, both from a biological perspective as well as medical. There is no one on this planet that is perfect or 100% healthy. We all have something that can either in time or under certain circumstances, turn into a condition that can drastically change our life. An understanding of your genetic makeup can help prevent, prepare and even give an insight on the best course of therapy that can specifically help you, depending on your unique biology.
The whole-genome sequencing by Nebula Genomics provides 2 sequencing tests:
30x Whole Genome Sequencing
Decoding 100% of your DNA at 30x coverage with the use of next-generation DNA sequencing technology.
100x Whole Genome Sequencing
Decoding 100% of your DNA at 100x coverage with the use of next-generation DNA sequencing including the discovery of rare genetic mutations.
Results from both packages include:
- Your whole-genome sequencing data as downloadable files: FASTQ, BAM, and VCF.
- Personalized reports.
- Unlimited use of genome exploration tools.
- Access to deep ancestry analysis.
- Premium support from geneticists.
Prevention in personalized health care
The study of the microbiome has created a 360-degree view on health, recognizing every patient as an individual ecosystem that thrives when it is balanced. As opposed to perceiving a patient as a statistic and destroying a pathogen at all costs, even if the cost will cause further damage to the patient’s own ecosystem. The medical community is still catching up to such a concept, yet published research from all across the globe has shown that so many conditions stem from a certain imbalance in the microbial community within the overall system.
The microbiome, unlike the genome, is constantly changing in every person. Technology now allows us to track changes within the microbiome and by doing so, gives us an overview of the causes of disbalance and practical approaches to bring the microbiome into harmony.
With the use of technology, Viome provides people with a detailed picture of the state and composition of their gut microbiome. They provide two test kits, one that focuses on just the gut microbiome and another which gives a broader view of the gut microbiome and together with analysis of your genetic makeup.
Gut Intelligence test
This test gives a comprehensive breakdown of your gut microbiome to help you understand the microscopic community in your gut. The gut microbiome plays a crucial role in how other parts of your body function, making it the key indicator for any disbalance.
Results from this test include:
- A complete health analysis based on the gut microbiome.
- Your own personalized 90-day nutrition plan.
- Your personalized supplement recommendations.
Health Intelligence test
This test includes an even broader spectrum of information. Apart from providing you with the information in regards to your gut microbiome (the Gut Intelligence test), it also uses broader analysis such as; microbial gene expression, human gene expression, and mitochondrial gene expression, providing you with insights into many other aspects of your health.
Results from this test include:
- A complete health analysis of the gut microbiome, cellular health, immune health, biological age, and stress response.
- Your unique nutrition plan including a list of foods to benefit your biology.
- Your personalized supplement recommendations; probiotics and prebiotics, specifically for your biology.
Skin, being the largest organ and being the primary barrier between the external world and our internal environment, plays a huge role in creating a bridge between the two environments. Research into the skin microbiota of communities untouched by modern developments, such as the Yanomami tribe, revealed that their skin microflora is very different from ours. Unlike us, they have never exposed their skin to harsh detergents and anti-bacterial soaps, resulting in the killing of microbes that resided on the surface of the skin. Good bacteria and phages that originally formed part of the skin micro-community to protect our skin, have been irradicated from our skin, leaving our skin exposed and defenseless.
Some brands try to help restore the most common good bacteria and phages that we have destroyed:
- Mother Dirt: restoring ammonia-oxidizing bacteria (AOB) in our skin flora.
- Phortify Probiotic Serum: restoring balance to good C. acnes bacteria using C. acnes bacteriophages, to help minimize and prevent acne skin.
Understanding the current state of your skin microbiome can help you begin your journey in restoring the flora. This will help prevent conditions from occurring, as well as aid in developing and strengthening the barrier organ, your skin.
Sequential Skin also utilizes technology that helps give people insights and a deep understanding of the state of their skin microbiome. Their test kit gives an in-depth breakdown to help you understand the current state of your skin.
Results from this test include:
- A complete analysis of your skin microbiome, including skin’s health through studying the unique relationship between your genes and your skin microbiome.
- Personalized recommendations based on your biology.
- Products that suit you personally, down to the best active ingredients.
- Improvement measures to build up healthy balanced skin with repeat testing.
Precision in personalized health care
Essentially, precise personalized health care takes a microscopic view of both the hereditary and environmental aspects of every individual. Whilst the genomic makeup helps understand the qualities the person is born with, the microbiome can give a current view of the person’s microbial community, which together, can help give insights on what may be causing a disbalance in their body. There is no such a thing as a perfect microbiome, however, there is a possibility to achieve a uniquely healthy and balanced environment for every person individually.
It is important to understand that nothing goes to waste in the human body. When one organism is diminished, another either takes its place or the existing organisms distribute the territory amongst themselves. The key is to maintain a balance within the environment by making sure a pathogenic organism does not cause a disbalance in the territory or environment. One practice that is overlooked by medical practitioners is not to simply test for the presence of a pathogen, but rather, to test the population ratio of the pathogen in comparison to all the organisms found in a sample. When taking into account that everyone’s body is a unique environment and that health is achieved when there is a balance in this environment, analyzing the proportions of all those who make up this environment is crucial.
Genes and precision care
Although your genes do not change throughout our lifetime, unless specifically modified, they can still give us a good understanding of the mechanisms we are born with. Some of these mechanisms can be crucial when it comes to treatment.
Gene CYP450 Cytochrome P450
It is not common practice for doctors to run gene tests into specific genes prior to prescribing medication. In some cases where medication needs to be taken for a long time prior to showing any signs of its success or failure, the patient must take the risk of taking medication that may not be effective. The effectiveness of medication does not only rely on the group of medication but also on the correct dosage for that particular patient. In addition to this, many of the medications that need to be taken for a long period of time which may not be effective, may also no longer be accepted by the body. This forces the patient to have to switch to another group of medications and start the process all over again.
The dosage that is commonly used for medication is also something that is unreliable. It is based on the average statistics of a specific condition, without taking the unique genetic makeup of each individual into consideration. This statistical approach ignores the system as a whole, which also means that it ignores the very unique parts of the genetic makeup that can give insights into which medication will particularly work for a patient and in what dosage.
The cytochrome P450 which includes the CYP2D6 enzyme is responsible for the processing of medications such as the majority of antidepressants and antipsychotics. Variations in gene CYP450 can offer a lot of insight into how your body responds to a particular antidepressant or antipsychotic. Further, with this knowledge, the patient can avoid a trial-and-error approach. Instead, the correct type of medication and its correct dosage for that particular patient can help eliminate any blinded treatments.
Therapies catered for a patient
The lack of a holistic approach in the treatment of patients leads to every specialist treating parts of the body which they specialize in, and dismissing the effects on the overall system. This is very well seen with the use of antibiotics. This ‘one-fits-all’ approach of therapy has certainly shown failure in the long run. Antibiotic resistance is a separate topic altogether, but simply put, antibiotics are like throwing gasoline and setting fertile land on fire to get rid of one small weed. Such an approach causes devastating consequences to the entire system in the long run and the boundaries of such an approach should certainly remain within extreme cases.
Bacteriophages and Phage therapy
Nature, as perfect and balanced as it is, has actually given bacteria a natural, type-specific bacterial enemy; bacteriophages. They are not interested in any other life form but its targeted bacteria. Bacteriophages, or phages, have become of great interest in a diversity of fields; medicine, wellness, animals, aquaculture, agriculture, food packaging, and even in the environment. They were discovered back in 1915 and 1917 by Frederick Twort and Felix d’Herelle independently. Bacteriophage therapy was abandoned in the 1940s after antibiotics came into the picture. This happened not because of the lack of their efficiency or safety, but because antibiotics were easier to produce and distribute.
There are many studies currently being done into bacteriophages primarily due to the rise in antibiotic resistance. Bacteriophages are some of the most unique organisms that have worked in the shadows to maintain nature’s balance within the micro and macro environments. Their ability to help establish balance within a given environment is the most fascinating aspect of their biology.
Phages are viruses commonly known for their natural ability to target and destroy strain-specific bacteria, leaving other organisms, and human cells untouched. It is important to understand that these are not simply bacterial assassins that can replace antibiotics, phages are a lot more than that. They have the ability to analyze a disproportion in a given environment, such as; an overgrowth of bacteria that they specifically target. Once a disbalance is detected, lytic bacteriophages switch to their strain-specific bacteria targeting mechanism. They do not destroy all the bacteria, only enough to establish a balance within the given environment. We are just beginning to scratch the surface on the importance of bacteriophages in the environment, and essentially, to aid us in our wellbeing.
Some of the more popular bacteriophage research that is being looked into:
- Phage cocktails: a wide range of phages to help maintain a balanced microbiome.
- Individual phage therapy: specific phages picked out for a patient after a culture is taken from a patient and a matching phage is found.
- Genetically modified phages and synthetic phages: modified phages that have a diversity of characteristics unlike natural phages such as; specific medical delivery systems commonly targetting specific proteins.
With every new technological advancement, personalized health care is becoming more and more tangible. For many decades, health care has been taking the shape of a business rather than a life science. Health and business do not walk hand in hand; from the two, only one is vital. Health should be placed as a priority, and businesses, along with regulations, must follow and adjust to it, not the other way round. It is the patients who are the foundation and reason for the health care system and are, ironically, found at the bottom of this elaborate pyramid. Personalized health care gives each individual the resources to understand themselves. It aids in painting a picture of their unique system and most importantly, gives the patient an element of control and understanding that the current health care system has taken away from them. It also bridges the gap between the general public and the closed-off medical community, plateauing the pyramid system that has benefitted the few and failed so many. Today, more than ever, the world is able to witness just how crippled the health system is from all angles. On the bright side, with the help of technology, we may soon witness the health care system return into the field of life sciences and see the full formation of a system based on personalized health care.