Systems Biology-Based Diagnostic Principles as Pillars of the Bridge between Chinese and Western Medicine

Abstract

Introduction !The health care system in Western societies and one of its pillars, modern medicine, are increasingly under debate. The increasing costs of health care are reaching the level where it will not be sustainable in the near future. Recent estimates for the US health care system show an increase from 17% of the gross domestic product (GDP) in 2009 to over 20 % of the GDP in 2018, when the total cost will reach US $ 4.35 trillion [1]. At the same time, hopes for developing medicines that are more effective are fading away, since the pharmaceutical industry produces fewer new chemical entities (NCEʼs) that reach the market every year. In this era, crucial global issues have surfaced in various domains, including the financial, ecological, political, educational, religious/spiritual, and social realms. Mechanisms that previously functioned effectively must be replaced by new approaches. These challenges are not local, but global, and system thinking will be mandatory in the future. In such times of change, one must reflect and focus on the driving force of the system that needs to evolve. In health care, there must be a shift from an emphasis on economics, technological developments and political agendas back to a patient-centred health care environment. In health care, the paradigm of system thinking has emerged as systems biology. It is limiting to develop interventions on how a single compound interacts with a single target that is linked to a specific symptom. This "one-drug-fits-all" paradigm has shifted to an idea that patients require personalized medicines. Some successful examples have been used to treat cancer, including Herceptin ® (trastuzumab), Gleevec ® (imatinib mesylaat) and Iressa ® (gefitinib). However, a thorough systems approach has not yet been applied to design new drugs. Moreover, the patient is not yet seen as a unique individual. Treatments focus on a disease or a disease phenotype rather than the person, even though effective treatments rely on a proper systems diagnosis. In this paper, we describe how the global nature of challenges must be recognized to develop global solutions. These solutions must integrate diverse concepts and intuition to bring about a Abstract ! Innovative systems approaches to develop medicine and health care are emerging from the integration of Chinese and Western medicine strategies, philosophies and practices. The two medical systems are highly complementary as the reductionist aspects of Western medicine are favourable in acute disease situations and the holistic aspects of Chinese medicine offer more opportunities in chronic conditions and for prevention. In this article we argue that diagnosis plays a key role in building the bridge between Chinese and Western medicine. Recent advances in the study of health, healing, placebo effects and patientphysician interactions will be discussed pointing out the development of a system-based diagnosis. Especially, a system biology-based diagnosis can be used to capture phenotype information, leading towards a s...

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