The Wearable, Implantable, Personalized Future Of Medicine

ecology of 20 sites on the human body targeted for analysis of microbial genome sequencing. (Photo credit: Wikipedia)

As doctors and scientists continue to make huge leaps in terms of genome sequencing and scanning devices, everything about your medical treatment is going to change.

As a child, you could always count on it, even after–especially after–you struck out playing T-ball, forgot your only line in the grade school play, and came home with chalk in your nose because you took the schoolyard dare. No matter what, your mom would hug you and tell you that you were special. Turns out, she was right.

Each of us is special and unique among the roughly seven billion humans on this planet. We are the walking, talking instantiation of the three billion instances of four nucleotides (abbreviated GATC) that constitute our unique genome’s DNA. Equally importantly, the interplay of that DNA with the environment and our individual lifestyles determines our susceptibility and predisposition to diseases.

Suppose you’re now middle aged and chest pains send you to a physician. You can’t change your genetic profile; it’s your parents most basic and lasting gift. However, that fondness for double bacon cheeseburgers and butter pecan ice cream, and an exercise regime that is all-too-frequently limited to wistful looks at the running shoes in your closet, both have consequences. That’s why your mother also warned you to eat your vegetables and wash your hands, not that you listened.

Today, your physician would run diagnostic tests, compare your current health and test results to that of a typical human of your age and gender, and treat your disease accordingly. Even though you’re special, today’s medical treatment is still generic. Therein is the problem. You are custom made, with a unique combination of lifestyle, environment, exercise patterns and food preferences. Although your nominal genetic profile is determined at conception, which genes are expressed (turned on) varies across organs and even with lifestyle and diet. Hence, it is not surprising that your reactions to a medical treatment may be quite different from another individual with the same test results.

That is all about to change. What biologist Leroy Hood has called P4 medicine–predictive, preventive, personalized and participatory–is tantalizingly near. The building blocks of that future are a deeper understanding of biological processes and continued advances in mobile sensors and big data analytics. Let’s imagine the future, one where you really are special.

Your physician will compare your current health to the best possible baseline. That would be you, but you in the best physical and mental condition of your life. Perhaps you were 25, at your optimum weight, exercising regularly, getting plenty of sleep, and eating a well-balanced diet (those vegetables again). Your physician would then tailor your treatment based on a detailed understanding of your genetic profile and gene expression, your current lifestyle and environment, and your body’s specific reactions to the prescribed treatment.

Continued advances in microfluidics, nanotechnology, microelectronics and robotics are rapidly reducing the cost of genome sequencing and metabolic characterization. Just a decade ago, the Human Genome Project spent over $3 billion to sequence one genome. Today, that same process costs just a few thousand dollars. In a few years, sequencing and metabolic analysis will be a routine diagnostic test costing just few hundred dollars. Everyone will know how their biological engine is working, and how it compares to that magical time when they were 25.

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