1. Integra(on of dierent perspec(ves in medicine Jan Schron MSc, OMD

2. As the 20th century was the centuryof the revolution of physics, the 21stcentury will be the century of therevolution of life science.For medicine it will mean a shiftfrom primarely curative to primarelypreventive and from generaltreatments to personalizedmedicine Prof. Dr. Jan van der Greef Universiteit Leiden

3. Systems Biology, towards personalized fingerprints Systems Biomarkers Transcripts InformaticsTissue Proteins Proteins Pathways System Metabolites Knowledge Cell Organism Measurement Analysis Interpretation Systems cannot be understood by studying fundamental constituents, the properties of the parts are not intrinsic but can be understood within the context of the whole Slide 3

4. Preven(ve What is health?

5. Are there opportunities to bring the system back in homeostasis? Health Reversible pathology Irreversible pathology Disease management Symptom focus Disease Health Promotion Improve resilience Healthy Changes in pathway dynamics to maintain homeostasis

6. Personalized We need to get the right drugs to the right pa(ents(right route, right dose, right (me)

7. Treating the right patients with the right medicine Approach : Current drugs + improved diagnosisEmpirical Medicine Treatment a Treatment b Treatment cBiomarker-Guided Medicine Treatment b Treatment a Biomarker-guided therapy Treatment c Slide 7

8. Dynamic Systems Theory In studying self-organizing systems a shi5 in focus occurs: From objects to rela(onships Mapping of paIerns From quan(ty to quality of rela(onships

9. How to design an intervention for a complex system? Current paradigm: Monotherapy 1 disease 1 target 1 drug fits all Blockbuster approach Systems Theory : The scale and complexity of the problem and solution should match Prof. Dr. Yaneer Bar-Yam New England Complex Systems Institute New paradigm : Integrated Intervention Life style, nutrition, medicine (multi-dimensional pharmacology) and psychology Slide 9

10. John N. Wareld professor Emeritus, George Mason University, USA basis for stopping some of the bad pracGces in systems science community Underscoping the Systems Domain Unimagina(ve Workspaces Mismatched Media Linguis(c Pollu(on Premature Quan(ca(on Insensi(vity to Discovered Behavioral Pathologies Inadequacy of Comparisons of Alterna(ves Blindness to History Monotonous Bifurca(on

11. Blindness to History Some people thought about systems long ago. There seems to be a strongly entrenched belief that systems thinking originated in the last half of the twen(eth century. Virtually every important concept that backs up the key ideas emergent in systems literature are found in ancient literature and in the centuries to follow. It is (me to recognize the contribu(ons of these elder scholars and factor them into systems science where their presence is absolutely essen(al to a mature science. an introduc(on to systems science

12. 3 tradi(onal systems Ayurveda Tradi(onal Chinese Medicine Unani

13. If the only tool you have is a hammer, you tend to treat everything as if it were a nail.Abraham Maslow (1908-1970)

14. New Medicine based on systemofbiology! New theoretical and clinical approach medicine! Sciences Western Chinese Sciences Medicine Medicine Western Chinese philosophy philosophy of Science of Science Western philosophy Chinese philosophy Western culture Chinese culture Origin of Man

15. The Binocular dilemma of Master Yuen Yongli

16. Diagnosis development stepwise strategy ? One-size-fits-all Stratified/Individualized Care Symptom/Signs Molecular pathology Personalized Health Care Ecosystem Symptom/Signs Molecular pathology fingerprint @ Life style @ Psychology/Consciousness Environment, Nutrition Medicine Subtype B Subtype ADisease - symptom management Targeted care disease phenotype focus Patient Wellness focus1 disease -1 target 1 (block buster) drug theranostics related to efficacy and adverse effects Integrated systems approach Slide 17

17. Systems biology guided byTraditional Chinese Medicinereveals new diagnostic markersfor rheumatoid arthritis A China Dutch joint project of the Sino-Dutch center for Personalized and Preventive Medicine Herman van Wietmarschen LACDR, Analytical Biosciences 18

18. The ongoing sub-typing of MSX/Diabetes2 project- System Biology based development ofdiagnostic biomarkers for Diabetes type 2 A China Dutch joint project of the Sino-Dutch center for Personalized and Preventive Medicine Koko Wei PhD student Sino-Dutch Centre, TNO 19

19. Acknowledgment Acknowledgment Jan van der Greef Wang Mei Wei Koko Jan van der Wietmarschen Mei, Koko Wei, Carina Rubingh, Herman van Greef, Wang Eduard vanPasman, Nicole Cnubben, Herman van Wilrike Wijk Everine van der Kraats Kistemaker of the Sino-Dutch Wietmarschen, Cor Roel van Wijk Centre for Preventive and Personalized ResearchWang Xinlu and TNO MedicineMaster Yuen YongliAnd Yang Yifang Ph.D.; Albert van Dinteren M.D.