Embracing Complexity beyond Systems Medicine: A New Approach to Chronic Immune Disorders

被引:24
作者
te Velde, Anje A. [1 ]
Bezema, Tjitske [2 ]
van Kampen, Antoine H. C. [3 ,4 ]
Kraneveld, Aletta D. [5 ,6 ]
't Hart, Bert A. [7 ,8 ,9 ]
van Middendorp, Henriet [10 ]
Hack, Erik C. [11 ]
van Montfrans, Joris M. [12 ]
Belzer, Clara [13 ]
Jans-Beken, Lilian [14 ]
Pieters, Raymond H. [6 ,15 ]
Knipping, Karen [5 ,16 ]
Huber, Machteld [17 ]
Boots, Annemieke M. H. [18 ]
Garssen, Johan [5 ]
Radstake, Tim R. [19 ]
Evers, Andrea W. M. [10 ]
Prakken, Berent J. [20 ]
Joosten, Irma [21 ]
机构
[1] Acad Med Ctr, Tytgat Inst Liver & Intestinal Res, Amsterdam, Netherlands
[2] Immunowell Fdn, Utrecht, Netherlands
[3] Acad Med Ctr, Bioinformat Lab Clin Epidemiol Biostat & Bioinfor, Amsterdam, Netherlands
[4] Univ Amsterdam, SILS, Biosyst Data Anal, Amsterdam, Netherlands
[5] Univ Utrecht, Fac Sci, Utrecht Inst Pharmaceut Sci, Div Pharmacol, Utrecht, Netherlands
[6] Univ Utrecht, Fac Med Vet, Inst Risk Assessment Sci, Utrecht, Netherlands
[7] Biomed Primate Res Ctr, Dept Immunobiol, Rijswijk, Netherlands
[8] Erasmus Univ, Med Ctr, Dept Immunol, Rotterdam, Netherlands
[9] Univ Groningen, Univ Med Ctr Groningen, Dept Neurosci, Groningen, Netherlands
[10] Leiden Univ, Fac Social & Behav Sci, Inst Psychol, Hlth Med & Neuropsychol Unit, Leiden, Netherlands
[11] Univ Med Ctr Utrecht, Lab Translat Immunol, Utrecht, Netherlands
[12] Univ Med Ctr Utrecht, Wilhelmina Childrens Hosp, Div Pediat Pediat Immunol & Infect Dis, Utrecht, Netherlands
[13] Wageningen Univ, Microbiol Lab, Wageningen, Netherlands
[14] Open Univ, Dept Psychol & Educ Sci, Heerlen, Netherlands
[15] HU Univ Appl Sci Utrecht, Inst Life Sci & Chem, Utrecht, Netherlands
[16] Nutricia Res, Immunol Platform, Utrecht, Netherlands
[17] Inst Posit Hlth, Amersfoort, Netherlands
[18] Univ Groningen, Dept Rheumatol & Clin Immunol, Univ Med Ctr Groningen, Groningen, Netherlands
[19] Univ Med Ctr Utrecht, Dept Rheumatol & Clin Immunol, Lab Translat Immunol, Utrecht, Netherlands
[20] Univ Med Ctr Utrecht, Wilhelmina Childrens Hosp, Div Pediat, Lab Translat Immunol, Utrecht, Netherlands
[21] Radboud Univ Nijmegen, Med Ctr, Dept Lab Med, Lab Med Immunol, Nijmegen, Netherlands
关键词
chronic immune disorders; common pathways; data integration; life style; psychosocial factors; GUT MICROBIOTA; PSYCHOLOGICAL STRESS; INTESTINAL MICROBIOTA; GENETIC ARCHITECTURE; PSORIATIC-ARTHRITIS; BIG DATA; DISEASE; HEALTH; AUTOIMMUNE; INFLAMMATION;
D O I
10.3389/fimmu.2016.00587
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
In order to combat chronic immune disorders (CIDs), it is an absolute necessity to understand the bigger picture, one that goes beyond insights at a one-disease, molecular, cellular, and static level. To unravel this bigger picture we advocate an integral, cross-disciplinary approach capable of embracing the complexity of the field. This paper discusses the current knowledge on common pathways in CIDs including general psychosocial and lifestyle factors associated with immune functioning. We demonstrate the lack of more in-depth psychosocial and lifestyle factors in current research cohorts and most importantly the need for an all-encompassing analysis of these factors. The second part of the paper discusses the challenges of understanding immune system dynamics and effectively integrating all key perspectives on immune functioning, including the patient's perspective itself. This paper suggests the use of techniques from complex systems science in describing and simulating healthy or deviating behavior of the immune system in its biopsychosocial surroundings. The patient's perspective data are suggested to be generated by using specific narrative techniques. We conclude that to gain more insight into the behavior of the whole system and to acquire new ways of combatting CIDs, we need to construct and apply new techniques in the field of computational and complexity science, to an even wider variety of dynamic data than used in today's systems medicine.
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页数:9
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