Precision Medicine and the Reinvention of Human Disease (from Preface)

Something has happened in the past two decades that has changed the way that modern biomedical scientist thinks about diseases. Because the changes in our perceptions have happened slowly, few of us have really taken notice of what it all means. The purpose of my latest book, Precision Medicine and the Reinvention of Human Disease, published January, 2018, is to show how advances in the field of Precision Medicine will forever change the way we understand and treat disease. Specifically, these advances are:

• Diseases develop in steps. Modern methodology has enabled us to dissect the biological events and metabolic pathways that ultimately lead to the expression of disease. We can no longer think in terms of the "cause" of a disease, because most diseases have multiple contributory causes, that act over time. [Glossary Pathway]

• Because disease development requires the successful completion of multiple, sequential steps, and because we can now observe some of these steps, Precision Medicine has given us multiple targets that we can attack, with the expectation of preventing diseases from developing, delaying the development of disease, or treating diseases that are driven by identifiable pathways.

• Because different paths of development may lead to the same set of clinical findings, diseases can be subtyped into classes according to the specific pathways that drive their biology. Hence, treatment can be precisely targeted to subtypes of diseases that were formerly indistinguishable from one another.

• Because diseases that appear to be unrelated might share biological pathways that can be successfully targeted by new classes of drugs, we can now prevent or treat a variety of diseases, using a drug that was specifically developed for one rare subtype of disease.

Precision Medicine and the Reinvention of Human Disease explains how we have come to believe that these four advances in Precision Medicine are true, and how these advances are impacting the practice of medicine.

- Jules Berman

key words: precision medicine, rare diseases, jules j berman, jules berman, pathogenesis