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"How Scientific Wellness will Drive The Future of Health" - Nathan Price (Professor, Institute of Systems Biology)

  1. How Scientific Wellness will Drive the Future of Health Nathan Price, PhD Institute for Systems Biology Seattle, WA Hyper Wellbeing November 13, 2016 @ISBNathanPrice
  2. Disclosures • Dr. Price is a Co-Founder of Arivale, which partially funded and may license discoveries resulting from the Hundred Person Wellness Project (to be described). • Dr. Price serves on Scientific Advisory Board of Habit, a new personalized nutrition company Founders Clayton Lewis, CEO and Co-founder Maveron, MarketLeader, Harborview Medical Center, Capitol Hill Lee Hood, MD, PhD, Co-founder, SAB Chair ISB, Amgen, National Academies, Presidential Medal Nathan Price, PhD, Co-founder, Board of Directors ISB, University of Illinois, Urbana-Champaign, UCSD, UW
  3. 86% of Healthcare Costs Treat Chronic Disease
  4. Determinants of Health in U.S. 60% 30% 10% Genetics Behavior & environment Health Care Steven Schroeder et al. New England J Medicine, 2007
  5. U.S. Healthcare Spending $3.8 Trillion (2014) Wellness Industry Scientific Wellness → A New Industry U.S. Healthcare Spending $3.8 Trillion (2014) Wellness Industry Scientific Wellness→ ↔
  6. Conceptual Themes of P4 Medicine Disease DemystifiedWellness Quantified P4 Medicine Predictive Preventive Personalized Participatory Scientific Wellness Industry Disease Industry
  7. Proposing the 100K Wellness Project Nature, News piece, (2014) Hood and Price, Science Translational Medicine (2014) Hood and Price, Clinical Omics, (2014)
  8. Scientific Wellness: Two Integrated Directions Arivale • A consumer facing scientific wellness company • 5,000 individuals in the first 18 months • Transform how biotech industry operates ISB-Providence • Dense, dynamic, personal data clouds • Research to validate wellness metrics • Research for better assays • Optimize wellness • Study wellness to disease transitions • Study disease [progression, response to therapy and transition to wellness
  9. PIONEER 100 PROJECT Principal Investigators: Lee Hood and Nathan Price The 100K Wellness Project was initiated in 2014 with the generation of dynamic data clouds for 108 individuals. These data provided spectacular insights into what it is to be well and the nature of wellness to disease transitions (and vice versa).
  10. • 108 participants • Age range: 20s to 88+ • 9-month study launched March 2014 • IRB approved • Evaluation / insights for next phase • Whole genome sequence • Detailed blood, urine, saliva measurements 3x • Gut microbiome 3x • Continual self-tracking and lifestyle monitoring • Data integration & correlations • Monthly coaching sessions on actionable data • Discovery research • Events and education
  11. Assays / Measurements—108 Pioneers Database of actionable possibilities that will grow over time GENOME Whole Genome Sequencing. SNPs Millions LABS Detailed lab tests 3x (blood, urine, saliva) Clinical chem. 150 Metabolites 700 Proteins 400 SELF- TRACKING Continual self-tracking & lifestyle monitoring MICROBIOME Gut Microbiome 3x Creating dense and dynamic personal data clouds
  12. Wellness coaching for participants Sandi Kaplan, MS, RD Craig Keebler, MD Wellness Coach Study Physician
  13. Clinical Labs Discovery: Improvements in blood health with behavioral coaching 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100% Cardiovascular Diabetes Inflammation Nutrition %changeinout-of-rangemeasurements Baseline 3 months 6 months Improved by 33%Improved by 6% Improved by 12% Improved by 21%
  14. Clinical Labs Discovery: Significant pre-diabetes improvements Seven participants with pre-diabetes were completely normalized in six months 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% HbA1c (Glycated hemoglobin) Fasting glucose HOMA (Insulin resistance) Insulin %changeinout-of-rangemeasurements Baseline 3 months 6 months Improved by 19%Improved by 38% Improved by 55% Improved by 56%
  15. A wellness to disease transition—genetics plus environment—an actionable possibility
  16. • Blood + Genetics illuminated the effects of increasing copies of the Hemochromatosis variant • Left untreated, this disorder could lead to cartilage damage, liver cancer, diabetes, and heart disease: Easily treated by regular blood donations to reduce the iron stores • One participant ALREADY had cartilage damage from his undiagnosed disease • Subsequent family genetic testing detected other family members at risk 0.0 50.0 100.0 150.0 200.0 250.0 Zero copies of rare variant (86 individuals) One copy of rare variant (12 individuals) Two copies of rare variant (2 individuals) Ferritinlevels Baseline 3 months Genetics and Clinical Labs: Hemochromatosis Detected risk of a deadly disease in two participants
  17. Deriving Insights from Data: New Frontiers C
  18. Identifying inter-related molecular modules
  19. • Cholesterol is positively associated with alpha- tocopherol (Vitamin E) • Cholesterol is negatively associated with endogenous thyroxine • A beneficial side effect of the drug thryroxine (Synthroid) is lowering LDL cholesterol Total cholesterol community
  20. The largest molecular community: related to cardiometabolic health
  21. We can determine your genetic risk for at least 60 diseases.
  22. Estimated risk for the disease or trait relative to a population GWAS variants have been determined for about 60 diseases and traits Variant rs6827 Variant rs8572 Variant rs68883 Variant rs0994 Variant rs9769 Variant rs14445 Var iant Variant rs111393 Variant rs6837 Variant rs5837 Variant rs68279 Variant rs59583 Variant rs1352 Variant rs6827 Variant rs68883 Variant rs9769 Variant rs14445 Variant rs5837 Detrimental VariantBeneficial Variant 0 20 40 60 80 100 120 140 Cumulative Risk Below average Distribution from 2000 Genomes ADHD COPD Myopia Alzheimer's disease Crohn's disease Obesity Anorexia Esophageal cancer Osteoarthritis Asthma Gout Osteoporosis Atrial fibrillation Grave's disease Ovarian cancer Breast cancer Hematocrit Pancreatic cancer Bipolar disorder Hypertension Parkinson's disease Blood pressure Hypothyroidism Primary biliary cirrhosis Bone mineral density Inflammatory bowel disease Prostate cancer Inflammation Iron levels Psoriasis Calcium Lung Cancer Rheumatoid arthritis Cardiovascular disease Lupus Schizophrenia Celiac disease Macular degeneration Stroke Cholesterol levels Magnesium levels Type 1 Diabetes Chronic kidney disease Metabolic syndrome Type 2 Diabetes Colorectal cancer Migraine Ulcerative colitis Coronary heart disease Multiple sclerosis Urate levels
  23. Nutrient measurements correlated with genetic predisposition for IBD cystine (plasma) glutathione (cytosol) Sido, B., Hack, V., Hochlehnert, A., Lipps, H., Herfarth, C., and Dröge, W. (1998). Impairment of intestinal glutathione synthesis in patients with inflammatory bowel disease. Gut 42, 485–492. Ulcerative colitis activity Pilot Study Correlation Network cysteine (cytosol) -2 0 2 4 6 -4 plasmacystine -4 -2 0 2 4 Inflammatory bowel disease genetic score N = 107 rho = - 0.44 p = 2.3e-6 q = 0.03
  24. Dense, Dynamic Personal Data Clouds These personalized data clouds are the foundation of what Precision Medicine should be.
  25. Enabling Individuals to take Responsibility for their Own Wellness (and Disease) Individuals taking responsibility for their own health will dramatically reduce the cost of healthcare
  26. Project Leadership • Leroy Hood, MD, PhD • Nathan Price, PhD • Sean Bell, Business Director Data Analytics • Nathan Price, PhD – Analytics Lead Gustavo Glusman, PhD, Genomics • Andrew Magis, PhD, Multi-omics • John Earls, Data integration Project Management • Kristin Brogaard, PhD Project Manager • Sara Mecca, Project Assistant • Mary Brunkow, PhD, Project Coordinator Medical Advisory Board • Robert Green, MD • Jane Guiltinan, ND • Michael Raff, MD • Sarah Speck, MD Communications • Gretchen Sorenson, Consultant • Hsiao-Ching Chou, Commun. Director Participant Engagement • Jennifer Lovejoy, PhD, VP Clinical Affairs • Sandi Kaplan, Wellness Coach • Craig Keebler, MD, Study Physician ISB Hundred Person Wellness Project: Team Special thanks to our funders: Robert Wood Johnson Foundation and M.J. Murdock Charitable Trust @ISBNathanPrice

Hinweis der Redaktion

  1. Actionable big data for systems medicine and proactive healthcare
  2. Steven Schroeder et al. New England J Medicine, 2007 McGinnis JM, Williams-Russo P, Knickman JR. Health Aff (Millwood) 2002
  3. Growth will be driven primarily by preventive health and wellness categories such as vitamins, nutrition, weight management and fortified foods and beverages; fitness and mind; alternative medicine and workplace wellness The global POC market was worth $13.8 billion in 2011. By 2018, the market is expected to grow to $24 billion in the U.S. alone. Thu Mar 26, 2015 12:13am EDT By Sharon Begley from a survey of 121 representative U.S. employers by Fidelity Investments and the National Business Group on Health   NEW YORK (Reuters) - Employers have ratcheted up the financial incentives they offer workers to participate in wellness programs to a record $693 per employee, on average, this year from $594 in 2014 and $430 five years ago, found a report released on Thursday (Companies with more than 20,000 employees are offering an average of $878
  4. Arivale-a wellness sciences company—consumer facing —generate 10,000 dense and dynamic individual data clouds in next 18 months—may really lead the large-scale adoption of P4 medicine and the democratization of healthcare—one of the first companies in the scientific wellness sector The 100,000 person wellness project—academic—discovery science at ISB—pioneer assays (to the smart phone) and pioneer the integrative and modeling analytics—seek Precision Medicine funding—focus on both wellness and early disease transitions and on following disease to therapy to wellness transitions.
  5. 100 participants 9 month study starting in March They will get:  there whole genome sequenced Detailed Blood measurements 3 times detailed urine and saliva measurements 3 times Gut microbiome 3 times Continual activity and lifestyle monitoring discovery research on their samples Coaching component to focus on actionable information for the participants and help guide them through the study Regulatory: We are IRB approved Multiple events with guest speakers held throughout the 9 months to foster community and educations For bio-sample collection participants will go to blood draw centers for will be given kits to collect samples at home
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  10. What might this mean: paint the picture for the board Have a summary slide: arivale research portal can provide the genetic risk of populations for specific diseases Patent: idea that we can identify the genetic risk for a given population and use that risk disposition to identify molecules that are relevant to those disease associations What about the guy that was diagnosed during the study, is he low