Kategori: Lytics

Who and what am I?

We often hear: “it’s not possible”, “it costs too much”, “we don’t know how to do it”, in the myriad of no-nos.

If you inhale volcano dust you may end up in serious trouble. If symptoms evolve your doctor will let you know you developed deadly silicosis. If your doctor instead wants to play word-games with you she might instead say you suffer from pneumonoultramicroscopicsilicovolcanoconiosis. If you stay tuned and analyze the statement it makes good sense, it describes your problem (better than silicosis).

The long complex word lets you know that you have inhaled (coniosis) into your lungs (pneumono) fine (ultramicroscopic) quartz (silico) dust from a volcano (volcano) that resulted in serious silicosis. Complex matter is understandable, however still complex.

Let’s look at a geekier example. If you’re a chemist you may sit in front of this three-hour readout of:

“Methionylalanylthreonylserylarginylglycylalanylserylarginylcysteinylproly- larginylaspartylisoleucylalanyla-…-ylserylphenylalanylhistidylprolylmethionylleucylarginyltyrosylthreonylasp- araginylglycylprolylprolylprolylleucine”
(the whole word here)

If you’re in your lab and don’t have the complete and extremely complex stuff organized you have no chance to get it right. The fabric of letters, syllables and words is a beautiful construction for advanced, and distinct, communication and messaging. Access only to fragments in this fabric muddies the waters. Or said this way, when we don’t have all the pieces of the puzzle on the table, and not all of them in their right place, we can only make (qualified) guesses.

Let me digest this a little bit further. If we don’t see or have access to the whole word (or bigger picture) we’re sort of lost. Not even silicosis gives you enough information; basically only that your lungs are affected by (quartz) particles and that you probably will die rather sooner than later. We know nothing of what’s behind the diagnosis, what the patient’s needs are and what we can do to make the patient live a reasonable good rest-of-her-life. Nope, we have to get our arms around the bigger picture.

The exponential development in sciences hasn’t left medicine at rest. We treat deadly diseases routinely and cure patients; we can measure and analyze more or less everything that’s going on in the human body (and mind), the specificity of modern drugs is phenomenal, and doctors and nurses know so much more. When ill, you’re in very good hands.

But, there is a BUT.

A disease or a medical problem is never, yes I prefer to say never, understood from just a few, and however sophisticated, analyses. When you dance out from the emergency room, happy to have survived, or when you leave your doctor’s office with a prescription for SSRI, you also leave the qualified institutions behind with patient records far from being a good-enough guide to your problems, what you value and need. Technically, you are probably given the best advice you can get. Probably, they still don’t know enough about you to know what’s best for you the next several days to come.

I would prefer to be met by someone who tries to dig into my inner me, who wants to understand who and what I am. So why isn’t that just what happens? I would prefer if the first questions you’re asked are: “how are you”, “what do you need from us”, “what can we do for you”, “how can we help you do what you love”, and “what kind of life do you want to live”. The overarching answer to these questions is that we don’t, generally, practice the bigger-picture-approach. And that’s because your guardian angels don’t have all the information they need combined or all the pieces of the puzzle in place to enable them to see you as the complete and complex individual you are, and not just as a subject/patient with a problem/diagnosis.

Let’s imagine you sit in front of this giant puzzle with pieces that don’t seem to fit at all. Your first impression is that it’s a total mess (like the chemical above) and that the pieces make up not just one big puzzle, but several. The next logical step is to simplify and find the pieces that attract you most and seem to come together as something reasonable. You may end up with a decent combo, but are still extremely confused by the huge number of pieces not yet dealt with. If the big puzzle is me, the tremendous number of pieces comprises everything from my shoe size (from when I was just a kid till to date) to my genes (and the way they are set up and influenced over time), and everything in between. Okay, I agree. It’s not obvious that an obscure variable must be critical. But that’s the point, it’s not obvious. Just because of that we have to bring everything reasonable, and unreasonable, into the equation – for the bigger picture.

All right, next problem. We can’t gather everything, and if we could, how do we handle virtually millions of variables? It’s already impossible for our brains to grasp and understand how just a few variables relate to each other and what they express has happened, and will happen – what we can learn and what we can predict from that we are taught.

Oh well, it’s not really correct. Today, we have the methodologies, technologies and tools to collect more or less everything around and within us, and next dissolve and interpret the messy and extremely complex totality of information and variables into Heureka-messages and indicative predictions.

There is no longer a good reason, for anyone, to say: “no we can’t”.

The more we observe, the less tricky

I used to run a lot. Not at a competitive level but long distances daily for year after year. My pace is now at a different level and during my runs I can appreciate just to sit down to figure out where my mind wants to take me.

Long-distance running year around has not only trained my body to physiologically adapt to various conditions. It has exercised my brain and nervous system to regulate and program my system to proactively react to environmental influence as well as to variations in the internal body balance. The quality I appreciate most is the predictive value of how my body will react and perform next time when I take the first step. The anticipation is the treat I get from the regular exercise where my body and brain frequently sample information and continuously tune my system.

My endurance and performance is very much related to the presets and modulation of my cardiovascular and muscular functions, all controlled by my vivid central nervous system. That’s how it works. And my body settings are the result of continuous input and real-time processing and analyses, resulting in regulated and readjusted settings.

Urine is an important part of my past and present life. The secrets behind the way our kidneys work helped me as a researcher to dig into the complexity of homeostasis, the state where my body functions are regulated to optimal performance. The enormous amounts of urine I produce when my blood is filtered in my kidneys runs through machinery that makes sure that nothing I need go to waste. Good stuff is recovered and only metabolic residual products are [normally] leaving my body. This sophisticated regulation is, again, the result of a continuous process regulating andtuning my body for optimal performance.

From urine production to breathing air. Shaping good and useful medicines is a really challenging area as we rarely find shortcuts to useful and safe drugs. Drugs that help patients to swiftly restore or offset the painful mess from a disease. One reason is off course that we know too little about what’s really going on in the complex universe residing inside the patient’s skin. During my 25 years in pharmaceutical research and development with specific focus on lung diseases and primarily chronic obstructive pulmonary disease (COPD) I feel frustrated that we still to date, haven’t gotten further helping these patients. I believe one reason for failures is the overarching design of the research and development process, too often designed to figure out the benefits of a product and product sales.

Most of the time research is investigating specific mechanisms, which is a sound and reasonable approach. However, when we take the next step in the research process where we add additional pieces to the puzzle’s mystery we’re running into trouble. Just because the way a specific low-level mechanism interoperates and influence the whole organism is a big-data-issue.  That’s almost always the intriguing challenge we face when we test new chemical entities or biological compounds, only because everything we do results in a cascade of internal events: to our benefit; something my body may fight, try to avoid or work around; events that may be a risk, or even hazardous.

The same reasoning goes for more or less any disease, being not just one diagnosis. COPD is a complex disease that has developed over time and developed into various states of irreversibility. That’s really the painful fact of our current scientific insights, that patients who consult their physician because of their lung problems cannot be treated to reverse their COPD to normal but instead leaving them with relieving treatment. Okay, you would think you could just say: “quit smoking and you’re better off”. It’s not as simple as that. COPD is a complex disease and smoking, however fundamentally instrumental in the development of this terrible burden, is just one of many variables in the equation that describes a COPD patient’s life in an environment with a multiplicity of distressing influences. On top of this, many of the patients have a history that is important to understand to provide best care, and furthermore, most patients have accumulated symptoms indicating [several] other diseases of diagnoses.

Phew, that’s a tough message, I know.

The good news is that I believe we can do something to fix the problem. In Lytics we look at the complexity this way: what is the problem we need to find a solution for, what are the needs of an individual or a patient, and how does it all come to together in an individual-centric insight. The methodology and technology we developed and use provide a new platform that takes us so much further.