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The Mechanisms of How Genomic Heterogeneity Impacts Bio-Emergent Properties: The Challenges for Precision Medicine

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Abstract

While the promise of precision medicine has generated excitement and high expectations, there are challenges for some key assumptions on which the concept is based. Since most common and complex diseases belong to adaptive systems where fuzzy inheritance interacts with the dynamic environment during nonlinear somatic cell evolution, both disease progression and treatment response are less predictable if based only on the precision of gene profiles. Although increased voices have expressed their concerns for this neo-reductionist approach (reduction based on big data), few have directly studied the conceptual limitations of precision medicine. In this chapter, we will focus on the relationship between bio-heterogeneity and emergent properties, a subject crucial to understanding why the targeting of lower-level agents (genes and pathways) provides unsatisfactory results at higher levels of this system such as clinical outcomes, which is practically the ultimate goal. Such analyses illustrate that dynamic interactions of heterogeneity in lower-level agents lead to the unpredictability of complex adaptive systems. As a result, stress-induced multiple genomic heterogeneity-mediated evolutionary processes present the greatest challenges for precision medicine.

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Notes

  1. 1.

    Endoplasmic reticulum.

  2. 2.

    Mitochondrial DNA.

  3. 3.

    Homologous recombination: a type of genetic recombination in which nucleotide sequences are exchanged between two similar or identical molecules of DNA, particularly to repair DNA damage affecting both strands of the double helix.

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Acknowledgement

This chapter is part of a series of studies entitled “The mechanisms of somatic cell and organismal evolution.”

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Authors and Affiliations

  1. Center for Molecular Medicine and Genomics and Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA

    Henry H. Heng

  2. Center for Molecular Medicine and Genomics, Wayne State University School of Medicine, Detroit, MI, USA

    Guo Liu, Sarah Alemara, Sarah Regan & Zachary Armstrong

  3. Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    Christine J. Ye

Authors
  1. Henry H. Heng
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  2. Guo Liu
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  3. Sarah Alemara
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  4. Sarah Regan
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  5. Zachary Armstrong
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  6. Christine J. Ye
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Corresponding author

Correspondence to Henry H. Heng .

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Editors and Affiliations

  1. School of Medicine and Public Health, University of Newcastle, Wamberal, NSW, Australia

    Joachim P. Sturmberg

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Heng, H.H., Liu, G., Alemara, S., Regan, S., Armstrong, Z., Ye, C.J. (2019). The Mechanisms of How Genomic Heterogeneity Impacts Bio-Emergent Properties: The Challenges for Precision Medicine. In: Sturmberg, J. (eds) Embracing Complexity in Health. Springer, Cham. https://doi.org/10.1007/978-3-030-10940-0_6

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  • DOI: https://doi.org/10.1007/978-3-030-10940-0_6

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