Are we ready for personalised medicine? – urban microbiome perspective
In the era of fast-paced development of technology and services, there are limitless opportunities for customization to meet specific user needs. This is understandable since non-specific interventions for non-targeted populations often fall short of desired performance expectations in health outcomes. Over the next decade, as much as half of the proportion of health care will shift from the hospital and clinic to the home and community . With Personalized Medicine understood as prevention and treatment strategies that take individual variability into account we need to identify this individual variability via characterizing each person’s individual baseline health state instead of resorting to population-based variable distributions.
This health state baseline cannot be, however, determined with use of just the classical medical records. Recent technological advances have created opportunities to harness additional sources of biomedical data on a real time basis, for instance through the use of (1) mobile medical devices for monitoring dedicated health parameters (insulin, heart rate, etc), and (2) wearables [2, 3]. Initially starting out as simple devices to monitor basic wellness parameters, these devices have in recent years attracted a lot of interest and efforts from companies (e.g. Apple and Google) who are keen on developing innovations that border on wellness and healthcare. The synergy of these two streams should provide a good estimate of the health state baseline.
In order to model estimated data of health state baseline and future scenarios, it is imperative to include an important, yet largely missing third component – the exposome. This term cover all the exposures of an individual in a lifetime. So far it was mostly connected with air quality, light, climatic variations, ozone and volatile organic compounds. But we cannot forget about the ’living’ component of exposome. As dense human environments such as cities account for over a half of the world population  (in EU 80%) there is a need to build a molecular portrait of cities in order to study what lives around us and how it affects our health and wellbeing .
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