PPPM(Predictive, Preventive and Personalized Medicine)

as a new model of and thus a unique tool in global restructuration of national and international healthcare services

Dr Sergey Suchkov, MD, PhDProfessor in Immunology & Medicine

A.I.Evdokimov Moscow State Medical & Dental University andI.M.Sechenov First Moscow State Medical University

EPMA (European Association for Predictive, Preventive and Personalized Medicine), Brussels, EU;

ISPM (International Society for Personalized Medicine), Tokyo, Japan

PMC (Personalized Medicine Coalition), Stanford, USA;

Dr Sergey Suchkov, MD, PhDProfessor in Immunology & Medicine

A.I.Evdokimov Moscow State Medical & Dental University andI.M.Sechenov First Moscow State Medical University

EPMA (European Association for Predictive, Preventive and Personalized Medicine), Brussels, EU;

ISPM (International Society for Personalized Medicine), Tokyo, Japan

PMC (Personalized Medicine Coalition), Stanford, USA;

Dr Olga Golubnitschaja, PhDProfessor in Medicine

Department of Radiology, Rheinische Friedrich-Wilhelms-University of Bonn, Bonn, Germany

EPMA (European Association for Predictive, Preventive and Personalised Medicine), Brussels, EU

Dr Hiroyuki Abe, MD, PhDProfessor in Medicine

President, ISPM (International Society for Personalized Medicine), Tokyo, Japan

On behalf of

EPMA, (Brussels, EU),ISPM (Tokyo, Japan) andPMC (Stanford, USA)it gives me a genuine pleasure to cordially welcome you at a meeting illustrating the positive outcome of consolidated efforts to let Arabian countries to move ahead faster!

Over the course of its history, medicine has given special attention to the already diseased individual, focusing on a type of disorder rather than on one’s health or the so-called pre-illness conditions, the latter being left in the shade.

The link that might exert reliable control over morbidity, mortality and disabling rates and significantly reduce the cost of treatment for those who had fallen ill has now been available and would sound as PPPM (Fig. _).

PPPM associated withSubclinical and Predictive

Diagnostics

To achieve the implementation of PPPM, it is necessary to create a new strategy based upon the pre-early (subclinical) recognition of defects long before the illness clinically manifests itself.

This strategy would give a real opportunity to secure preventive measures whose personalization could have a significantly positive influence on demographics!

NIH (National Institutes of Health) has added PPPM to a list of the five most prioritized branches of in 21st century.

PPPM is also being actively supported and promoted by the European Commission, FDA and CDC.

Dr Francis Collins, MD, PhDDirector General,

National Institutes of Health/NIH,Bethesda, MD, USA

Dr Notkins, Abner, PhDScientific Director,

NIDCR,NIH, Bethesda, MD, USA

Dr Olga Golubnitschaja, PhDSecretary General, EPMA,

Brussels, EU

PPPM as the big change to forecast is rooted in a new science to be rooted from the achievements of Hi-Tech platforms which are being implemented into the daily practice to secure visualizing of lesions that was previously invisible and thus unknown to clinicians (Fig. _ _)

Meanwhile,a combination of those

(above-mentioned)Hi-Tech platforms would make

a physician able to predict risks of the chronification andthus of disabling since

chronic diseases are preceded bya long subclinical (symptom-free)

phase or a period of latency(Fig. __)

Stage of subclinical

autoaggression

Stage offull-term

autoaggression

Clinical illness

Subclinical (cryptic) latency A stepwise (subclinical-clinical) course to be developed

A stepwise progression of autoaggression

Tissue-derived information being harvestedand accumulated from the Hi-Tech Protocols

would have to be combined with the:

● individual's medical records;● family history;

● molecular imaging data;

to developpersonalized and preventive treatments.

But how is the whole databank (dataset)provided by the Hi-Tech technologies

could be comprehended?

It is bioinformatics and

cloudy technologiesto suit the needs whilst constructing and

maintaining unified biobanks and databanks necessary for

personal health monitoring.

As a result, the patient becomes a data carrier, whilst learning about possible risks of a disease,

and the physician can reasonably select a kind of preventive and personalized protocol

rooting from the predictive assays made(Fig. __).

● Predictive branch is mainly designedto meet the interests of healthy individuals,

its purpose being to determine whether susceptibility to a particular disease

is increased or not.

●● Preventive branch is aimed attaking measures to avoid development of clinical manifestations rather than cure or

treat it on manifestation.

●●● Personalized medicine proposesthe customization of healthcare, being tailored

to the individual patient

PPPM-oriented surveyshould be thus based on

biomarkers and algorithmsto differ essentially from those employed in traditional clinical

strategies, namely,

(i) algorithms for predictive and subclinical diagnostics on one hand,

and

(ii) algorithms for preventive therapy,on the other one

Persons-at-risks pre-selectedwould have to be undergone to

a Multi-Step Procedureto monitor:

● potential patients,

● persons-at-risks predisposed to the disease, and/or

● persons at subclinical stagesof the disease (Fig. __).

Colon cancer

Lung cancer

Breast cancer

Implementation of PPPM would require the adjusted technology armamentarium

for proper interpretation of diagnostic and predictive data before

the current model “physician-patient”could be gradually displaced by a

“medical advisor-healthy persons-at-risk” model.

This approach should be based on postulates which will change the

incarnate culture and social mentality.

Due to our viewpoint, all healthcare professionals of the future should be educated to deliver patient-centric care as members of

interdisciplinary teams, emphasizing evidence-based practice,quality improvement approaches and bioinformatics.

That concerns the need for novel training programs since the society is in bad need of large-scale dissemination of

novel systemic thinking and minding.

And upon construction of the new educational platforms,there would be not a primitive physician created but

a medical artistto gift a patient a genuine hope to survive but for

a person-at-risk – a trust for being no diseased.So, the existing medical education would strongly need to be

restructured to involve along with traditional graduate andpost-graduate training, pre-graduate preliminaries to disclose

for schoolchildren the mysteries of the evidence-based medicine and PPPM as the entity

We have tried anon-canonical approach

towards reshufflingthe traditional educational

tandem

“School-University”

to create a team oftalented and gifted

teenagers to be engaged into PPPM-related areas.

The Team has been givena roof under the aegis of

European Association of Predictive, Preventive and

Personalized Medicine (EPMA), Brussels, EU,

and started upto move ahead now

(Fig ___)

The First Anglo-Russian Students’ Workshopon PPPM and Translational Medicine

Lancaster University4th September 2012

 Location: TR1/TR2 Gordon Manley buildingChairs: Professors Frank Martin, PhD (UK)Director, Environmental and Biophotonics Center, and Chairman, Dept for

Biochemistry, Lancaster University, UKProfessor Sergey Suchkov, MD, PhD (Russia)Dept of Pathology, School of Pharmacy, I.M.Sechenov First Moscow State Medical

University, and Dept of Clinical Immunology, Moscow State Medical & Dentistry University, First Vice-President and Dean, School of PPPM, University of World Politics and Law, Moscow, Russia

Dr Sergey Suchkov, MD, PhDProf in Immunology and Medicine,I.M.Sechenov First Moscow State Medical University, A.I.Evdokimov Moscow State Medical & Dental University,EPMA (Brussels, EU)

Olga Golubnitschja EPMA, Brussels

Trevor MarshallAutoimmunity FoundationLos Angeles USA

Noel RoseJohns Hopkins University, Baltimore, USA

under the aegis of

EPMA (Brussels, EU)I.M.Sechenov First Moscow State Medical University,

A.I.Evdokimov Moscow State Medical & Dental University,

Johns Hopkins University, Baltimore, USANIH, Bethesda, USA

InternationalPPPM Research Team of Youngsters

Abner NotkinsNIH, USA

EPMA-World Congress 2011September 15th19th, Bonn, Germany

InternationalResearch Team of Youngers

EPMA World Congress 2013Europarliament, Brussels, EU, Sep 2013

Section For Young Professionals (Session)

Some comments:

Individuals to be under regular monitoring that helps to detect pathological shifts at subclinical

stages have a higher life expectancy andare able-bodied up to 8–15 years more than those

under traditional treatment.

This means that the society would save more thanUS$20,000–40,000 per person annually.

At the community level, the annual savings from each individual may vary from several thousands

to several tens of thousands U.S. dollars.

As you might feel, besides the scientific and clinical challenges, there are economic hurdles.

The opportunity arises for unusual and, even extraordinary, strategic partnerships between:

► governments, academic and business sectors.The healthcare industry, public policy sector, and consumer

industries will be required to developnew and creative business models and products.

The latter means that we are proposing neither separate (big or small) or temporarily exploited projects, nor regular commercial ones. We are applying for the support in systemic approach to overcome the mental barriers and to make the first step into a

safe future to come soon.

And, on behalf of EPMA (Brussels, EU),ISPM (Tokyo, Japan) and PMC (Stanford, USA),

let me invite our colleagues from Arabic countries and the rest of the world to join the TEAM which are now being planned to be

constructed and to start upthis unique Project together