title: How implementation of systems biology into clinical trials accelerates understanding of diseases.
abstract: Systems biology comprises a series of concepts and approaches that have been used successfully both to delineate novel biological mechanisms and to drive translational advances. The goal of systems biology is to re-integrate putatively critical elements extracted from multi-modality datasets in order to understand how interactions among multiple components form functional networks at the organism/patient-level, and how dysfunction of these networks underlies a particular disease. Due to the genetic and environmental diversity of human subjects, identification of critical elements related to a particular disease process from cross-sectional studies requires prohibitively large cohorts. Alternatively, implementation of systems biology principles to interventional clinical trials represents a unique opportunity to gain predictive understanding of complex diseases in comparatively small cohorts of patients. This paper reviews systems biology principles applicable to translational research, focusing on lessons from systems approaches to inflammation applied to multiple sclerosis. We suggest that employing systems biology methods in the design and execution of biomarker-supported, proof-of-principle clinical trials provides a singular opportunity to merge therapeutic development with a basic understanding of disease processes. The ultimate goal is to develop predictive computational models of the disease, which will revolutionize diagnostic process and provide mechanistic understanding necessary for personalized therapeutic approaches. Added, biologically meaningful information can be derived from diagnostic tests, if they are interpreted in functional relationships, rather than as independent measurements. Such systems biology based diagnostics will transform disease taxonomies from phenotypical to molecular and will allow physicians to select optimal therapeutic regimens for individual patients.
authors.affiliation: Neuroimmunological Diseases Unit, National Institute of Neurological Disorder and Stroke, National Institutes of Health , Bethesda, MD , USA ; Center for Human Immunology of the National Institutes of Health , Bethesda, MD , USA.
authors.forename: Bibiana
authors.initials: B
authors.lastname: Bielekova
authors.affiliation: Department of Surgery, University of Pittsburgh , Pittsburgh, PA , USA ; Center for Inflammation and Regenerative Modeling, McGowan Institute of Regenerative Medicine , Pittsburgh, PA , USA.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Vodovotz
authors.affiliation: Center for Inflammation and Regenerative Modeling, McGowan Institute of Regenerative Medicine , Pittsburgh, PA , USA ; Department of Surgery, Northwestern University , Chicago, IL , USA.
authors.forename: Gary
authors.initials: G
authors.lastname: An
authors.affiliation: Stroke Branch, National Institute of Neurological Disorder and Stroke, National Institutes of Health , Bethesda, MD , USA.
authors.forename: John
authors.initials: J
authors.lastname: Hallenbeck
keywords: clinical trials; clinical trials methodology; multiple sclerosis; polygenic diseases; systems biology