新科技将如何解决人口老龄化带来的医疗困境英文版

Howwillnewtechnologiesmakeage-relateddiseasesathingofthepast?Buildinganengagedagingstrategy2|Engagedaging3Buildinganengagedagingstrategy|InSeptember2016,MarkZuckerbergstoodinfrontofapackedauditoriumtoaskaprovocativequestion:“Canwecure,preventormanagealldiseasebytheendofthiscentury?”Soundaudacious?Itis.ThroughtheChanZuckerbergInitiative,theFacebookfounderandhiswife,Dr.PriscillaChan,arededicatingUS$3billionoverthenextdecadetoprevent,cureandmanagesomeoftheworld’scostliestdiseases,includingheartdisease,cancer,strokeandneurologicaldisorders.1Notbychance,theseglobalchronickillersalsohappentobeincreasinglycommonastheworld’spopulationagesandgrowsmoresedentary.Ifevertherewasatimeforboldstatementsandevenbolderambitions,nowisthemoment.Itisestimatedthatsometimebefore2020—forthefirsttimeever—theglobalpopulationofindividualsaged65andolderwilloutnumberchildrenunderagefive.2Withtoday’slifeexpectancy,thehealthcareexpenditurescouldbeenormous:theWorldEconomicForumestimatestreatingchronic,non-communicabledisorderscouldcostanestimatedUS$47trillionfrom2010to2030.34|EngagedagingBysomeestimates,wespendabout50timesmoreasasocietymanagingdiseasesastheyoccurthanwedoonresearchthatmightpreventthosediseasesfromhappeninginthefirstplace.Newgeneticanddigitaltechnologiescouldmakeagingmoresustainable,acceleratingthediscoveryandcreationofsolutions(seeFigure1).“Todaywearehealthyintheabsenceofdisease,”saysKenBloom,PresidentofHumanLongevity.“Butinreality,weareonly’healthy’becausewehaven’tidentifiedtheeventsthatwillageus,”Bloomnotes.Afteryears-longexposuretoinsultssuchasultravioletradiationandoxidativestress,ourcellsreachapointwheretheycannolongermaintainoptimalfunctionandfalter,whichmanifestsasage-relateddisease.Thegoalistousetransformativetechnologiestodelaythebreakdownoffunctionandextendthehealthspan—theabilitytoagedisease-free.IntheneartermthatmeansdeployingsensorsandInternetofthings(IoT)technologyinphonesandeversmallerwearablestocost-effectivelymonitor,andthenmanage,knowndiseasesassociatedwithaging.Longerterm,innovationsingeneticandregenerativemedicine,coupledwithcheapcomputingpower,improvedanalyticsandagrowingunderstandingofbothhumanbehaviorandthebiologyofagingwillmovetreatmentupstreamtothepre-diseasestate,whereconditionsshouldbecheaperandeasiertoremedy.Yettherealshifttowellnesswillcomewhenpre-emptiveeffortsaresoentrenchedinday-to-daylifethattheynolongermeritthelabel“prevention.”Wellnesswillbejustanotherpartofthenormalroutine,likebrushingone’steethorwashingone’sface.WhenlifespanmeanshealthspanFigure1:EnablingtechnologiestomakeagingmoresustainableDiseasemanagementDiseasepreventionDriversofchangeChangingdemographicsRisinghealthcarecostsIncreasingchronicdiseaseEvolvingcustomerexpectationsSolutionsEnablersIoTdevicesWearablesRegenerativemedicineArtificialintelligenceGeneticadvances5Buildinganengagedagingstrategy|Arangeoftechnologiesareneededtomoveusdownthepathtolifelongwellness.Manycomponentsalreadyexist—orwillinthenearfuture(seeFigure2).Considerthegeneticandscientificadvancesthatunderpintheemergingfieldofprecisionmedicine(i.e.,gettingtherightdrugtotherightpatientattherighttime).Withtheabilitytosequenceaperson’sentiregenomepoisedtocostlessthanUS$100,itwillsoonbereasonabletomapthegeneticblueprintsoflargenumbersofindividuals.Asaresult,itwillbepossibletouncoverraresignalsthat,whenlinkedtoobservablecharacteristics—calledphenotypes—identifynewmarkersfordiseaserisk.Ongoingeffortstounderstandthehumangenomewillbefurtherenhancedbycombininggeneticdatawitharangeofotherdatatypes,including:•▶Traditionalclinicallaboratoryresults•▶So-called“multi-omics”analysesthatquantifycollectionsofbiologicalmolecules,includingthetotalityofproteinsorgenetictranscripts•▶Real-timedatageneratedbywearablesandothermobiletechnologies•▶Behavioraldatagleanedfromsocialmediasites(e.g.,FacebookandTwitter)andadvocacyorganizations(e.g.,PatientsLikeMe)Theintegrationofthesedatawillultimatelytransformhealthcareandexpandprecisionmedicineapproachestohealthwrit-large.Acceleratingthisshifttoprecisionhealth,whatresearchersalsocallscientificwellness,arearangeofenablingtoolsthatincludethird-partycloudsfordatasharingandartificialintelligence(AI).Indeed,onebranchofAI,deeplearning,couldshortenthetimetoreachR&Dmilestones.Advancesincomputationalpowernowmakeitpossiblefordeeplearningsoftwaretoreplicatetheneuronalactivityinhumanbrains.Asaresult,thesoftwarecannowbeusedtoidentifypatternsinextremelylargedatasets,revealingpotentialnewlinkagesbetweenspecificgenesorproteinsanddiseasemorerapidlythanhumancounterpartscouldfindthem.Deeplearningalgorithmscouldbeparticularlyimportantinenablingprobabilisticdiseasepredictionbeforesymptomsmanifest,developingnewdrugtargetsforage-relateddiseasesaswellasidentifyingkeypointsforbehavioralinterventions.Alreadyarangeofstart-ups,includingCalicoandInsilicoMedicine,areusingtheapproachtoadvancethescienceoflongevity.Steppingalongthecontinuum:fromdiseasemanagementtowellnessFigure2:Solutionstopromotehealthyagingcanbearrayedonadiseasemanagement—preventioncontinuumDiseasemanagementCurre