传记作为治疗反应的黑暗物质
Ralph I Horwitz1, Allison Hayes Conroy1, Mark R Cullen2
1Temple University, Philadelphia, USA.
The American journal of medicine
|February 10, 2026
概括
个性化医疗往往失败,因为它忽视了诸如创伤和压力之类的经历. 将这些"生物暗物质"因素与生物学结合起来,可以提高治疗预测和疗效.
科学领域:
- 生物医学研究生物医学研究
- 个性化医疗是个性化的医疗.
- 健康心理学 心理健康心理学
背景情况:
- 尽管基因组学取得了进展,但现代医学仍在努力预测患者的治疗反应.
- 基于基因组的个性化医学由于患者异质性高,其有效性有限.
- 影响治疗结果的关键因素通常在临床环境中未被测量.
研究的目的:
- 提出未测量的生活经验,称为"传记暗物质",显著影响治疗反应.
- 认为将传记数据与生物数据相结合可以提高预测准确性.
- 建议临床试验的新范式,包括全面的患者因素.
主要方法:
- 对个性化医学当前局限性的概念分析.
- 关于将生活经验与健康结果联系起来的生物机制的文献综述.
- 关于在临床试验设计中整合传记和生物数据的建议.
主要成果:
- 对各种生活经验的平均治疗反应可能会掩盖显著的生物效应.
- 没有测量过的生物因素可能会造成治疗效率微弱或不存在的外观.
- 特定的生物学-传记相互作用机制很可能被当前的试验设计掩盖.
结论:
- 将"生物暗物质" (生活经验) 整合到临床试验中,对于改善预测医学至关重要.
- 解决生物异质性的问题可以导致更准确的患者分层和治疗匹配.
- 这种方法提供了一条超越当前个性化医疗策略日益减少的回报的道路.
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