Network medicine: facilitating a new view on complex diseases

Abstract

Complex diseases are prevalent medical conditions which are characterized by inter-patient heterogeneity with regards to symptom profiles, disease trajectory, comorbidities, and treatment response. Their pathophysiology involves a combination of genetic, environmental, and psychosocial factors. The intricacies of complex diseases, encompassing different levels of biological organization in the context of environmental and psychosocial factors, makes them difficult to study, understand, prevent, and treat. The field of network medicine has progressed our understanding of these complex mechanisms and highlighted mechanistic overlap between diagnoses as well as patterns of symptom co-occurrence. These observations call into question the traditional conception of complex diseases, where diagnoses are treated as distinct entities, and prompts us to reconceptualize our nosological models. Thus, this manuscript presents a novel model, in which the individual disease burden is determined as a function of molecular, physiological, and pathological factors simultaneously, and represented as a state vector. In this conceptualization the focus shifts from identifying the underlying pathophysiology of diagnosis cohorts towards identifying symptom-determining traits in individual patients. This conceptualization facilitates a multidimensional approach to understanding human physiology and pathophysiology in the context of complex diseases. This may provide a useful concept to address both the significant interindividual heterogeneity of diagnose cohorts as well as the lack of clear distinction between diagnoses, health, and disease, thus facilitating the progression towards personalized medicine.

Keywords: complex diseases; multidimensional patient characterization; network medicine; nosology; pathophysiology.