We Will Live Longer

If Leroy Hood, one of Seattle's leading visionaries, is right, you could spend more time on this Earth.

Hood is predicting that technology and medicine will improve within two decades to increase a person's life by 10 to 20 years.

Whether he is right remains unknown. There will be critics. People will demand debate, scrutiny and answers.

But he has seen success with advocating controversial ideas before, such as mapping the human genome. He has helped start several biotechnology companies, including Amgen, Applied Biosystems and recently a blood diagnostics business, Homestead Clinical Corp.

Hood leads the Institute for Systems Biology, a multidisciplinary organization near Lake Union that focuses on chemistry, mathematics, medicine, biology and other topics.

He recently talked about his vision, a revolutionary campaign that he dubs predictive, preventive and personalized medicine.

On the origins of the entire idea:

The roots of it started back when we began (some) studies in 1994 or 1995. The version I am telling you now came about probably in 2001 or 2002. It is an evolution because there are a whole series of ideas embedded in these concepts.

On the idea itself:

The essence is a really simple idea. It is the idea that when you're sick, a diseased organ has its networks perturbed by defective genes or by environmental stimuli, such as infectious agents. These perturbed networks change how they express genes. Therefore, you get sick.

From a systems approach to disease, there were two really interesting questions.

Can we look at the networks that are specifically perturbed in prostate cancer or breast cancer or diabetes? Can we find proteins whose patterns of expression have changed, which are secreted into the blood?

They would be a molecular fingerprint to the blood. To say, "You don't have a normal organ anymore. You've got prostate cancer. Or you've got an infection in your prostate."

On the importance of blood analysis:

What's exciting is that blood is very accessible. We've proven for prostate that there are blood fingerprints that will allow us to detect the disease. We can use those elements of the blood fingerprints that point to disease to actually indicate which of the networks in which cells are perturbed.

So the idea, then, is not only will we be able to identify the targets for drugs, we will be able to use systems approaches to identify the side effects far more effectively than they've ever been identified before and actually identify them before you put the drugs in the patient.

If you have a lot of side effects for a drug, you can just say, "It's not worth it. Let's throw this one away."

We think that we'll be able to make thousands of measurements from a fraction of a droplet of blood.

On the predictive aspect:

My prediction is that within 10 years, we will have a predictive medicine that will have two separate components.

No. 1, it will have the ability to sequence every human's genome for less than $1,000. We will be able to make predictive health histories for each individual from the varying genes that come from that sequencing.

No. 2, we will have a little hand-held nanotechnology device that will prick your finger and make a thousand measurements and by wireless, send that to a server. It will analyze all your past records.

It will say, "Nothing's changed. You're fine. Do it again in six months." Or it will say, "Go see your oncologist or go see your rheumatologist" or whoever might be appropriate.

Your physician would get an e-mail, too.

On how predictions help:

These predictions will be very useful because with cancer, if we can make early diagnosis, we can cure them. And with other diseases, if we can do early diagnosis, we can manage them better.

On the prevention of diseases:

The next stage would come in the 10- to 15- to 20-year time period. It would be the stage of preventive medicine. We will use this new systems approach to identify drug targets. Initially, we'll use them as therapies to change disease-perturbed networks more back toward normal.

But in the future, we'll design drugs that will never let your network become disease-perturbed.

We will say to you, "Suppose you have a 65 percent chance of getting prostate cancer when you're 65. If you start taking these pills when you're 45, that percent will change to 2."

On personalized medicine:

Take into account that your genome and mine differ by 6 million nucleotides (which is the basic unit of organic acids found in all living cells). Then therefore, we're susceptible to all sorts of combinations of diseases.

We have to treat you differently than we treat me and everybody else. How we create an era of highly personalized medicine will depend entirely on new diagnostic, therapeutic and ultimately, these preventive techniques.

What we'll do is feed your genome sequence into a grid network of computers that will do many different kinds of analyses simultaneously. You'll get a summary sheet that says here are the things and here are the probabilities that you'll likely have to worry about in the future.

On the global impact:

It would start here. But it would apply to Europe and to Asia. A lot of these tools will be very inexpensive because it's like the digitization of (information technology).

When you essentially make chips, you can make them really inexpensive. Anybody in the world can have a cell phone now, right?

For medicine, it's going to be the same way because of technology; we will be able to mass-produce these things and make them inexpensively.

We will be able to export this medicine to Africa and the developing world and so forth.

What this digitization of medicine will do is democratize medicine. If you think of the three major problems in the world, they are education, poverty and health. This, in a very fundamental way, will attack one of those three problems.

On business opportunities and adapting to the change:

I think a really interesting question is: "Will (the) big (pharmaceutical industry) be able to adapt to these opportunities? Or is it too bureaucratically rigid? Is it too embedded in the old way of doing things?"

My guess is that a few pharmaceutical companies, like the younger, more nimble ones, would be able to respond. Some of the bigger and more rigid ones are going to have more trouble.

On getting people to understand:

It takes five years for people to get anything. The first few times they hear it, they can think of a thousand reasons why it's wrong. Then, after they've heard it a few more times, it starts to sound more logical.

If you're a missionary, you've got to be patient with your congregation. We are at the very beginning stages of thinking about this.

On elements that will be needed:

The key things that you have to assemble are the computational, technology and biological people to make this a reality.

We have to be able to assemble blood samples so we can do these blood diagnostics and we can correlate the fingerprints with their respective diseases and so forth.

Another thing we have to assemble is mathematics that can actually figure out new mathematical ways of extracting the enormous amount of information that will be contained in these blood fingerprints.

The old ways weren't set up for this kind of information. Essentially, a new kind of mathematics is going to have to be invented.

On an ethical question:

If you can make good predictions about horrible diseases, but you can't do anything about them, should you ever make the predictions?

Some people would want to know, even if you couldn't fix it. But what is complicating about that is some of the people who think they would want to know, when they know, fall apart.

On overall success and past criticism about genome mapping:

It can't fail. Not everybody is going to agree with that. But look, everything that I've done, there was the genome and cross-disciplinary science and systems biology. There have been infinite skeptics for all of those things. Every one of them has worked.

I remember getting invited to give one of the big lectures in biology. This was in 1987 or something like that. Everybody attacked me afterward. They were really angry about the whole thing.

It was: This is "trivial science" because it's not hypothesis-driven. It was: Only idiots will do this. It was all those types of defensive arguments.

The interesting thing is that when I got done with all the questions, which lasted 45 minutes, my host had left. He was so angry about this whole thing. I didn't even know where I was supposed to go and stay that night.

I was really angry that this guy had just left me there. That was how strongly people felt. It was really amusing.

On the future:

I think in 20 years, we'll be in full force.

You see what drives the change? Technology. If we invent the technologies that enable this, everything else gets dragged right along. That is one of the fundamental rules of civilization.

I think it will make medicine less costly, infinitely more efficient. I think within 20 to 25 years, we'll be living productively 10 to 20 years longer.

Suppose you're 90 years old, and you're young, vigorous, alert, creative. We're used to tossing the old aside so we can make room for the young. Suppose the old aren't ready to be tossed aside. What do you do about that?

On when he thinks the best:

I try and run an hour, three times a week. I always do it by myself. So I can think about deep, hard problems. No one bothers me. I can organize lectures. I can organize chapters. I can think about new ideas. When I'm out mountaineering, I think about science as I'm walking alone.

On his next goal:

The thing I haven't really figured out at all is the brain and consciousness and memory. That's the last frontier. It's going to be a hard one. In my next career, after another 10 years, I can start thinking about the brain.

Source: Institute for Systems Biology

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