Multiomics represents the future of medicine, present today. What is it? What is its relevance to you and your health and wellness future?
Many throw out the multi-omics word like a keyword or AdWord campaign. They recognize its importance to draw people in but don’t recognize what it actually is. They don’t realize how multi-omics is active in medicine today. More, multi-omics home is more clearly applicable in natural, holistic, and integrative therapies. This post will empower you with the knowledge of multi-omics and put the future of healing at the tip of your fingers today.
I first wrote and spoke on multi-omics in early 2022 and at a conference in September 2022. At this conference, I presented on the pharmacokinetics and pharmacodynamics of treating cancer with vitamin C. Surprisingly to most physicians, there is an overwhelming number of studies on the use of vitamin C in the treatment of cancer. More startling to most in the medical world is the detailed description of the mechanisms of action of vitamin C in the treatment of cancer are known. In this discussion, I presented the content of vitamin C and its impact on metabolomics in cancer treatment. The slide is immediately below.
Metabolomics can be described as:
“The comprehensive analysis of metabolites in a biological organism.” 1
In the slide below, the actual metabolomic impact of vitamin C in the treatment of cancer is shown. The image and the quote are taken from a 2015 article 2. The green highlighted metabolites reflect decreased metabolite levels, and the red highlighted metabolites reflect increased metabolite levels. Instead of increasing or decreasing metabolites, one must think more about the impact of metabolism flow. The metabolism, flow of metabolites, of the body is not static but, in fact, is quite dynamic. Side effects abound from the conventional approach of obstructing war efforts. Instead, working within metabolomics, the goal is to influence physiologic pathways to promote balance or homeostasis.
When you are the first to promote an idea founded in science, it is great to see others follow.
As cool as metabolomics is, it is just one arena of study in the growing continuum of multi-omics research. I presented the slide below at the annual A4M conference in Las Vegas in December 2022 to expand the clinical relevance and application of natural, holistic, and integrative medicine beyond metabolomics.
The genome is the complete set of genes in an organism. Genes are the genetic material that is encoded in DNA. Genomics is the study of that entire set of genes—the genome.
Epigenetics means “above genetics”. The power in genes, or the genome, is not in the fixed DNA, though it is very powerful, but in that which it encodes above the genome— the epigenome. Epigenetics is the study of the change in genetic expression, above the genome (epigenome), in response to the environment.
Transcriptomics is the study of the entirety of the products of transcription. Transcription is the biochemical process in which DNA is encoded into ribonucleic acid (RNA). The transcriptome is the total RNA (ribosomal, messenger, and transfer) present in a living organism. In addition to the three primary RNA types, there are numerous lesser-known types, small nuclear RNA (snRNA), microRNA (miRNA), and small interfering RNA (siRNA), that contribute to the transcriptome.
Metabolomics is defined above. Beyond the simple definition, metabolomics studies the function, inter-relational signaling, and physiologic effect of all metabolites in a living organism.
Immunomodulomics is a word I came up with. It seemed like the logical next in the field of “omics”. Immunomodulomics points to the study of the signaling modification of the immune system and its impact, either in wellness or disease. Immunomodulomics assesses both localized immune and systemic immune change. It is an assessment of the environment’s impact on the immune system and the immune system’s modification effect on the entirety of the body. This immunomodulation can include both immunostimulation and immunosuppression, also known as immunoediting.
This dynamic concept of immunoediting has specific implications in cancer. Tumor immunoediting comprises the dual co-existing tumor-suppressing and tumor-promoting actions of the immune system via three distinct processes:
The ever expanding field of “omics” research has added exomics to the mix.
The collective sequence of genes in the genome consists of both encoding regions, called exons, and non-coding regions, called introns. The exome comprises all of the exons within the genome, which remain within the transcribed RNA after the non-coding introns are removed in a process called RNA splicing.
The last 100 years of medicine have created and propagated a cookie-cutter approach to treating the masses. In the field of cancer, it has brought some definite successes, but despite these successes, winning the “war on cancer” is a goal that is slipping away. An article published in 2015 pointed to the trend that predicted that 1 in 2 women and 1 in 3 men would develop cancer in their lifetime 3. This 2015 publication was ahead of the previously mentioned Prospective Urban and Rural Epidemiology study in 2019 which provided further collaboration of the building next Pandemic. When will see 1 in 1 men or women?
Patients intuitively recognize this fact. For example, a six foot six, 360-pound man acknowledges that his type of cancer and his dosing of treatments should be different than that of the five-foot 115-pound lady sitting next to him. More than intuitive, it is a scientific fact. Data points to the #1 threat to health, wellness, and longevity as cancer. According to the
Prospective Urban and Rural Epidemiology (PURE) study published in the Lancet journal in 2019, cancer is now the #1 cause of adult mortality. More than sitting alone atop, cancer exceeds the #2 cause of adult mortality, cardiovascular disease, by a whopping 2.5 times. It didn’t just inch ahead; it blew right past cardiovascular disease and shows no sign of slowing.
One of the lead authors of the PURE study and professor of medicine at Stanford University Medical Center, Dr. Latha Palaniappan, said it best:
“We are seeing a new epidemiologic transition — from heart disease to cancer as the leading cause of death — which is occurring first in high income communities…”
Why the ever-advancing field of multi-omics? Beyond the simple move away from the archaic cookie-cutter approach, the goal is precision and accuracy treatments for the individual. It is all about individualized care—precise accuracy of care for each person. Precision is defined as the freedom from inessential elements, and accuracy is defined as conformity to truth. In short, the field of multi-omics is the elimination of non-essential elements with conformity to truth. It is the freedom found in truth.
The collective field of multi-omics rejects the reductionism, top-down, compartmentalized approach that has dominated medicine for the last hundred-plus years. One must give credit to Christian Smuts, the father of the concept of holism, who first rejected the compartmentalized, reductionist thought that permeated business, philosophy, and education in the 19th century. Christian Smuts introduced the idea of holism in his 1926 book entitled Holism and Evolution. Interestingly, Christian Smuts had no significant connection to medicine at all. Christian Smuts was a prominent South African Academic, British Commonwealth statesman, military leader, philosopher, and Prime Minister of South Africa. It was only in the mid-1900s that medicine adopted the fusion of Holistic and Medicine.
The idea of reduction compartmentalization was that systems are best studied through their compartments or individual parts instead of the top-down, almost unrelated perspective in how things in the biological versus non-biological were constructed and related to each other. Christian Smuts was able to see the disconnect where most were blind. In contrast, Christian Smuts discarded the compartmentalization and top-down view and pursued the bottom-up approach in which the whole transcends the individual parts. The individual parts support and point to the whole. His idea was that systems, whether biological or non-biological, are best served and evaluated by focusing on the parts that benefit the whole. The whole is more important than the individual parts. The individual parts exist to serve the whole.
The field of multi-omics research and its clinical application is the future of precision cancer care available today. It is a revolution born from the similar rejection of the reductionism, top-down, compartmentalized approach that permeated and dominated Christian Smuts’s time and culture. A similar medical revolution is found today funneled through multi-omics. It is a revolution that begets a revolution. The field of multi-omics provides a stark contrast, almost paradoxical, between the one-size-fits-all, cookie-cutter approach, which dominates the top-down, compartmentalized conventional medicine approach. Instead, a holistic approach that manifests itself in multi-omics provides a non-compartmentalized, bottom-up, wholistic approach to healing.
Who knows how many “omics” research areas are yet to be added? Whatever the number, they will all fall under the collective umbrella of multi-omics. The multi-omics approach to medicine is turning information into clinical application. Of course, the most consistent approach to this application
1 Hoffmann MA, Kretschmer F, Ludwig M, Bäcker S. MAD HATTER Correctly Annotates 98% of Small Molecule Tandem Mass Spectra Searching in PubChem. Metabolites. 2023 Feb 21;13(3):314. doi: 10.3390/metabo13030314. 2 Uetaki M, Tabata S, Nakasuka F, Soga T, Tomita M. Metabolomic alterations in human cancer cells by vitamin C-induced oxidative stress. Sci Rep. 2015 Sep 9;5:13896. doi: 10.1038/srep13896 3 Ahmad AS, Ormiston-Smith N, Sasieni PD. Trends in the lifetime risk of developing cancer in Great Britain: comparison of risk for those born from 1930 to 1960. Br J Cancer. 2015 Mar 3;112(5):943-7. doi: 10.1038/ bjc.2014.606.