5.6 未来展望

5.6 未来展望

来自体内外的破坏不断威胁着身体健康,机体必须阻止和修复各种损坏,并且在可能的情况下对丢失的结构和丧失的功能重新生成以实现完全恢复并做到重新整合。结构修复和再生响应于对系统造成确切损害的类型,而以特定的方式对刺激发生反应。至今为止,人们已经发现自己的身体从细胞到系统早已形成了复杂的信号网络,以系统地感知身体的各个阶层中特定类型的损伤并对其做出反应。

利用血浆蛋白表达模式显示多种不同的健康状况,可能成为评估未来疾病风险和生活方式的有效指标[50]。目前已经有了11种不同健康指标的蛋白质表型模型,即肝脏脂肪、肾脏过滤、体脂百分比、内脏脂肪量、瘦体重、心肺健康、身体活动、饮酒、吸烟、糖尿病风险和原发性心血管事件风险。随着年龄的增长而身体中各种分子如何发生变化方面的细节尚不清楚[51]。衰老被广泛定义为影响大多数生物体的时间依赖性功能衰退,在整个人历史中吸引了好奇心和兴奋的想象力。然而,在秀丽隐杆线虫(Caenorhabditis elegans)中分离出第一个长寿菌株后,衰老研究的新时代才开始,到如今,还不足30年时间。另外,在一些研究中,有人对106名年龄在29~75岁之间的健康个体进行了纵向和深度的调研,包括转录产物、蛋白质、代谢物、细胞因子、微生物和临床实验室值等多指标,探索它们如何与年龄相关。也确定了与年龄相关的已知和新标记物,以及与胰岛素敏感个体相比,胰岛素抵抗者衰老的不同分子模式[52]

时至今日,科技进步一日千里,我们掌握的理论和技术日臻完善。今天以极高的精度评估人类健康的能力部分归功于基因测序、生理和环境监测、高级成像技术和行为跟踪方法,以极高的清晰度理解和处理上述观察结果的能力是由基因组编辑、细胞重编程、组织工程和人工智能的进步推动的[53]。在此基础上,我们试图提出进一步进行健康研究的设想,也是我们今后研究努力的方向。首先,要定义个人健康基线,健康研究的基础在于对健康决定因素的个体水平测量的精确和全面评估。根据这些个人基线制定健康风险和干预措施的评估标准。在具体研究中我们将采取个人与自己进行比较的办法,适当地采用广泛的人口统计数字进行比较;其次是精确预防,通过对健康决定因素的持续或频繁评估,可以在某些问题出现临床表现之前及早发现健康参数的变化,并对健康参数偏离个人基线做出反应,从而做到预防或延缓健康问题的出现和疾病的发作;再次,进行高精度干预,在出现健康问题或者疾病发作时,根据个人健康基线以及疾病的精确影响因素设计精确干预措施,这种做法将会得到越来越多工作的验证,使得为监测特定健康问题的过程而量身定制的高效工具能够及早识别干预的成功或者失败;最后,需要众多已经明确数据的人群,将上述健康基线、精确预防和高精度干预结果数据收集直接纳入健康促进实践,无缝实现不断改进,使其帮助保持个人的健康。

【注释】

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