The Tissue Image as an Integrative System*
David Harrison, MD
Professor of Pathology, University of St. Andrews
How fundamental is the implementation of tissue phenomics into practice? One aim of medical advances should be to predict what will happen, rather than simply to describe what has happened; but scientific medicine has often been based on reductionism rather than synthesis. Much of this comes from the historical importance of infection in shaping medicine; cause and effect (Koch’s postulates), external causes (antibiotics) and effects (death of organisms). We have biomarkers based on images and morphology, but it has been difficult at times to ensure standardisation between pathologists and institutions.
We now understand that the processes we call “inflammation and immunity” are much more important in maintaining homeostasis, and in terms of diagnosis, prognosis and prediction. Phenomics offers an invaluable tool for implementation of systems medicine approaches to both understanding and treating disease, and not just cancer: the tissue image is the synthesis of underlying biological systems. I will reflect on the A1:O28 of a more integrative approach to disease and tissue analysis, and in particular the challenges of encouraging an understanding of immune processes leading to their inclusion into clinical practice.