Personalized Prognosis and Diagnosis of Type 2 Diabetes - Vision or Fiction?

Typical civilization diseases, such as type 2 diabetes, share
several features: their worldwide frequency, the complexity of the
underlying pathogenic mechanisms, heterogeneity in the phenotypes
and their multifactorial nature due to a wide variety of possible
combinations of disease susceptibility or protective genes in
different tissues and negative or positive environmental factors.
This is in sharp contrast to classical inherited diseases, such as
Huntington's chorea, which are often caused by complete loss- or
gain-of-function mutations in a single gene. The causative
polymorphisms of susceptibility genes, however, are characterized
by relatively subtle alterations in the function of the
corresponding gene products, i.e. low penetrance and effect size,
which do not support the pathogenesis per se, and by their high
frequency; these two characteristics result in high expenditures
for their identification and a rather low predictive value. In the
future, the reliable and early diagnosis of common diseases will
thus depend on the determination of all (or as many as possible)
polymorphisms of each susceptibility gene together with the
corresponding gene products and the metabolites emerging thereof
for each individual. Great hopes are currently associated with
systems biology to cover these demands in time (i.e. along the
pathogenesis) and space (i.e. in all relevant tissues). Copyright
(C) 2010 S. Karger AG, Basel