Precisions prevention av kardiometabol sjukdom

Our VR supported project “Precision prevention of cardiometabolic disease” answers the following questions which represent novel principles of precision prevention: (1) Can information of healthy diet intake based on measured levels of metabolites in blood improve adherence to clinical dietary advice? (2) Can pharmacological inhibition of the liver-fat and atherosclerosis promoting hormone neurotensin (NTS) revert liver steatosis in individuals who have an NTS-driven form liver steatosis (NTS>150 pmol/L in plasma)? (3) Can targeted life-style or specific pharmacological therapies revert genetic enzyme deficiencies and improve the clinical phenotype linked to the enzyme deficiency in question?

These are novel precision medicine-based approaches that can improve prevention of cardiometabolic disease. For example, no one would argue against that measurement of blood pressure regularly after initiation of blood pressure lowering medication is fundamental for achieving good clinical outcome. In analogy, we now (in #1) test if objective regular follow-up and information/feedback of “healthy diet related metabolites measured in blood” in individuals at risk for cardiometabolic disease will improve adherence and clinical outcomes after dietary advice. In #2 we test if a therapy tailored at lowering secretion of NTS reduces fat accumulation in the liver specifically in individuals with liver steatosis driven by high levels of NTS. Evolutionary, high NTS is a genetically driven trait that has been enriched as it prevented death from starvation during times of limited food access by assuring fat (calorie) storage in the liver. Today this high NTS driven liver fat storage capacity is common (25% of population) but is not needed and instead causes disease. In #3 we identify genetic enzyme deficiencies which result in high cardiometabolic disease risk and then test if specific life style interventions, supplementation strategies and pharmacological therapies can improve enzyme activity and reduce disease risk.

In summary, these precision medicine approaches can improve prevention of cardiometabolic disease through identification and accurate measurement of biological disturbances, which are present in susceptible subsets of the population, and molecule specific therapies targeted at the biological disturbances in question.