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Welcome to BIOTECH NATION !!! With understandable interviews requiring no background in science, BTN attracts a wide global audience. From everyday people looking for hope in treatments in development, to bioentrepreneurs interested in the experience of their fellow travelers, to venture capitalists looking for possibilities in cutting-edge breakthroughs, to scientists simply interested in the work of others, BioTech Nation is the voice of human endeavor, driving science to new realities for everyone. These interviews are drawn directly from the public radio program, "Tech Nation", which also can be heard in numerous global radio and podcasting venues.
Today on Tech Nation, we hear from doctor Leroy Hood and doctor Nathan Price about the concept and promise of focusing on our wellness, all with the help of science. Doctor Hood developed the first technology to decode your DNA and is often called the father of systems biology. Doctor Price is the chief science officer of Thorne Health Tech and is a professor at the Institute For Systems Biology. They're here today with the age of scientific wellness, why the future of medicine is personalized, predictive, data rich, and in your hands. And now doctor Leroy Hood and doctor Nathan Price.
Dr. Moira Gunn:Well, doctor Hood and doctor Price, welcome to Tech Nation.
Dr. Leroy Hood:Glad to be here. Wonderful to be here.
Dr. Nathan Price:Yeah. Yeah. Thanks, Moira.
Dr. Moira Gunn:Now this is unusual for me. In fact, I don't recall ever having done this in the history of the show, but just about anybody can write a book, and I do a selection of your credentials before, during, and after this interview. But you too, when I look at your careers, you have enough credentials for 6 people. You have enough credentials, excellent credentials for 6 people. So when 2 people like you find the time to write a book, number 1, I'm thinking it must be important.
Dr. Moira Gunn:And number 2, how the heck did this happen? Now before we get to those questions, let me go a little deeper for our audience into your credentials. Doctor Price, you have a PhD and a master's in bioengineering from UC San Diego. And, again, a selection of your credentials, chief science officer for Thorne Health Tech, while you continue to be a professor at the Institute For Systems Biology and an affiliate professor at the University of Washington. You're on the board of life sciences for the National Academies of Sciences, Engineering and Medicine, founded several companies.
Dr. Moira Gunn:We're an assistant professor at the University of Illinois Urbana Champaign, and we're an American Cancer Society post doctoral fellow. And you're also the co author with the fewest credentials. So just to say, don't feel bad.
Dr. Nathan Price:In the case, yes.
Dr. Moira Gunn:So don't feel bad there. So now let's get to you, doctor Hood. In the interest of time, we'll just say a few here. Your undergraduate was at Caltech where your professors included Linus Pauling and Richard Feynman. Your MD is from Johns Hopkins, and you returned to Caltech where you earned a PhD.
Dr. Moira Gunn:Sort of ran out of earning credentials there. We'll give you that. You served at the National Institutes of Health, NIH, and within that, the National Cancer Institute. You returned to be a professor at Caltech then moved up to the University of Washington, ultimately resigning to create the Institute For Systems Biology. Now I am skipping a lot here, but let's not leave out several of your many scientific instruments that you've developed.
Dr. Moira Gunn:Then I'll mention just 2. As listeners, I think we'll understand why they're important. One is the first automated DNA sequencer identifying the order of your DNA, the order of those GCAs and Ts, in your DNA. A big thank you from everyone who's ever gotten their DNA read and from all of 23andme in particular. Another invention I wanna point out is your DNA synthesizer, which enables the generation of short sequences of DNA.
Dr. Moira Gunn:Short sequences of DNA can be inserted into existing sequences of DNA, and they can create proteins which you might be missing or correcting some currently defective proteins in your body as just a few examples. Now I'm gonna make a little more time for your awards. You're a member of 3 National Academies, Sciences, Engineering, and Medicine. A hat trick. This does not happen very often.
Dr. Moira Gunn:As well as the American Academy of Arts and Sciences. Many prestigious awards including the Lemelson MIT prize for innovation and invention, the Heinz award for technology, and the National Medal of Science. Needless to say, dear listeners, whatever my guests are telling you, it's true. They know it. And so we're talking about just an amazing amount of credentials.
Dr. Moira Gunn:So let's go back to those first two questions. How did you 2 come together to write this book, and why is it important?
Dr. Leroy Hood:You wanna start, Nathan?
Dr. Nathan Price:Sure. Yeah. So Lee and I have been working together. We actually met for the first time 21 years ago. So we've been together and and working for quite a long time.
Dr. Nathan Price:And for about the past 11 years, we've really been engaged, deeply in, what we call scientific wellness. And so Lee and I had become really convinced that medicine was too focused on care after illness, after you got to a stage where reversal is really hard. And there's many confounding factors that have happened. You have the cause of the disease. You have downstream consequences, and also compensatory mechanisms which where the body is trying to save itself, and those can often be misinterpreted as related to the disease.
Dr. Nathan Price:And so we became very convinced that we had to focus upstream and be on health. So this led, as we'll get into a number of studies, but at the end of all this process, when we with all we've learned over the last decade, we really felt like there was enough that people needed to know, and we wanted to get our story out in a form that's not just in all the very many scientific papers that we write, but in a form that was easy to digest, that people could understand so that we could get enough excitement so that we could help to put hopefully more pressure or insight or into the medical system to say we need to restructure as much as we can around a wellness paradigm and not only late stage disease.
Dr. Leroy Hood:And, I would add to that, that what I think really enabled us to write the book more than anything else was COVID 19. And basically what happened is we were in suspended animation for two and a half years, and Nathan and I actually decided that that was a great time to write a book. I have a place out on Friday Harbor, San Juan, which is an island off the coast of, state of Washington, and we decided we could spend a fair amount of time there, both conceptualizing exactly what the book should include, dividing up the chapters, and we pretty much evenly split the book right in half, Nathan writing the half that, was most relevant to his expertise, and I doing exactly the same thing. And I think what was unusual about our partnership is it's rare do you get to spend that much time with your soulmate in writing a book, so that we really had thoroughly discussed and raked over everything we were going to do. And even with that, I must say, after writing the first edition of the book, when we took it to Harvard University Press, we had a wonderful editor that said, Well, this book is okay, but here, you can fix it all these ways.
Dr. Leroy Hood:And I would guess, I don't know, perhaps we rewrote more than half the book in that context, and we certainly modified, almost all of it in accordance with suggestions she made. So I think the intrinsic product that we created together with her experience in these kind of books has has created a book that we hope is is going to present a compelling story for really the two points that we would like to make. 1 is the idea that we have to have a healthcare that's wellness and prevention oriented as opposed to disease oriented. And 2, a really critical point is we believe we can bring this data driven, AI driven health care to every single individual and improve both their wellness and their ability to avoid disease.
Dr. Moira Gunn:You're right. Few people realize it, but the 10 most popular drugs in the United States today were collectively for only about 10% of treated patients. Don't these people have these conditions?
Dr. Leroy Hood:So I think the real point that comes out of that study, which was published in Nature, a really prestigious journal, and I will say people argue about whether 10% is too low, but I would say even if it's 30 or 40%, that's way too low still. And the important point is, 1, a lot of people are getting exposed to drugs where they do no good and in fact they only experience their harmful side effects. And number 2, if you realize that we spend $600,000,000,000 a year on drugs, and let's say we could get rid of 90% of that money, because with a data driven approach to health care, we'll be able to identify and identify quite quickly for major drugs, biomarkers that will say unequivocally it'll work for you, but it won't work for you.
Dr. Moira Gunn:And even in the aftermath of taking it, there's technology that could say, well, it's not working now. We don't know why, but it's not working as opposed to the doctor saying, how do you feel?
Dr. Nathan Price:Yeah. That's exactly right. And so you can stratify the way that you look at data just the way you you describe. So where you identify what are called surrogate endpoints, which are basically changes that are associated with changing the course of the disease itself, and you could see those in an earlier facet. Like, one that we we looked at, which is quite interesting around statins, is you can wait to see if it changes your LDL cholesterol, which is itself a, you know, marker for cardiovascular disease.
Dr. Nathan Price:But you can, in fact, get an instantaneous readout in most of these cases by something called HMG, which is a molecule that will change immediately if the statin is hitting its target even before you wait to see how big of an effect it will have down stream. That's just an example, but you could build those same kind of things around all the different diseases. And the big thing that you need is to have data sources that are rich, that predate disease in in large populations, and that's what we've been spending a lot of the last decade really building out.
Dr. Moira Gunn:Well, now we get to data. You've both mentioned data, whether you said biomarkers, meaning biological measurements of something going on or just large datasets that AI might look at. We'll get to that. But this data might be looked at in 3 different categories. And the first two, we have terms for that I I really want people to remember.
Dr. Moira Gunn:And it's genome and phenome. Phenome is p h e n o m e, phenome. What's the difference between genome and phenome, and what are they to begin with?
Dr. Leroy Hood:So the genome is the basic source code of life. It is the order of the four letters of DNA language present in your 23 pairs of chromosomes. And the genome, for a first approximation, is invariant across life. You're born with a genome and that doesn't change, except in the case of cancer in many cases. The phenome, on the other hand, is something that measures how you change as you develop and you age and you move into old age and so forth.
Dr. Leroy Hood:And in a sense, the phenome is a snapshot of you at each point, each instant in your life. So, we have an essential infinity of phenomes that we could measure. And we measure the phenomes by actually putting together 3 important things, and these phenomes are governed by those three things. So one is your genome, the source code. It directs development.
Dr. Moira Gunn:Your DNA. Yes.
Dr. Leroy Hood:Your DNA. The other is your behavior. It has a profound effect on your phenome. Do you exercise? Do you eat too much?
Dr. Leroy Hood:And so forth. And the third thing is your environment. Are you in a healthy environment? Are you in a environmentally compromised environment with toxins and things like that. So those three things can be measured very easily by 1, doing your whole genome sequence, determining the order of the letters in the, in your chromosomes.
Dr. Leroy Hood:By 2, sampling the blood, and in the blood are a multiplicity of proteins and a multiplicity of metabolites and lipids and things like that. Number 3, sampling your gut microbiome. That is identifying the diversity and nature of species that live in your gut microbiome and have a profound impact on your health. And then 4, we've used digital health measurements like the Fitbit to look at activity and sleep and things like that. So all of these things together are called the phenome, and the phenome is what gives us really an accurate view of what your health trajectory is at any given instance in time.
Dr. Leroy Hood:And with those measurements, we're learning to assess your health trajectory and to optimize it as we move into the future.
Dr. Moira Gunn:Which gets us to that big third one, digital measurements of health, which may not be the internal measurements, but all kinds of measurements as well.
Dr. Nathan Price:Yeah. So this is an area that's exploded, you know, really in in recent years and, you know, so many of us have that. Right? You probably have your your Apple Watch or your Fitbit or the Garmin or the anyway, you could you could mention a a million of these.
Dr. Moira Gunn:A big list. Big list. Yeah.
Dr. Leroy Hood:A
Dr. Nathan Price:big list. But, basically, you can get a lot of health relevant information on a daily basis. You can get pings from your devices to change behavior. You can monitor for heart health. You can monitor for activity, for skin temperature, for, you know, on and on breathing patterns and so forth.
Dr. Nathan Price:And so these really give a lot of rich information that you can tie together with a lot of the molecular data that that Lee just went through and give you a very complete view of health, which you can then take to give personalized recommendations back to people, to help them optimize, their wellness as they go through their life.
Dr. Moira Gunn:Now we don't often talk about our minds when we're talking about the health of our bodies, but you have a chapter entitled keeping your mind healthy for life. What's the connection?
Dr. Leroy Hood:Well, an important part of of, health is the integrated health of your brain, the health of your body, and the health of your microbiome. And they seamlessly together make you healthier, make you unhealthy. And what is really striking in modern medicine is brain health has almost entirely been ignored. For example, when is the last time you ever had a physician say, then how is your brain?
Dr. Moira Gunn:About ever.
Dr. Leroy Hood:And it turns out that we're collaborating with Professor Michael Merzenich at UCSF, who started a company, Posit, that has a digital approach to the assessment of 25 different kinds of cognitive features. And what this assessment can do is not only say where is your reaction time, where is your depth of field perception, how is your memory, on and on for the other 22, 22 concept. But it can correct them if they're deficient by essentially providing games that challenge the very aspects of cognitive limitation that you have. And the remarkable contribution that that Michael Marzenich made to understanding the brain, is for the first time, he made it clear that the brain is plastic, that it can be changed at any point in your life. In fact, he did studies that demonstrated beautifully, as we grow, our cognitive abilities come typically to a maximum in the mid thirties and they decline thereafter for most people.
Dr. Leroy Hood:And so, what Marzenich showed is by taking close to a 1000 people, that the majority of them could actually be encouraged to reconstitute their lost functional activities at somewhat near the level they would have had at their maximum. So it means there's hope for all of us Yeah. That we can go back to where we went before. But but the essence of the idea is it's beyond ridiculous to talk about health without realizing that the brain has to be exercised, just like the heart and body does, to really be healthy. And so what we want to do is create opportunities for that exercising that deals, not only with the cognitive features, but there are exercises one can do that deal with the integrative features of the cerebrum and how it puts everything together for you and executive function, and all these kinds of things.
Dr. Leroy Hood:And the ultimate objective of the integration of these three things, the, brain health, the body health, and the gut microbiome, is we want to give people the wherewithal to move into their nineties or even into their 100, physically capable, mentally alert, and in a position to be creative, interactive, communicative, and so forth, which is just not true of many people today. That is, we like your health span, the amount of time that you live in good health, to equal your lifespan and have that equal a 100 or more years.
Dr. Moira Gunn:One thing I'd like to talk about is cancer and how we need to think about cancer. Will early diagnosis really become sort of widespread routine diagnostics every year because it's so early? And once diagnosed, what can we hope for? Can we hope for cures or simply to keep cancer at bay to outlive your cancer, if you will?
Dr. Leroy Hood:You know, initially, we started with techniques that were burn, slash, and cut. So they were enormously nonspecific, and you just tried to cut out and or destroy tumors wherever they might be, and that was not very discriminating. And from that, we moved to an era of chemotherapy where you tried to poison the cancer with the arguments being they're very rapid growing cells, and if you kill the rapid growing cells, you'll kill the cancer. You care kill other normal rapid growing cells at the same time. So it wasn't necessarily a desirable solution.
Dr. Leroy Hood:But, you know, collectively, those things didn't move the the, scale very much on improving our ability to, deal with cancer.
Dr. Moira Gunn:You're listening to TECHNATION. I've been speaking with doctor Leroy Hood and doctor Nathan Price about the age of scientific wellness, why the future of medicine is personalized, predictive, data rich, and in your hands. Doctor Hood has been speaking about developments in cancer.
Dr. Leroy Hood:I think the one big hope that is just coming to the fore now over the past 10 years or so, is immunotherapy. The ability to turn the immune system and to direct its attack at the cancer and to direct that attack in a very specific targeted way that just goes after cancer cells. Now, that isn't nearly as easy as it sounds and people are still struggling with that, But anyway, that is the real hope for the future. But the really important point, I think, about cancer is this whole idea that we now have a technique we think that will allow us to detect cancer very early, years before it ever manifests itself clinically. And if we can do that with appropriate biomarkers for all the different kinds of cancer, then you can imagine a data driven strategy whereby we'd say, Look, Mrs.
Dr. Leroy Hood:Jones has a marker that says in 4 years she's going to get pancreatic cancer that could progress to stage 4. Let's treat it now. Now, we have to think about how to treat it, but we know that at that early moment of transition from wellness to cancer, the changes are simple. So we can really characterize the simple changes and make them. And in fact, it might even be really effective to have immunotherapy really aggressively attack that cancer when it's very small and hasn't had many changes and things like that.
Dr. Leroy Hood:But be that as it may, I think we now have the possibility with this data driven approach to health, to be able to continuously monitor several every 6 months, patients, and to say, Oh my goodness, here are a set of proteins that says you're gonna get type 2 lung cancer, or type 3 breast cancer, or whatever it is. And there is experimental evidence that suggests this is true, that has come out of a study of 5,000 individuals that were followed over 4 years and a company called Arugale that was bringing scientific wellness to consumers, where a 167 of them transitioned from wellness to disease. And we actually looked at 10 of them that made the transition to cancer and demonstrated there were these markers that we can detect. But I think to convince the world what we're gonna have to do is what my non profit company, Phenom Health, argues we should do, is we'd like to look at a 1000000 normal individuals, over a period of 10 years doing this genome phenome analyses. And we think supported in a sense as a second genome project by the government, we think there'll be just a superb chance that we can unequivocally show, 1, the quality of healthcare has increased enormously for all of the individuals in the program, and even more important, 2, we can end up saving 1,000,000,000,000 of dollars for the healthcare system.
Dr. Leroy Hood:Because to take it from a disease oriented system to a wellness oriented system, there has to be financial gain for people that are in it. And these are the kind of savings that I think can really turn heads. That's a long answer, but at least it gives you a complete one.
Dr. Moira Gunn:You've just listened to part 1 of a 2 part interview with doctor Leroy Hood and doctor Nathan Price. Part 2 of that interview is featured in our next podcast. My guests today are doctor Leroy Hood and doctor Nathan Price. Their book is the age of scientific wellness, why the future of medicine is personalized, predictive, data rich, and in your hands. It's published by the Belknap Press of Harvard University Press.