Precision Medicine: The new era in medicine

Precision medicine, also known as stratified medicine or personal-ized medicine, aims to better target intervention to the individual, maximize benefit and minimize harm. Enthusiasm for the prospect of precision medicine has grown significantly in the last few years. There has been increasing interest in two streams of development in precision medicine. First is the integration of electronic medical records capturing longitudinal data and providing clinical phenotypes into decision making tools for precision medicine. Secondly, the advance in genomic medicine and pharmacogenomics research provides an expanding arsenal of genetic predictors of disease and health outcomes. Together these two streams provide a unique framework for an individualized diagnostic and therapeutic approach. Genetics has been a part of the health care system since introduction of the newborn screening in the 1960s, now it has become a priority area for prevention and treatment of common chronic diseases such as cancer and heart diseases (Auffray et al., 2016). In cancer research, personalized medicine based on genomics and pharmacogenomics is expanding rapidly. Other chronic diseases, such as diabetes and neurodegenerative diseases have widened their horizons and included precision medicine in their research strategies. Inflammation appears in a wide spectrum of diseases and has a very heterogeneous phenotype, including autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis to autoinflammatory diseases and immunodysregulatory diseases such as secondary hemophagocytic lymphohistiocytosis. In the last 25 years, the understanding of inflammatory diseases has dramatically increased and changed our approach to treatment. Initially these under-recognized childhood and adult diseases were associated with high burden of disease and associated high mortality rates. In rheuma-toid arthritis, the single discovery of the cytokine TNF-alpha has changed a joint-destructing debilitating disease refractory to treatment EBioMedicine 4 (2016) 24–25 into a well-controlled disease (Cuppen et al., 2015). Inflammatory brain diseases are a relatively new area of inflammation, but have a vastly expanding spectrum of diseases. Inflammatory brain diseases, including infectious meningitis, en-cephalitis, vasculitis, T-cell mediated inflammatory brain diseases, and demyelinating diseases are rare diseases and would benefit from a precision medicine approach. The spectrum of inflammatory brain diseases has rapidly expanded during the last decade and keeps expanding with new discoveries (Twilt and Benseler, 2014). Diseases such as small vessel primary CNS vasculitis, previously only diagnosed on autopsy, are now increasingly recognized early in the disease course, before irreversible neurological deficits are developed. One of the big challenges in in-flammatory brain diseases is the overlapping …