Our Childhood Aim
Conventional medicine focuses on treating individuals when a symptom arises which is often late in the disease onset and compromises treatment efficacy. The Metabolic Health Center wants to change this model and focus on early disease prevention, detection and monitoring. Detecting diseases early allows correction of abnormalities and avoid life-long complications.
How is the Metabolic Health Center researching and detecting metabolic diseases?
Given the fact that every disease has a metabolic component and metabolic dysregulation is often detectable before the symptoms arise, measuring metabolites should help prevent, detect and monitor diseases. We are using the latest technologies in metabolic profiling, pioneered by Drs. Michael Snyder and Kévin Contrepois (PMID: 25787789), to precisely measure thousands of metabolites simultaneously. This type of measurement gives access to your child’s biochemistry in extraordinary detail and could lead to diagnosing a disease that you may not have been aware of. The findings can also support treatment plans and targeted therapies.
We believe collecting metabolic profiles on many children will be key in better classifying diseases. Our center is building a large database that will contain hundreds of thousands of metabolic profiles from healthy and diseased individuals. This database will be determinant in accurately diagnosing diseases early. If we are unable to match a specific profile to a disease (i.e. undiagnosed disease or disease not present in the database) we will still be able to detect outlier metabolites which will give us some insights into which metabolic pathways are deregulated. Altogether, combining a large amount of metabolic profiles in our database as well as pattern recognition algorithms will help us detect and stratify complex diseases as well as efficiently treat children early.
How can metabolic profiling help us detect early complex diseases, like diabetes or autism for example?
In contrast to genetic diseases that are explained by mutations in a single gene, it is much harder to determine a person’s risk for developing a complex disease because it is based on a combination of genetic, environmental and lifestyle factors.
One example is Diabetes. Diabetes is a complex and heterogeneous disease with new diagnoses made in tens of thousands of children each year. Because of this heterogeneity, one treatment may be efficient for one patient but not another. Thus, a better sub-classification is required to efficiently treat the disease. Dr. Michael Snyder has been working on this topic for many years and is a leader in this area (PMID: 25211071, PMID: 29361466). Recent research shows that there may be up to five sub-types of diabetes. Most people know of Type 1 (the body stops making insulin) and Type 2 (the body is insulin resistant) but other subtypes have been defined, including the Maturity-Onset Diabetes of the Young (MODY). MODY is different from other diabetes because it is associated with a genetic mutation. Diabetes heterogeneity is further shown by the fact that 80 percent of individuals with Type 2 diabetes respond to metformin and 20 percent respond to salicylate (similar to aspirin). Likewise, MODY diabetics respond to a very different drug than those used for Type 2 Diabetes. If we can better sub-classify disease, our hope is to offer the right treatment for the right patient.
Another example includes autism in children. Researchers believe that it may be possible to modify the behavior of a child with autism by interfering with the gut microbiome (microbes living in the gut with food). However, after age five, making these changes have little effect on the child’s behavior. This demonstrates the importance of diagnosing the disease early in order to treat the disease early.
How might modern medicine contribute to altering a child’s metabolism?
It’s clear there are strong associations between children who take antibiotics in their first two years of life and obesity. Antibiotics alter the microbiome, which in turn puts children at increased risk for developing obesity. This has brought increased scrutiny to the over-prescribing of antibiotics to children who have colds or other upper respiratory issues. Most of these illnesses are viral infections. As a result, antibiotics (which work on bacteria) cannot help children get better faster. What they will do, however, is wipe out good gut bacteria. Thus, misuse or overuse of antibiotics is not good for your child—it may in fact be harmful. The overuse of antibiotics given to farm animals further contributes to this problem.
If nearly every disease has a metabolic component, what does that mean for your child?
Your child’s biochemistry underlies much of their health, and there is a biochemical signature associated with all diseases. That’s why we are encouraging metabolic profiling throughout Lucile Packard Children’s Hospital Stanford and Stanford Children’s Health clinics. We believe it will help us understand, diagnose, and ultimately treat disease.
We want you to know that this process will take time. Your child’s metabolic profile may not be analyzed until months after we collect a sample, and the results are generally reserved for research purposes. Your child will continue to receive excellent care at Lucile Packard Children’s Hospital Stanford or in our Stanford Children’s Health clinics. If we find something that may impact your child’s care, we will not hesitate to communicate that to your child’s treating physician. It’s possible that we may not return results if we find no significant evidence of a metabolic disease.