Chapter 3
A Tale of Two Patients — 3
Artificial intelligence (AI) is starting to play a pivotal role in preventing age-related diseases. We’re seeing how—across all dimensions—it can precisely determine a person’s risk for specific conditions and provide actionable steps and interactive coaching. Multimodal AI integrates layers of data—electronic health records, labs, images, omics, exposure to pollution, social determinants of health, and state-of-the-art medical knowledge—to build personal medical forecasts. Virtual medical coaches have been a fantasy of primary disease prevention for decades, though it is still not yet a reality. However, Thrive AI Health, a joint initiative between Open AI and Thrive Global, may be on the way to making that dream come true.
5. Drugs/Vaccines
New drugs and vaccines are being rapidly developed because we can now predict the atomic shape of more than two hundred million proteins. You’re probably familiar with generative AI’s propensity to hallucinate. But that’s a good thing when you exploit this bug/feature to discover new proteins that don’t exist in nature and may fulfill big unmet needs in medicine. Guess where Ozempic and Wegovy came from. AI didn’t invent these man-made peptides out of thin air; their discovery was based on the naturally occurring ones that circulate at low levels in our bloodstream. These and other glucagon-like peptide-1 (GLP-1) drugs have far exceeded all expectations beyond the treatment of obesity and diabetes, improving the outcomes of heart attacks, strokes, heart failure, liver, and kidney disease—and more to come. New technology developed for COVID vaccines is now being successfully applied to a broad range of diseases, including cardiovascular and cancer. We now have drugs that take immune therapy against cancer to a new level, combining highly targeted chemotherapy to avoid noxious side effects. Vaccines to supercharge our immune response against cancer are taking hold, and the flip side, to block the immune system in autoimmune diseases. For the first time, after failing for many decades, we are seeing drugs for neurodegenerative diseases.
As shown in the graph below; all five dimensions interact with one another. Our lifestyle factors influence our microbiome and cells. Our response to drugs and vaccines is modulated by our genomics and cells, and discovery of new drugs has been enhanced by gene variants and by AI. We’ve learned how to engineer our cells to become living drugs (fig. 1.1).
Figure 1.1. The five dimensions and their interactions
THE DRIVING FORCE
This multidimensional revolution in health span has been powered by a convergence of breakthroughs in life science and information technology. It has taken more than twenty years from the sequencing of the human genome, ten years from discovery of CRISPR genome editing, thirty years for mRNA and nanoparticle development, and many decades to get to large language AI models. Cumulatively, hundreds of years of dogged perseverance have put us in an enviable position of being able to reset our human health span expectations.
I ask you to bear with me. This book is evidence based. In some chapters the technical information is quite dense on the page. We are talking about life and death, and I know many readers feel an urgent need for the level of detail I offer. If nothing else, it will help families discuss options with their doctors. But it’s my belief that these biomedical details build deep insights into our human potential.