Revisiting social MPE: an integration of molecular pathological epidemiology and social science in the new era of precision medicine

ABSTRACT

Introduction

Molecular pathological epidemiology (MPE) is an integrative transdisciplinary area examining the relationships between various exposures and pathogenic signatures of diseases. In line with the accelerating advancements in MPE, social science and its health-related interdisciplinary areas have also developed rapidly. Accumulating evidence indicates the pathological role of social-demographic factors. We therefore initially proposed social MPE in 2015, which aims to elucidate etiological roles of social-demographic factors and address health inequalities globally. With the ubiquity of molecular diagnosis, there are ample opportunities for researchers to utilize and develop the social MPE framework.

Areas covered

Molecular subtypes of breast cancer have been investigated rigorously for understanding its etiologies rooted from social factors. Emerging evidence indicates pathogenic heterogeneity of neurological disorders such as Alzheimer’s disease. Presenting specific patterns of social-demographic factors across different molecular subtypes should be promising for advancing the screening, prevention, and treatment strategies of those heterogeneous diseases. This article rigorously reviewed literatures investigating differences of race/ethnicity and socioeconomic status across molecular subtypes of breast cancer and Alzheimer’s disease to date.

Expert Opinion

With advancements of the multi-omics technologies, we foresee a blooming of social MPE studies, which can address health disparities, advance personalized molecular medicine, and enhance public health.

KEYWORDS:

• Alzheimer’s disease
• breast cancer
• health inequality
• heterogeneity
• laboratory medicine
• molecular pathological epidemiology
• precision medicine
• prevention
• social science
• social epidemiology

Article highlights

• Social MPE is an integrative research discipline that relates social-demographic factors to heterogeneities in molecular pathological biomarkers and associated disease subtypes.

• Parallel advances in social sciences and MPE generate increasing opportunities to center social MPE frameworks in research and practice, which will deepen precision medicine initiatives.

• By evaluating breast cancer through the social MPE framework, the current study adds to evidence suggesting heterogeneous associations between race/ethnicity and socioeconomic status on neoplastic disease subtypes.

• By evaluating the role of race/ethnicity and socioeconomic status on Alzheimer’s Disease etiology, this is the first study summarizing the application of social MPE framework on a non-neoplastic disease.

• We recommend transdisciplinary pathology training programs and increasing representation of minority populations in research studies to diminish health disparities and ensure the benefits of social MPE are equitably distributed.

Notes on Contributions

A Nishi and S Ogino designed the project. J Dai, A Nishi, N Tran performed literature review and wrote the first version of the manuscript. G Dewey, Y Yamamato, T Ugai and S Ogino analyzed the findings. All the authors revised the manuscript.

Declaration of interest

A Nishi is a consultant to Urbanic & Associates. Y Yamamoto is the Founder and CEO, Kyoto Angel Fund, Inc. in Japan. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported in part by USA National Institutes of Health grants (R35 CA197735 to S.O.; R01 CA248857 to S.O.).