Hiroyasu Iso

Olga Golubnitschaja

Vincenzo Costigliola

PubMed

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MEETING ABSTRACT Open Access
Coincidence of cardiovascular disease and breast
cancer in females: Multi-modal strategies by
predictive, preventive and personalised medicine
Olga Golubnitschaja1,2*, Vincenzo Costigliola2, Hiroyasu Iso2,3
From EPMA-World Congress 2013
Brussels, Belgium. 20-21 September 2013
Epidemiologic background
Regarding most frequent pathologies in females, the cau-
sal link between diabetes mellitus and development of
severe cardiovascular complications is well acknowledged.
In contrast, the co-incidence of the cardiovascular disease
(CVD) and breast cancer is poorly understood. This is an
extremely unlucky situation, since compared to all other
pathologies, both - CVD and breast cancer demonstrate
the highest frequency of incidence in females. Hence, the
probability to identify a female postmenopausal patient
above 55 years old diagnosed with sporadic invasive
breast cancer but CVD-free is rather low. However, an
obvious coincidence of CVD and breast cancer in peri-
and post-menopausal females, synergic co-prevention,
common diagnostic tools and multi-drug co-treatments
are currently not considered for medical services.
Current deficits in prevention, diagnosis and
treatments of a coincident breast cancer
• Worldwide 8-12 women from hundred get diseased on
breast cancer. Around 50% of DCIS (ductal carcinoma
in situ) will progress to invasive and metastasis disease
if untreated, with 20% of recurring ones despite “appro-
priate” treatments.
• Breast cancer metastatic disease (BCMD) is currently
incurable [1].
• Causative factors such as co-incidental ones underly-
ing recurrence of DCIS or progression to invasive dis-
ease are currently not known.
• 95-98% are sporadic breast cancer cases versus 2-5%
familial ones: the majority of sporadic breast cancer
cases are peri- and post-menopausal women – the
group at significantly higher risk of CVD.
• Co-morbidities in breast cancer are considered
rather from view point of psychological aspects and pal-
liative care but not as the realistic model in biomedical
research, common diagnostic tools and treatment
multimodalities.
• Consistent data do not exist to recognise co-incident
pathologies by patient profiling.
• Cost-effective healthcare promotion in breast cancer
and its common or even persistent co-morbidities such
as CVD and diabetes is not provided.
• A gap between current research performance and
clinically applicable results is dramatic.
‘Stress proteome’ targets: innovative biomedical
approaches meet personalised healthcare
Stress response is the key ability of each organism that
enables it to adapt and survive. Individual stress response
can explain the individual reactions towards similar condi-
tions and underlies the molecular (pathological) mechan-
isms of individual outcomes [2]. The minimal stress
proteome mainly consists of the following functional
groups: Nucleic acid metabolism, Molecular chaperones,
DNA damage sensing/repair and cell cycle control, Basic
transcription, DNA replication and RNA processing,
Translation regulation, protein synthesis and degradation,
Redox regulation, CoA metabolism, Energy metabolism
and ATPases/ABC transporters [3]. These functional
groups represent potential targets to be utilised for com-
plex diagnostic tools and treatments tailored to the person.
As reviewed previously [4], genotoxicity is the most fatal
consequence of any kind of stress factor, such as the most
ubiquitous emotion stress, smoking and alcohol consump-
tion, hyperhomocysteinemia, folate and taurine deficiency,
* Correspondence: olga.golubnitschaja@ukb.uni-bonn.de
1Molecular Diagnostics, Radiological Clinic, Medical Faculty, Friedrich-
Wilhelms-University of Bonn, Germany
Full list of author information is available at the end of the article
Golubnitschaja et al. EPMA Journal 2014, 5(Suppl 1):A87
http://www.epmajournal.com/content/5/S1/A87
© 2014 Golubnitschaja et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
UV and ionising irradiation, fluctuating blood glucose con-
centration (starvation and diabetes mellitus), asphyxia /
ischaemia / stroke / reperfusion, genetic syndromes such
as Down’s syndrome, and neurodegenerative diseases such
as Huntington’s, Alzheimer’s and Parkinson’s disease, and
glaucoma. Recent studies showed individual stress
responses to be well or less adapted to life situations.
Inadequate stress response can be caused by the dysfunc-
tion of red-ox control, cell cycle machinery, apoptotic/
repair mechanisms leading to severe pathologies such as
human genetic syndromes, accelerated ageing, cardiovas-
cular and neuro/degenerative diseases and cancer [4].
Multi-modal strategies by predictive, preventive
and personalised medicine
➣ Creation of gender-specific profiles for CVD-diagnos-
tics and treatments by well-funded large-scale studies
with parity of both sexes including “omics”-based blood
analysis, molecular imaging and elaboration of gender-
specific questionnaires for accurate description of pro-
dromal and acute symptoms of CVD 5.
➣ Consideration of CVD-specific sex-determinants
such as mutated maternal mitochondrial DNA that
emerges complications and fatal outcomes of CVD.
➣ Performance of large-scale population studies to
identify most frequent profiles of co-incident pathologies
for effective treatments suitable for corresponding com-
bination of co-morbidities such as depression/diabetes/
CVD/breast cancer in female patients.
➣ Creation of strictly individual treatment priorities
and regiments request personalised medical approaches
of high plasticity and new generation of multi-cocktail
drug compositions.
➣ New drug delivery systems that allow for targeted
treatments.
➣ Reasonable convergence between diagnostic and
pharmaceutical industry in development of predictive/
prognostic approaches based on new multifunctional
targets for diagnostic and treatment purposes.
➣ Besides general prevention in populations, there is
an urgent need for targeted prevention in childhood,
adolescence and adulthood as the most cost-effective
approach that requests complete reconsideration of cur-
rent diagnostic and treatment programmes offered in
healthcare systems: major CVD risk factors overweight,
obesity and diabetes type 2 are the most frequent nutri-
tional disorders in industrialised countries.
➣ Creation of new programmes in healthcare systems
for effective promotion of and financial motivation for
healthy life-style.
➣ Creation of the network among healthcare perso-
nals dedicated to the task, namely research groups in
women’s health (predictive medicine), primary
healthcare (preventive measures) and networked clini-
cians for personalised treatments in female patient
cohorts.
Authors’ details
1Molecular Diagnostics, Radiological Clinic, Medical Faculty, Friedrich-
Wilhelms-University of Bonn, Germany. 2European Association for Predictive,
Preventive and Personalised Medicine, Brussels, Belgium, Avenue des
Volontaires, 19, 1160 Brussels, Belgium. 3Osaka University Graduate School of
Medicine, Osaka, Japan.
Published: 11 February 2014
References
1. Golubnitschaja O, Yeghiazaryan K, Costigliola V, Trog D, Braun M, Debald M,
Kuhn W, Schild HH: Risk assessment, disease prevention and personalised
treatments in breast cancer: is clinically qualified integrative approach in
the horizon? EPMA J 2013, 4:6.
2. Golubnitschaja O, Costigliola V: Common origin but individual outcomes:
time for new guidelines in personalized healthcare. Personalized Med
2010, 7(5):561-568.
3. Kultz D: Evolution of the cellular stress proteome: from monophyletic
origin to ubiquitous function. J Exp Biol 2003, 206:3119-3124.
4. Golubnitschaja O: Cell cycle checkpoints: the role and evaluation for
early diagnosis of senescence, cardiovascular, cancer, and
neurodegenerative diseases. Amino Acids 2007, 32:359-371.
5. Golubnitschaja O: Changing Long-Held Beliefs Is Never Easy: A Proposal
for Multimodal Approaches in Female Healthcare – An Integrative View.
In in the book-volume Healthcare Overview: New Perspectives. Springer;V.
Costigliola 978-94-007-4602-2 2012:, Book Series “Advances in Predictive,
Preventive and Personalised Medicine” (Series Ed.: Golubnitschaja O).
doi:10.1186/1878-5085-5-S1-A87
Cite this article as: Golubnitschaja et al.: Coincidence of cardiovascular
disease and breast cancer in females: Multi-modal strategies by
predictive, preventive and personalised medicine. EPMA Journal 2014 5
(Suppl 1):A87.
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Coincidence of cardiovascular disease and breast cancer in females: Multi-modal strategies by predictive, preventive and personalised medicine

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Coincidence of cardiovascular disease and breast cancer in females: Multi-modal strategies by predictive, preventive and personalised medicine

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