Chronomik ergänzt Genomik: Rechnergestützte Wissenszweige treffen sich in München, November 29-30, 2002

The atom was once the smallest particle that could not be further split. Breaking the atom opened the door to a new universe of particles governed by new forces and physical laws. The field of nuclear physics evolved and brought with new knowledge a new energy source and a wealth of practical applications. By contrast, today health and environmental care are still practiced as if changes in the normal range, like those in an atom, cannot be split. This is the current state of affairs in everyday physiology, laboratory medicine, economics or politics; the former two disciplines may well involve the latter. Alternatively, as in splitting the atom, one can lift the curtain of ignorance hiding the range of physiologic variation and thus uncover a new world of biological functions, instead of striving for constancy in a homeostatic framework. We can split the normal range into elements of time structures, chronomes (from chronos, time, and nomos, rule), consisting of chaotic endpoints and trends, all undergoing coordinating rhythms, the backbone of life itself. Entering the physiologic range revealed a new biologic rule suggesting that if we found a biological periodicity, we may look for an environmental counterpart: thus the geomagnetic week was found. Vice versa, a geomagnetic half-year led to the finding of biological cyclic counterparts, e.g., in epilepsy and in diseases of the oral cavity. The collection of such new information is the task of the science of chronobiology which resolves biological diversity in time, complementing genetics for the study of diversity in space. While genetics spawned genomics, chronobiology spawned chronomics for the mapping of chronomes, that represent gene expression in its broadest sense. Chronomics is chronophysiological genomics, not based upon the concept of the genes underlying the true blood pressure or the true heart rate, but replacing the historically useful homeostatic truisms by the dynamic endpoints of a variable in the biosphere and/or in its cosmos. Apart from providing a better understanding of the universe, common to both nuclear physics and chronobiology, perhaps one of the most challenging applications of chronobiology is that of improving the quality of "health" care of individuals, societies and environments while also reducing its costs by focusing on detecting and treating risk to prevent overt diseases again of societies, such as homicide and war, and of individuals, such as severe vascular disease or cancer. For such aims, chronomics offers the opportunity to refine the definition and assessment of health and broader normalcy, positively and individually, rather than quantifying disease as a deviation from normalcy, negatively as the absence of disease, and only for populations, as percent morbidity and mortality. Early time structure (chronome) alteration indicates earliest risk elevation. Herein, we try to note the cost-effectiveness of using a data base of vascular chronomes for severe disease prevention. Chronomics specifically resolves risks of stroke and other severe incapacitating diseases, higher than the risk associated with hypertension and other oncological and psychiatric disease risks. At variance with the black box of an airplane or current pacemaker-cardioverter-defibrillators, a "chronome-box" could provide an adult lifelong record of the dynamic changes in systems of different physiologic variables. Single casual tests can hence be replaced with the synthesis, in a moment, of the whole past history, and on this basis, help can be sought long before a heightened risk has developed into overt disease. The hardware is available and is sufficiently unobtrusive to be carried by an animal as small as a mouse for most of its lifespan. The software is available as modules for windowing, compacting and recycling in repeated passes over the accumulating information as-one-goes. Of two groups of physicians of similar competence, the one given only the history provided a better diagnosis than the one allowed only a physical examination. It would be much better yet if the salient features of the history would be dictated by the individual, again as-one-goes, and stored along with continuously and automatically collected and analyzed vital signs. One could thus split and exploit the normal range, making it the custodian of our health in a telehygiene as well as telemedicine system for the home, whether it is near or far from a health care center. Its aim is to act by prehabilitation rather than by rehabilitation, before rather than after the fact disease, as soon after birth as practical and preferably also earlier. This task is the challenge of what may become chronopediatrics as a follow-up on past, present and, we wish, future contributions by Theo Hellbrügge, the first professor of social pediatrics, who nearly half a century ago started the thorough systematic mapping of time structures in child development.