Ioannis P Androulakis

Quantitative systems pharmacology aims at systematizing, in a model-based manner, the integration of systems biology and pharmacology in an effort to rationalize the process of assessing the ability of a drug to enhance well-being by off-setting the effects of a disease. Systems engineering, on the other hand, has enabled us to develop principles and methodologies for designing and operating engineered networks of structures exploring the integration of the underlying governing (design) laws. Although the computational tools which have resulted in major advances in the design, analysis, and operation of complex engineered structures have had tremendous success in the analysis of systems pharmacology models, it is argued in this opinion paper, that exploring the underlying conceptual foundation of complex systems engineering will enable us to move toward integrated models at the host level to explore, and possibly, induce synergies between low-level drug targets and higher level, systemic, defense mechanisms. This is an approach which would require refocusing of the key activities; however, it is likely the more promising approach as we enter the new era of personalized and precision medicine. We finally argue for the development of an allostatic approach to quantitative systems pharmacology and the development of an integrated framework for considering drugs in their broader context, beyond their local site of action. For further resources related to this article, please visit the WIREs website.