Keynote Medical Reseasrch Council Lecturer Jeremy Nicholson, of the Imperial College London, London, talked to a crowded audience in the Grand Ballroom about how systems biology can be applied at both individual and population levels to understand integrated biolchemical functions in relation to disease pathogenesis. He noted that there is now wide recognition that the extensive cross-talk and signalling between the host and the symbiotic gut microbiome links to both the response to therapy and disease risk factors. Dr. Nicholson stated that he has developed scalable and translatable strategies for phenotyping the journey that the patient takes in the hospital using top-down systems biology tools that capitalize on the use of both metabolic modelling and pharmaco-metabonomics for diagnostic and prognostic biomarker generation to aid clinical decision making at point-of-care. The diagnostics are extremely sensitive for the detection of diagnostic and prognostic biomarkers in a variety of conditions and are a powerful adjunct to conventional procedures for disease assessment that are required for future developments in precision medicine including understanding of the symbiotic influences on patient state.