Molecular Markers and the Promise of Precision Medicine for Interstitial Lung Disease.

Molecular Markers and the Promise of Precision Medicine for Interstitial Lung Disease.
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DOI:
10.1016/j.ccm.2021.03.011
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发表时间:
2021-06
影响因子:
5.7
通讯作者:
Herzog EL
Herzog EL
中科院分区:
医学3区
文献类型:
--
作者:
Newton CA;Herzog EL

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间质性肺疾病(ILD)包括以实质炎症和纤维化为特征的多种疾病。从历史上看,ILD已根据费力、复杂且有时不可重现的临床算法被细分为看似离散的类别,该算法基于对病史、检查、成像或活检的主观解释。1,2虽然炎性ILD通常采用免疫抑制治疗,但抗纤维化疗法用于以纤维化为主的ILD。3,4由于这些疗法的疗效可能有限且存在脱靶副作用,因此开发客观且可重复的诊断、预后和治疗不可知方法对于患者和护理他们的临床医生来说非常有价值。ILD等复杂且异质的疾病是精准医学的候选对象,它将临床表型与分子内型结合起来,以实现个性化护理。5这个过程利用了客观可量化的措施,或“生物标志物”,理想情况下是无创的,准确的,精确的,可重复的。将ILD内型和表型联系起来的探索已经产生了无数反映复杂病理生物学的生物标志物,这些生物标志物可以通过高通量“组学”发现来破译。因此,本综述描述了广泛研究的ILD、IPF中基于组学的生物标志物的开发。在描述了组学管道之后,我们回顾了IPF基因组学、表观基因组学、转录组学、蛋白质组学和代谢组学中的代表性生物标志物发现。好处和局限性
The interstitial lung diseases (ILD) encompass diverse disorders characterized by parenchymal inflammation and fibrosis. Historically, the ILDs have been subdivided into seemingly discrete categories according to laborious, complex, and at times irreproducible clinical algorithms based on subjective interpretation of history, exam, imaging or biopsy. 1, 2 While inflammatory ILDs are generally treated with immunosuppression, antifibrotic therapies are used for ILDs dominated by fibrosis. 3, 4 Due to the potential for limited efficacy and off target side effects of these therapies, the development of objective and reproducible diagnostic, prognostic, and theragnostic approaches would be valuable to patients and the clinicians who care for them.Complex and heterogeneous conditions such as ILD are candidates for precision medicine, which couples clinical phenotypes with molecular endotypes to individualize care. 5 This process leverages objectively quantifiable measures, or “biomarkers,” that are ideally noninvasive, accurate, precise, and reproducible. The quest to link ILD endotypes and phenotypes has yielded myriad biomarkers reflecting a convoluted pathobiology that may be deciphered by high throughput “omics” discoveries. Accordingly, this review describes omics-based biomarker development in an extensively studied ILD, IPF. After describing the omics pipeline, we review representative biomarker discoveries in IPF genomics, epigenomics, transcriptomics, proteomics, and metabolomics. The benefits and limitations
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