Clinical review: sepsis and septic shock--the potential of gene arrays.

Clinical review: sepsis and septic shock--the potential of gene arrays.
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DOI:
10.1186/cc10537
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发表时间:
2012-02-08
期刊:
Critical care (London, England)
影响因子:
--
通讯作者:
Wong HR
Wong HR
中科院分区:
其他
文献类型:
--
作者:
Wong HR

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在过去的十年里,一些研究人员将微阵列技术和相关的生物信息学方法应用于临床脓毒症和感染性休克,从而能够评估这一基因组医学分支如何或是否对脓毒症研究领域产生了有意义的影响。能够同时有效地测量来自特定组织来源的数千个转录本的稳定状态信使核糖核酸丰度,这提供了一个前所未有的机会,以获得更广泛的基因组水平的复杂和不同类型的临床症状,如败血症。一种治疗败血症和感染性休克的转译方法在技术上具有多个层面的挑战性,但尽管如此,仍在取得适度的、切实的进展。这些包括对脓毒症和感染性休克复杂性的基因组水平的了解,识别潜在干预的新的候选途径和靶点,发现新的候选诊断和分层生物标记物,以及将患者分成临床相关的、基于表达的亚类的能力。未来的挑战包括强有力的验证研究、技术方法的标准化、分析算法的标准化和进一步发展,以及大规模的合作。
Over the past decade several investigators have applied microarray technology and related bioinformatic approaches to clinical sepsis and septic shock, thus allowing for an assessment of how, or if, this branch of genomic medicine has meaningfully impacted the field of sepsis research. The ability to simultaneously and efficiently measure the steady-state mRNA abundance of thousands of transcripts from a given tissue source (that is, 'transcriptomics') has provided an unprecedented opportunity to gain a broader, genome-level 'picture' of complex and heterogeneous clinical syndromes such as sepsis. A trancriptomic approach to sepsis and septic shock is technically challenging on multiple levels, but nonetheless modest, tangible advances are being realized. These include a genome-level understanding of the complexity of sepsis and septic shock, identification of novel candidate pathways and targets for potential intervention, discovery of novel, candidate diagnostic and stratification biomarkers, and the ability to stratify patients into clinically relevant, expression-based subclasses. The challenges moving forward include robust validation studies, standardization of technical approaches, standardization and further development of analytical algorithms, and large-scale collaborations.
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