Multiomic definition of generalizable endotypes in human acute pancreatitis

Multiomic definition of generalizable endotypes in human acute pancreatitis
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人类急性胰腺炎普遍内型的多组学定义

DOI:
10.1101/539569
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发表时间:
2019
期刊:
--
影响因子:
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通讯作者:
Neyton L
Neyton L
中科院分区:
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文献类型:
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作者:
Neyton L

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急性胰腺炎 (AP) 是一种突然发作的胰腺炎症,会导致多器官功能障碍综合征 (MODS) 并导致某些患有 AP 的个体死亡,而其他人则会出现轻微的全身炎症。在这里,我们表明,观察到的系统反应和结果的多样性伴随着分子亚型的多样性,可以使用临床和多组学数据的计算分析来识别分子亚型的多样性。我们整合了一组患有 AP 的患者在连续时间点同时发生的全血转录组、血浆蛋白质组和血清代谢组数据,并使用内部和外部有效性的无偏见数学、生物学和临床测量方法系统地评估了患者相似性的四种不同指标。我们的结果确定了四种不同且稳定的 AP 内型,其特征在于代谢亢进、肝胰胆、分解代谢和先天免疫内型的途径和生物标志物组合定型。 AP 的分解代谢内型惊人地再现了先前报道的急性呼吸窘迫综合征(一种公认的 AP 并发症)中的疾病内型。我们的研究结果表明,AP 中存在临床相关且可推广的内型。
Acute pancreatitis (AP) is sudden onset pancreas inflammation that causes multiple organ dysfunction syndrome (MODS) and death in certain individuals who develop AP yet minimal systemic inflammation in others. Here, we show that this observed diversity in systemic response and outcome is accompagnied by diversity in molecular subtypes that can be identified using computational analysis of clinical and multiomic data. We integrated co-incident whole blood transcriptomic, plasma proteomic, and serum metabolomic data at serial time points from a cohort of patients presenting with AP and systematically evaluated four different metrics for patient similarity, using unbiased mathematical, biological and clinical measures of internal and external validity. Our results identify four distinct and stable AP endotypes that are characterized by pathway and biomarker combination stereotypes into hypermetabolic, hepatopancreaticobiliary, catabolic and innate immune endotypes. The catabolic endotype in AP strikingly recapitulates a disease endotype previously reported in acute respiratory distress syndrome, a recognized complication of AP. Our findings demonstrate that clinically-relevant and generalizable endotypes exist in AP.
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