Biomarker discovery and development in pediatric critical care medicine.
Biomarker discovery and development in pediatric critical care medicine.
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DOI：
10.1097/pcc.0b013e3181e28876
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发表时间：
2011-03
期刊：
影响因子：
--
通讯作者：
Wong HR
中科院分区：
文献类型：
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作者：
Kaplan JM;Wong HR
构建生物标志物发现和开发的一般过程，并描述基于多生物标志物的儿科感染性休克风险模型的开发建议。叙述性文献综述和作者生成的数据。生物标志物可根据预期功能分为四大类：诊断、监测、替代和分层。生物标志物的发现和开发需要一个严格的过程，这在重症监护医学文献中经常没有得到很好的遵循。很少有生物标志物成功地从候选阶段过渡到真正的生物标志物阶段。人们对开发脓毒症的诊断和分层生物标志物非常感兴趣。降钙素原是目前最有前途的脓毒症诊断生物标志物。最近的证据表明，白细胞介素-8可用于对感染性休克儿童进行分层，这些儿童在标准护理下生存的可能性很高。目前，有一个多机构的努力，以开发一个多生物标志物为基础的脓毒症风险模型，旨在预测个别儿童感染性休克的结果和疾病的严重程度。生物标志物的发现和开发是儿科重症监护医学转化研究议程的重要组成部分。这项工作将需要多个机构和调查人员的合作。严格开展以生物标志物为重点的研究有望改变我们护理个体患者的能力，以及我们以更有效的方式进行临床试验的能力。
To frame the general process of biomarker discovery and development, and to describe a proposal for the development of a multi-biomarker based risk model for pediatric septic shock. Narrative literature review and author generated data. Biomarkers can be grouped into four broad classes, based on the intended function: diagnostic, monitoring, surrogate, and stratification. Biomarker discovery and development requires a rigorous process, which is frequently not well followed in the critical care medicine literature. Very few biomarkers have successfully transitioned from the candidate stage to the true biomarker stage. There is great interest in developing diagnostic and stratification biomarkers for sepsis. Procalcitonin is currently the most promising diagnostic biomarker for sepsis. Recent evidence suggests that interleukin-8 can be used to stratify children with septic shock having a high likelihood of survival with standard care. Currently, there is a multi-institutional effort to develop a multi-biomarker based sepsis risk model intended to predict outcome and illness severity for individual children with septic shock. Biomarker discovery and development is an important portion of the pediatric critical care medicine translational research agenda. This effort will require collaboration across multiple institutions and investigators. Rigorous conduct of biomarker-focused research holds the promise of transforming our ability to care for individual patients and our ability to conduct clinical trials in a more effective manner.