Manchester Molecular Pathology Innovation Centre (MMPathIC): bridging the gap between biomarker discovery and health and wealth

分层医学(与个性化或精确医学相结合)是一种治疗方法，根据患者患特定疾病的风险或他们对特定药物或疗法的可能反应将患者分类。关键是有正确的测试和技术，可以根据患者的确切疾病类型和可能对特定治疗的反应将个人分组(分层患者)。其中一种可能的方法是应用分子病理学，这是一种特定类型的病理学(研究疾病)，专注于通过检查器官、组织或体液中的分子，如血液、尿液或滑液(关节中发现的液体)来诊断和重复鉴定疾病。曼彻斯特分子病理学节点(曼彻斯特分子病理学创新中心-MMPathIC)的目标是创造一个环境，使基于分子病理学技术的新测试得以开发。然后，这些数据可以用来对患者进行分层，以便更准确地诊断或预测最佳治疗方法。由于我们已经有了来自炎症性疾病(牛皮癣、类风湿性关节炎和狼疮)患者的大量患者样本，我们将首先关注这些疾病。这些疾病也很重要，因为它们影响了我们人口的很大一部分，治疗可能很昂贵(而且往往不是第一次起作用，这意味着患者必须尝试一些昂贵的药物才能缓解他们的症状)，这些疾病通常会因为疼痛和不适而严重影响一个人的生活质量。此外，我们将从我们在癌症分子病理学方面的现有专业知识中吸取教训，并在提供靶向治疗方面进一步发展。我们将使用一种新技术来研究这些炎症性疾病患者的样本，这种新技术支持在微创样本(如血液、尿液或组织)中测量许多蛋白质。这将允许检查例如健康人和患有特定疾病的人的样本之间的差异-某些蛋白质的差异可能被证明是有用的生物标志物测试，可以用来诊断疾病。此外，通过检查对药物有反应的患者与无反应的患者特定标记蛋白水平的差异，医生将能够确定哪种药物是对特定患者最好的治疗方法。这有望带来经济效益，因为药物不会用于那些不会从这些药物中受益的患者，但MMPathIC将通过对潜在标记物进行健康经济分析来确保经济效益--这也将允许NHS官员做出明智的决定，他们必须决定哪些测试是可行的，以便引入医疗服务。由于我们可以测量这些蛋白质，我们还建议确保这些数据与基因组数据(这些构成蛋白质的蓝图)和健康记录相联系-这种整合将由MMPathIC的工作人员促进。这将包括熟练的信息专家，他们可以理解产生的数据和已经存在的数据(数据挖掘)。与业界(他们拥有将新测试商业化的专业知识，并克服必要的监管障碍)合作，我们的目标是在拨款的前3年生产至少6种准备好商业化或准备在医院病理实验室使用的新测试

Stratified medicine (which is allied to personalised or precision medicine) is an approach to treating patients through categorising them into groups based on their risk of developing a particular disease, or how they are likely to respond a particular drug or therapy.It is key that the correct tests and techniques are available which can put individuals into groups (stratify patients), depending on their exact disease type and likely response to particular treatments. One way in which this might be possible is by application of molecular pathology, a specific type of pathology ( which is the study of disease), focused on the diagnosis and repeated characterisation of disease through the examination of molecules within organs, tissues or bodily fluids, such as blood, urine or synovial fluid (the fluid found in joints).The aim of the Manchester molecular pathology node (Manchester Molecular Pathology Innovation Centre- MMPathIC) is to create an environment which enables new tests, based on molecular pathology techniques, to be developed. These can then be used to stratify patients, to allow more accurate diagnosis or prediction of the best treatments to use. As we already have significant groups of patient samples from people who suffer from inflammatory disease (psoriasis, rheumatoid arthritis and lupus), we will focus on these diseases in the first instance. These diseases are also important as, between them, they affect a large part of our population, treatment can be expensive (and often doesn't work first time, meaning patients have to try a number of expensive drugs before getting any relief from their symptoms), and these diseases often severely affect a person's quality of life due to pain and discomfort. In addition, we are going to build upon the lessons already learned in this area from our established expertise in cancer molecular pathology, which is far further developed in the provision of targeted therapies.We will look at samples from patients with these inflammatory diseases, using a new technique that supports the measurement of many proteins within a minimally invasive sample (such as blood, urine or tissue). This will allow differences between samples from, for example, healthy people and people with a specific disease, to be examined- differences in certain proteins may prove useful as biomarker tests which can be used to diagnose a disease. In addition, by examining the differences in the levels of particular marker proteins from patients who respond to a drug compared to those who don't respond, doctors will be able to identify which drug is the best treatment for specific patients. This will hopefully have economic benefit as drugs will not be used on patients who will receive no benefit from them, but MMPathIC will ensure there is economic benefit through undertaking health economic analysis of potential markers- this will also allow informed decisions to be made by NHS officials who have to make decisions about which tests are viable for introduction into the health service.As we can measure these proteins, we also propose ensuring that this data is linked to genomic data (the blueprint for these building blocks that are proteins) and health records- this integration will be facilitated by MMPathIC's staff, which will include skilled information specialists who can make sense of the data produced and data which already exists (data mining).In collaboration with industry (who have the expertise to commercialise new tests, and navigate the necessary regulatory hurdles), we aim to produce at least 6 new tests which are ready to be commercialised, or ready to be used in hospital pathology laboratories in the first 3 years of the grant