Center for the Study of Symptom Science, Metabolomics and Multiple Chronic Conditions

在美国，超过25%的成年人患有多种慢性病（MCC）， 数字上升，特别是在经历最高MCC发病率的黑人男性和女性中。那些 MCC患者经常出现症状或症状群，这些症状或症状群破坏了他们的生活质量和 自我管理重要的是，即使MCC相同，症状的严重程度也不同，这表明 MCC中驱动症状的机制并不固定，而是以不同的方式使其易于接受 有针对性的干预-护理科学的精髓。“中心”的宏伟目标 症状科学、代谢组学和多种慢性疾病的研究”是为了加强 不同的护士科学家的教师进行创新的转化研究，使用尖端的代谢组学 和微生物组学技术，以减少MCC患者的症状。该中心的研究目标是 应用下一代代谢组学技术和数据分析策略，以刺激发现 代谢物和代谢途径存在于MCC个体中，重点关注代谢物和 代谢途径在各种条件下协同作用，并与严重的疲劳症状有关， 抑郁症或焦虑症及其集群，但在MCC患者中代表性较低， 或者没有症状将根据协变量评价与症状相关的代谢产物和途径 例如作为生物变量性别、年龄、压力和歧视、饮食和药物。探索性的目标 将研究肠道微生物组的组成作为这些症状的潜在协变量。这一目标 利用我们学校在微生物组研究和证据方面的优势，将微生物组与这些 症状试点1-3将检查与代谢相关的循环代谢物和代谢谱。 MCC患者疲劳、抑郁和焦虑症状的严重程度以及协变量， 并检查每个时间点的关联，而飞行员4将应用数据分析技术来模拟 MCC中与症状严重程度、协同作用、集群和健康质量结果相关的复杂途径。 试点5将测试试点4模型，以证明试点1-3中确定的代谢物和协变量 与症状严重程度相关，是有效的干预目标。与之相关的代谢物 MCC中的症状，包括协同作用的症状，有助于聚集的症状，或与微生物组相关的症状， 还有待描述。在26名中心人员中，有18名是中心教师和成员。我们的研究基地 在MCC，自我管理、代谢组学和微生物组学很强，每年直接成本为4.7美元 万数据科学中心每年获得50万美元的支持，并将提供基础设施 数据科学核心我们将利用埃默里代谢组学和综合基因组学的资源， 丹装备初级教师考虑复杂的理论和采用尖端技术，而 专注于翻译，准备未来的护士科学家，以解决问题，重要的病人和家庭。

Over 25% of the adult population in the United States suffers from multiple chronic conditions (MCC), with numbers rising, especially among Black men and women who experience the highest MCC morbidity. Those with MCC often experience symptoms or symptom clusters that undermine their quality of life and ability to self-manage. Importantly, symptom severity in those with even the same MCC varies, suggesting that the mechanisms driving symptoms in MCC are not fixed but vary in ways that may make them amenable to targeted interventions – the very essence of nursing science. The over-arching goal of the “Center for the Study of Symptom Science, Metabolomics and Multiple Chronic Conditions” is to strengthen the capacities of a diverse faculty of nurse scientists to conduct innovative translational research using cutting-edge metabolomics and microbiomic technologies to reduce symptoms in individuals with MCC. The Center’s research aim is to apply next-generation metabolomics technology and data analytic strategies to stimulate discovery of the metabolites and metabolic pathways that are present in individuals with MCC, focusing on the metabolites and metabolic pathways that synergize across conditions and associate with severe symptoms of fatigue, depression, or anxiety and their cluster, but are less represented in individuals with MCC who have minimal or no symptoms. Metabolites and pathways associated with symptoms will be evaluated in light of covariates such as sex as a biological variable, age, stress and discrimination, diet and medications. An exploratory aim will investigate the composition of the gut microbiome as a potential covariate to these symptoms. This aim takes advantage of our School’s strength in microbiome research and evidence linking the microbiome to these symptoms. Pilots 1-3 will examine the circulating metabolites and metabolic profiles that associate with the severity of the symptoms of fatigue, depression, and anxiety in individuals with MCC and in light of covariates, and examine the associations at each time point, while pilot 4 will apply data analytic techniques to model the complex pathways associated with symptom severity, synergy, cluster, and health quality outcomes in MCC. Pilot 5 will test the Pilot 4 model for proof of concept that the metabolites and covariates identified in Pilots 1-3 do associate with symptom severity and are valid targets for intervention. Metabolites associated with symptoms in MCC, including those that synergize, that contribute to clustering, or are microbiome-associated, have yet to be described. Of the 26 Center Personnel, 18 are Center Faculty and Members. Our research base in MCC, self-management, metabolomics, and the microbiome is strong with annual direct costs of $4.7 million. The Center for Data Science is supported with ½ million dollars annually, and will provide infrastructure to the Data Science Core. We will leverage resources of the Emory Metabolomics and Integrated Genomic Cores. Equipping junior faculty to consider complex theories and employ cutting-edge technology, while focused on translation, prepares future nurse scientists to address issues that matter to patients and families.