Chen Edward S, Moller David R
Division of Pulmonary and Critical Care Medicine, Department of Medicine, The Johns Hopkins University, Baltimore, Maryland, USA.
Proc Am Thorac Soc. 2007 Jan;4(1):101-7. doi: 10.1513/pats.200607-140JG.
Granulomatous lung diseases, such as sarcoidosis, hypersensitivity pneumonitis, Wegener's granulomatosis, and chronic beryllium disease, along with granulomatous diseases of known infectious etiologies, such as tuberculosis, are major causes of morbidity and mortality throughout the world. Clinical manifestations of these diseases are highly heterogeneous, and the determinants of disease susceptibility and clinical course (e.g., resolution vs. chronic, progressive fibrosis) are largely unknown. The underlying pathogenic mechanisms of these diseases also remain poorly understood. Within this context, these diseases have been approached using genomic and proteomic technologies to allow us to identify patterns of gene/protein expression that track with clinical disease or to identify new pathways involved in disease pathogenesis. The results from these initial studies highlight the potential for these "-omics" approaches to reveal novel insights into the pathogenesis of granulomatous lung disease and provide new tools to improve diagnosis, clinical classification, course prediction, and response to therapy. Realizing this potential will require collaboration among multidisciplinary groups with expertise in the respective technologies, bioinformatics, and clinical medicine for these complex diseases.
肉芽肿性肺病，如结节病、过敏性肺炎、韦格纳肉芽肿病和慢性铍病，以及已知感染病因的肉芽肿性疾病，如结核病，是全世界发病和死亡的主要原因。这些疾病的临床表现高度异质性，疾病易感性和临床病程的决定因素（例如，缓解与慢性、进行性纤维化）在很大程度上尚不清楚。这些疾病的潜在致病机制也仍未得到充分理解。在此背景下，人们已采用基因组学和蛋白质组学技术来研究这些疾病，以便我们能够识别与临床疾病相关的基因/蛋白质表达模式，或识别参与疾病发病机制的新途径。这些初步研究的结果凸显了这些“组学”方法在揭示肉芽肿性肺病发病机制方面的潜力，并提供了改善诊断、临床分类、病程预测和治疗反应的新工具。要实现这一潜力，需要多学科团队之间的合作，这些团队在这些复杂疾病的各自技术、生物信息学和临床医学方面具有专业知识。
