Aerts Johannes M, van Breemen Marielle J, Bussink Anton P, Ghauharali Karen, Sprenger Richard, Boot Rolf G, Groener Johanna E, Hollak Carla E, Maas Mario, Smit Suzanne, Hoefsloot Huub C, Smilde Age K, Vissers Johannes Pc, de Jong Sheryas, Speijer Dave, de Koster Chris G
Clinical Proteomics Facility, Academic Medical Center, Amsterdam, The Netherlands.
Acta Paediatr. 2008 Apr;97(457):7-14. doi: 10.1111/j.1651-2227.2007.00641.x.
A biomarker is an analyte that indicates the presence of a biological process linked to the clinical manifestations and outcome of a particular disease. An ideal biomarker provides indirect but ongoing determinations of disease activity. In the case of lysosomal storage disorders (LSDs), metabolites or proteins specifically secreted by storage cells are good candidates for biomarkers. Potential clinical applications of biomarkers are found in improved diagnosis, monitoring of disease progression and assessment of therapeutic correction. These applications are illustrated by reviewing the use of plasma chitotriosidase in the clinical management of patients with Gaucher disease, the most common LSD. The ongoing debate on the value of biomarkers in patient management is addressed. Novel analytical methods have revolutionized the identification and measurement of biomarkers at the protein and metabolite level. Recent developments in biomarker discovery by proteomics are described and the future for biomarkers of LSDs is discussed.
Besides direct applications for biomarkers in patient management, biomarker searches are likely to render new insights into pathophysiological mechanisms and metabolic adaptations, and may provide new targets for therapeutic intervention.
生物标志物是一种分析物,它表明存在与特定疾病的临床表现和转归相关的生物学过程。理想的生物标志物能提供对疾病活动的间接但持续的测定。就溶酶体贮积症(LSDs)而言,贮积细胞特异性分泌的代谢物或蛋白质是生物标志物的良好候选物。生物标志物的潜在临床应用见于改善诊断、监测疾病进展和评估治疗矫正效果。通过回顾血浆壳三糖苷酶在戈谢病(最常见的LSD)患者临床管理中的应用来说明这些应用。文中探讨了关于生物标志物在患者管理中的价值的持续争论。新型分析方法彻底改变了蛋白质和代谢物水平上生物标志物的鉴定和测量。描述了蛋白质组学在生物标志物发现方面的最新进展,并讨论了LSDs生物标志物的未来。
除了生物标志物在患者管理中的直接应用外,生物标志物的研究可能会对病理生理机制和代谢适应产生新的见解,并可能为治疗干预提供新的靶点。