Faculty of Medicine, University of New South Wales, Sydney, Australia.
Expert Rev Proteomics. 2010 Jun;7(3):361-72. doi: 10.1586/epr.10.9.
Asthma, chronic obstructive pulmonary disease (COPD) and lung cancer cause extensive mortality and morbidity worldwide. However, the current state-of-the-art diagnosis and management schemes of these diseases are suboptimal as the incidence of asthma has risen by 250% over the last two decades and the 5-year mortality rate of lung cancer remains at 88%. Proteomic analysis is at the frontier of medical research and demonstrates tremendous potential in the early detection, diagnosis and staging, as well as providing novel therapeutic targets for improved management of smoking-related lung diseases. Advances in analytical tools, such as 2D gel electrophoresis, mass spectrometry, protein arrays and improved bioinformatics, allow sensitive and specific biomarker/protein profile discoveries and the infusion of new knowledge towards the molecular basis of lung diseases and their progression. Significant hurdles still stand between these laboratory findings and their applications in clinical practice. One of the challenges is the difficulty in the selection of samples that provide scope into the specific disease entity. Induced sputum, bronchoalveolar lavage, exhaled breath and exhaled breath condensate are methods of sampling airway and lung fluids that can serve as a window to assess the microenvironment of the lungs. With better study design standardization and the implementation of novel technologies to reach the optimal research standard, there is enough reason be optimistic about the future of proteomic research and its clinical implications.
哮喘、慢性阻塞性肺疾病（COPD）和肺癌在全球范围内造成了广泛的死亡率和发病率。然而，这些疾病的当前最先进的诊断和管理方案并不理想，因为哮喘的发病率在过去二十年中上升了 250%，而肺癌的 5 年死亡率仍然保持在 88%。蛋白质组学分析处于医学研究的前沿，在早期检测、诊断和分期方面具有巨大的潜力，并为改善与吸烟有关的肺部疾病的管理提供了新的治疗靶点。分析工具的进步，如二维凝胶电泳、质谱、蛋白质阵列和改进的生物信息学，允许进行敏感和特异性的生物标志物/蛋白质谱发现，并将新知识注入到肺部疾病及其进展的分子基础中。这些实验室发现与临床实践的应用之间仍然存在重大障碍。其中一个挑战是难以选择提供特定疾病实体范围的样本。诱导痰、支气管肺泡灌洗、呼出气和呼出气冷凝物是采样气道和肺部液体的方法，可以作为评估肺部微环境的窗口。通过更好的研究设计标准化和实施新的技术以达到最佳的研究标准，有足够的理由对蛋白质组学研究及其临床意义的未来持乐观态度。
