Royal Brompton & Harefield NHS Foundation Trust, Adult Intensive Care Unit, Sydney Street, London, UK.
Curr Opin Crit Care. 2011 Oct;17(5):495-503. doi: 10.1097/MCC.0b013e32834a4b19.
In this article, we review recent developments in translational research in the fields of acute lung injury, acute kidney injury and sepsis with a focus on emerging biomarkers and outline future advances in the field.
There is currently a significant and unmet need for high quality translational research in critical care. The emergence of '-omics' technologies and sophisticated imaging techniques have resulted in a rapid growth of emerging biomarkers. Biomarkers would ideally provide early and reliable endpoints for proof of concept in clinical trials and inform clinical decision making through earlier and more precise diagnosis and risk stratification.
Despite significant investment in basic science and time-consuming clinical trials, the majority of pharmacological interventions developed for critical illness have yet to translate into measurable clinical benefit. Future validation and qualification of emerging biomarkers allied to advances in pharmacogenomic profiling have the potential to provide valuable clinical information while accurately phenotyping patients enrolled in future clinical trials.
本文综述了急性肺损伤、急性肾损伤和脓毒症领域转化研究的最新进展,重点关注新兴的生物标志物,并概述该领域的未来进展。
目前重症监护领域迫切需要高质量的转化研究。“组学”技术和复杂的成像技术的出现,导致新兴生物标志物的迅速发展。生物标志物理想情况下应为临床试验的概念验证提供早期和可靠的终点,并通过更早、更精确的诊断和风险分层为临床决策提供信息。
尽管在基础科学和耗时的临床试验上投入了大量资金,但为危重病开发的大多数药物干预措施尚未转化为可衡量的临床获益。新兴生物标志物的未来验证和鉴定,以及药物基因组 profiling 的进步,有可能在准确表型患者的同时,为未来的临床试验提供有价值的临床信息。