Institute of Nephrology, Zhong Da Hospital, Southeast University, Nanjing, Jiangsu 210009, China.
Chin Med J (Engl). 2012 Jul;125(14):2603-9.
Chronic kidney disease (CKD) is a major public health problem that affects about 10% of the general population. Current approaches to characterize the category and progression of CKD are normally based on renal histopathological results and clinical parameters. However, this information is not sufficient to predict CKD progression risk reliably or to guide preventive interventions. Nowadays, the appearance of systems biology has brought forward the concepts of "-omics" technologies, including genomics, transcriptomics, proteomics, and metabolomics. Systems biology, together with molecular analysis approaches such as microarray analysis, genome-wide association studies (GWAS), and serial analysis of gene expression (SAGE), has provided the framework for a comprehensive analysis of renal disease and serves as a starting point for generating novel molecular diagnostic tools for use in nephrology. In particular, analysis of urinary mRNA and protein levels is rapidly evolving as a non-invasive approach for CKD monitoring. All these systems biological molecular approaches are required for application of the concept of "personalized medicine" to progressive CKD, which will result in tailoring therapy for each patient, in contrast to the "one-size-fits-all" therapies currently in use.
慢性肾脏病(CKD)是一个重大的公共卫生问题,影响着大约 10%的普通人群。目前用于描述 CKD 类别和进展的方法通常基于肾组织病理学结果和临床参数。然而,这些信息不足以可靠地预测 CKD 进展风险,也不能指导预防干预措施。如今,系统生物学的出现提出了“组学”技术的概念,包括基因组学、转录组学、蛋白质组学和代谢组学。系统生物学与微阵列分析、全基因组关联研究(GWAS)和基因表达系列分析(SAGE)等分子分析方法一起,为全面分析肾脏疾病提供了框架,并为肾脏病学中使用的新型分子诊断工具的开发提供了起点。特别是,尿 mRNA 和蛋白质水平的分析正在迅速发展成为 CKD 监测的一种非侵入性方法。所有这些系统生物学分子方法都需要应用“个性化医学”的概念来治疗进展性 CKD,这将导致为每个患者量身定制治疗方案,而不是目前使用的“一刀切”疗法。