Lengauer T
Max-Planck-Institut für Informatik, Campus E1 4, 66123, Saarbrücken, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Nov;56(11):1489-94. doi: 10.1007/s00103-013-1819-x.
Medicine is experiencing a period of change: Extensive molecular biological data on the patient are increasingly included in diagnosis and treatment. This trend is based on the development of targeted drugs and accompanying diagnostics, which serve the purpose of providing advance evidence that the medication promises therapy success for the patient. According to this concept drugs are often given in combination. The sizes of patient groups for which a given therapy out of many possible alternatives can be expected to be successful are quite limited. The relationship between the molecular data pertaining to a patient and their disease phenotype are complex and cannot be determined manually. Thus, computer-based bioinformatics methods play a central role in interpreting the molecular data and as an instrument for providing recommendations for the practicing physician. Bioinformatics is an essential component in basic research, in the development of new concepts for diagnosis and therapy as well as in clinical practice, in which these concepts are applied to treating patients. This article discusses the role of bioinformatics in both basic research and clinical practice. We present the example of treatment of HIV patients, for which bioinformatics-assisted therapy selection has already entered clinical practice. Such a therapy concept is also predestined for other diseases (e.g., cancer). The article concludes with remarks on the prerequisites for society as a whole for ensuring success of this concept of personalised medicine as a factor of medical progress.
关于患者的大量分子生物学数据越来越多地被纳入诊断和治疗中。这一趋势基于靶向药物和伴随诊断技术的发展,其目的是提前证明该药物有望为患者带来治疗成功。按照这一理念,药物常常联合使用。在众多可能的治疗方案中,预期某一特定治疗对之有效的患者群体规模相当有限。患者的分子数据与其疾病表型之间的关系复杂,无法手动确定。因此,基于计算机的生物信息学方法在解释分子数据以及为执业医师提供建议方面发挥着核心作用。生物信息学是基础研究、新诊断和治疗概念开发以及临床实践(即将这些概念应用于治疗患者)的重要组成部分。本文讨论了生物信息学在基础研究和临床实践中的作用。我们给出了艾滋病患者治疗的例子,生物信息学辅助的治疗选择已进入临床实践。这样的治疗理念也适用于其他疾病(如癌症)。文章最后论述了整个社会为确保个性化医疗这一作为医学进步因素的理念取得成功所需的前提条件。