Schanstra Joost P, Mischak Harald
Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Toulouse, France.
Pediatr Nephrol. 2015 May;30(5):713-25. doi: 10.1007/s00467-014-2790-y. Epub 2014 Mar 15.
Biomarkers hold the promise of significantly improving health care by enabling prognosis and diagnosis with improved accuracy, and at earlier points in time. Previous results have indicated that single biomarkers are not suitable to describe complex diseases such as kidney disease. Here we provide an update on the progress of urinary proteomics-based studies and strategies to develop biomarker-based classifiers that tolerate instability and inconsistency of individual biomarkers. The examples focus on two major fields in nephrology: chronic kidney disease in the adult population and obstructive nephropathies in the pediatric population. When employed adequately, urinary proteomics demonstrates a clear value in kidney disease, indicating that the current status quo ruling for decades now could be changed by applying modern "omics" approaches. However, while research is able to deliver these useful tools for patient management, the issues associated with implementation are not yet solved. Active engagement of the relevant clinical professional societies, as well as patient's organizations, might help to implement these omics approaches that have shown a clear benefit for the patient.
生物标志物有望通过提高准确性并在更早的时间点进行预后和诊断，从而显著改善医疗保健。先前的结果表明，单一生物标志物不适用于描述诸如肾脏疾病等复杂疾病。在此，我们提供基于尿液蛋白质组学研究进展的最新情况，以及开发能够耐受个体生物标志物不稳定性和不一致性的基于生物标志物的分类器的策略。实例聚焦于肾脏病学的两个主要领域：成年人群中的慢性肾脏病和儿童人群中的梗阻性肾病。如果运用得当，尿液蛋白质组学在肾脏疾病中显示出明确的价值，这表明应用现代“组学”方法可能会改变目前已沿用数十年的现状。然而，尽管研究能够为患者管理提供这些有用的工具，但与实施相关的问题尚未得到解决。相关临床专业协会以及患者组织的积极参与，可能有助于实施这些已显示对患者有明显益处的组学方法。
