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旧物新用:利用宿主反应诊断传染病。

What was old is new again: using the host response to diagnose infectious disease.

作者信息

Ko Emily R, Yang William E, McClain Micah T, Woods Christopher W, Ginsburg Geoffrey S, Tsalik Ephraim L

机构信息

a 1 Department of Medicine Center for Applied Genomics & Precision Medicine, Duke University, Durham, NC 27708, USA.

出版信息

Expert Rev Mol Diagn. 2015;15(9):1143-58. doi: 10.1586/14737159.2015.1059278. Epub 2015 Jul 4.

Abstract

A century of advances in infectious disease diagnosis and treatment changed the face of medicine. However, challenges continue to develop including multi-drug resistance, globalization that increases pandemic risks and high mortality from severe infections. These challenges can be mitigated through improved diagnostics, focusing on both pathogen discovery and the host response. Here, we review how 'omics' technologies improve sepsis diagnosis, early pathogen identification and personalize therapy. Such host response diagnostics are possible due to the confluence of advanced laboratory techniques (e.g., transcriptomics, metabolomics, proteomics) along with advanced mathematical modeling such as machine learning techniques. The road ahead is promising, but obstacles remain before the impact of such advanced diagnostic modalities is felt at the bedside.

摘要

一个世纪以来,传染病诊断和治疗方面的进展改变了医学面貌。然而,挑战仍在不断出现,包括多重耐药性、增加大流行风险的全球化以及严重感染导致的高死亡率。通过改进诊断方法,关注病原体发现和宿主反应,可以缓解这些挑战。在此,我们综述“组学”技术如何改善脓毒症诊断、早期病原体鉴定并实现个性化治疗。由于先进实验室技术(如转录组学、代谢组学、蛋白质组学)与机器学习技术等先进数学建模方法的融合,此类宿主反应诊断成为可能。未来前景广阔,但在床边感受到此类先进诊断方式的影响之前,障碍依然存在。

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