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精神障碍的创新生物标志物:精神医学面临的重大临床挑战。

Innovative biomarkers in psychiatric disorders: a major clinical challenge in psychiatry.

机构信息

a Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs , University of Bari Aldo Moro , Bari , Italy.

b Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences , IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo , Foggia , Italy.

出版信息

Expert Rev Proteomics. 2017 Sep;14(9):809-824. doi: 10.1080/14789450.2017.1375857. Epub 2017 Sep 11.

Abstract

Currently, the diagnosis of psychiatric illnesses is based upon DSM-5 criteria. Although endophenotype-specificity for a particular disorder is discussed, the identification of objective biomarkers is ongoing for aiding diagnosis, prognosis, or clinical response to treatment. We need to improve the understanding of the biological abnormalities in psychiatric illnesses across conventional diagnostic boundaries. The present review investigates the innovative post-genomic knowledge used for psychiatric illness diagnostics and treatment response, with a particular focus on proteomics. Areas covered: This review underlines the contribution that psychiatric innovative biomarkers have reached in relation to diagnosis and theragnosis of psychiatric illnesses. Furthermore, it encompasses a reliable representation of their involvement in disease through proteomics, metabolomics/pharmacometabolomics and lipidomics techniques, including the possible role that gut microbiota and CYP2D6 polimorphisms may play in psychiatric illnesses. Expert opinion: Etiologic heterogeneity, variable expressivity, and epigenetics may impact clinical manifestations, making it difficult for a single measurement to be pathognomonic for multifaceted psychiatric disorders. Academic, industry, or government's partnerships may successfully identify and validate new biomarkers so that unfailing clinical tests can be developed. Proteomics, metabolomics, and lipidomics techniques are considered to be helpful tools beyond neuroimaging and neuropsychology for the phenotypic characterization of brain diseases.

摘要

目前,精神疾病的诊断基于 DSM-5 标准。虽然针对特定疾病的内表型特异性有所讨论,但仍在寻找客观的生物标志物,以帮助诊断、预后或对治疗的临床反应。我们需要提高对跨传统诊断边界的精神疾病生物学异常的理解。本综述探讨了用于精神疾病诊断和治疗反应的创新后基因组学知识,特别关注蛋白质组学。

涵盖的领域

本综述强调了精神疾病创新生物标志物在精神疾病的诊断和治疗方面所取得的贡献。此外,它通过蛋白质组学、代谢组学/药物代谢组学和脂质组学技术,包括肠道微生物群和 CYP2D6 多态性在精神疾病中的可能作用,可靠地代表了它们在疾病中的参与。

专家意见

病因异质性、表达可变和表观遗传学可能会影响临床表现,使得单一测量难以成为多种精神障碍的特征性诊断。学术、工业界或政府的合作可能会成功地识别和验证新的生物标志物,从而开发出可靠的临床测试。蛋白质组学、代谢组学和脂质组学技术被认为是神经影像学和神经心理学之外有助于脑疾病表型特征描述的有用工具。

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