Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, MO, 63104, USA.
Division of Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Centre Göttingen, Robert-Koch-Straße 40, D-37075, Göttingen, Germany.
J Cachexia Sarcopenia Muscle. 2017 Dec;8(6):857-863. doi: 10.1002/jcsm.12231. Epub 2017 Sep 24.
Precision (P4) medicine represents a new medical paradigm that focuses on Personalized, Predictive, Preventive and Participatory approaches. The P4 paradigm is particularly appropriate for moving the care of persons with myopenia forward. Muscular dystrophies are clearly a set of genetically different diseases where genomics are the basis of diagnosis, and genetic modulation via DNA, oligonucleotides and clustered regularly interspaced short palendronic repeats hold great potential for a cure. The utility of personalized genomics for sarcopenia coupled with utilizing a predictive approach for the diagnosis with early preventive strategies is a key to improving sarcopenic outcomes. The importance of understanding different levels of patient enthusiasm and different responses to exercise should guide the participatory phase of sarcopenic treatment. In the case of cachexia, understanding the effects of the different therapies now available through the P4 approach on muscle wasting is a key to management strategies.
精准(P4)医学代表了一种新的医学模式,专注于个性化、预测性、预防性和参与性方法。P4 范式特别适合推动肌少症患者的护理向前发展。肌肉营养不良症显然是一组具有不同遗传基础的疾病,其中基因组学是诊断的基础,通过 DNA、寡核苷酸和规则间隔的短回文重复序列进行基因调控具有很大的治愈潜力。个性化基因组学在肌肉减少症中的应用,加上对诊断的预测方法以及早期预防策略的利用,是改善肌肉减少症结局的关键。了解患者对运动的不同热情程度和不同反应的重要性,应指导肌肉减少症治疗的参与阶段。在恶病质的情况下,通过 P4 方法了解现有的不同治疗方法对肌肉消耗的影响,是管理策略的关键。