Department of Microbiology and Immunology, Laboratory of Nephrology, Katholieke Universiteit Leuven, University of Leuven, Leuven, Belgium.
Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium.
J Am Soc Nephrol. 2018 Jan;29(1):24-34. doi: 10.1681/ASN.2017010004. Epub 2017 Oct 9.
The concept that individuals with the same disease and a similar clinical presentation may have very different outcomes and need very different therapies is not novel. With the development of many innovative tools derived from the omics technologies, transplant medicine is slowly entering the era of precision medicine. Biomarkers are the cornerstone of precision medicine, which aims to integrate biomarkers with traditional clinical information and tailor medical care to achieve the best outcome for an individual patient. Here, we discuss the basic concepts of precision medicine and biomarkers, with a specific focus on progress in renal transplantation. We delineate the different types of biomarkers and provide a general assessment of the current applications and shortcomings of previously proposed biomarkers. We also outline the potential of precision medicine in transplantation. Moving toward precision medicine in the field of transplantation will require transplant physicians to embrace the increased complexity and expanded decision algorithms and therapeutic options that are associated with improved disease nosology.
相同疾病和相似临床表现的个体可能有非常不同的结果,并需要非常不同的治疗方法,这一概念并不新颖。随着许多源于组学技术的创新工具的发展,移植医学正慢慢进入精准医学时代。生物标志物是精准医学的基石,旨在将生物标志物与传统临床信息相结合,为实现个体患者的最佳治疗效果而量身定制医疗方案。在这里,我们讨论了精准医学和生物标志物的基本概念,并特别关注了肾移植方面的进展。我们描述了不同类型的生物标志物,并对以前提出的生物标志物的当前应用和缺点进行了总体评估。我们还概述了精准医学在移植领域的潜力。在移植领域迈向精准医学,需要移植医生接受与改进疾病分类学相关的、更复杂和扩展的决策算法和治疗选择。