Allergy Center, CUF Descobertas Hospital and CUF Infante Santo Hospital.
CEDOC, Chronic Diseases Research Center, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon.
Curr Opin Pulm Med. 2018 Jan;24(1):94-103. doi: 10.1097/MCP.0000000000000437.
Metabolomics has been used to uncover the metabolic signatures of asthma, both for biomarker identification and pathophysiologic mechanisms research. We aimed to review recent advances in this field, published since 2016, and discuss these findings implications to future research and application into clinical practice.
Experimental asthma models and clinical studies in both children and adults supported independent metabolic signatures of asthma. Common reported pathways included purine, glycerophospholipid, glutathione, fatty acids, and arginine and proline metabolism. Metabolomics-based studies identified candidate biomarkers related to asthma severity and corticosteroid resistance, and supported the definition of the obesity-related phenotype at the molecular level. A systematic review with meta-analysis and recent prospective studies favored exhaled volatile organic compounds as one of the most promising biomarkers in asthma diagnosis and monitoring.
Metabolomics has provided unique and novel insights into asthma profiling at the molecular level. Current challenges include procedures standardization and control of potentially confounding variables for external validation. Point-of-care technology developments bring metabolomics closer to clinical practice. In addition to biomarkers identification, relating metabolites to their biologic role will serve as critical foundations for understanding the biology underpinning asthma heterogeneity and for specific-targeted therapies. VIDEO ABSTRACT.
代谢组学已被用于揭示哮喘的代谢特征，包括生物标志物鉴定和病理生理机制研究。我们旨在综述自 2016 年以来该领域的最新进展，并讨论这些发现对未来研究和临床实践的应用意义。
儿童和成人的哮喘实验模型和临床研究均支持哮喘的独立代谢特征。常见的报道途径包括嘌呤、甘油磷脂、谷胱甘肽、脂肪酸、精氨酸和脯氨酸代谢。基于代谢组学的研究确定了与哮喘严重程度和皮质激素抵抗相关的候选生物标志物，并支持在分子水平上定义肥胖相关表型。一项系统综述和最近的前瞻性研究支持呼出气挥发性有机化合物作为哮喘诊断和监测最有前途的生物标志物之一。
代谢组学为哮喘分子水平的特征提供了独特和新颖的见解。目前的挑战包括程序标准化和对潜在混杂变量的控制，以进行外部验证。即时检测技术的发展使代谢组学更接近临床实践。除了生物标志物的鉴定，将代谢物与其生物学作用联系起来将是理解哮喘异质性生物学基础和特定靶向治疗的关键基础。视频摘要。
