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概念内表型:推进心理神经内分泌学在精准医学中影响力的策略。

Conceptual endophenotypes: A strategy to advance the impact of psychoneuroendocrinology in precision medicine.

机构信息

Department of Psychology, University of Trier, D-54286 Trier, Germany.

Department of Psychosomatic Medicine, Faculty of Medicine, University of Basel and University Hospital Basel, Hebelstrasse 2, CH-4031 Basel, Switzerland; Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstrasse 60/62, CH-4055 Basel, Switzerland; Division of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University, Stromstrasse 1, D-10555 Berlin, Germany.

出版信息

Psychoneuroendocrinology. 2018 Mar;89:147-160. doi: 10.1016/j.psyneuen.2017.12.009. Epub 2018 Jan 9.

Abstract

Psychobiological research has generated a tremendous amount of findings on the psychological, neuroendocrine, molecular and environmental processes that are directly relevant for mental and physical health, but have overwhelmed our capacity to meaningfully absorb, integrate, and utilize this knowledge base. Here, we reflect about suitable strategies to improve the translational success of psychoneuroendocrinological research in the era of precision medicine. Following a strategy advocated by the National Research Council and the tradition of endophenotype-based research, we advance here a new approach, termed "conceptual endophenotypes". We define the contextual and formal criteria of conceptual endophenotypes, outline criteria for filtering and selecting information, and describe how conceptual endophenotypes can be validated and implemented at the bedside. As proof-of-concept, we describe some of our findings from research that has adopted this approach in the context of stress-related disorders. We argue that conceptual endophenotypes engineer a bridge between the bench and the bedside. This approach readily lends itself to being continuously developed and implemented. Recent methodological advances, including digital phenotyping, machine learning, grassroots collaboration, and a learning healthcare system, may accelerate the development and implementation of this conceptual endophenotype approach.

摘要

心理生物学研究产生了大量关于心理、神经内分泌、分子和环境过程的发现,这些发现与身心健康直接相关,但我们的能力已经无法充分吸收、整合和利用这些知识基础。在这里,我们反思了在精准医学时代提高心理神经内分泌学研究转化成功率的合适策略。我们遵循国家研究委员会提倡的策略和基于内表型的研究传统,在此提出了一种新方法,称为“概念内表型”。我们定义了概念内表型的上下文和形式标准,概述了筛选和选择信息的标准,并描述了如何在床边验证和实施概念内表型。作为概念验证,我们描述了在应激相关障碍背景下采用这种方法的一些研究结果。我们认为,概念内表型在实验台和床边之间架起了一座桥梁。这种方法很容易不断发展和实施。最近的方法学进展,包括数字表型、机器学习、基层合作和学习型医疗保健系统,可能会加速这一概念内表型方法的发展和实施。

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