Mann Sebastian Porsdam, Treit Peter V, Geyer Philipp E, Omenn Gilbert S, Mann Matthias
Department of Media, Cognition and Communication, University of Copenhagen, Copenhagen, Denmark; Uehiro Center for Practical Ethics, University of Oxford, Oxford, UK; New address: Faculty of Law, University of Oxford, Oxford, UK.
Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, Germany.
Mol Cell Proteomics. 2021 Jan 14;20:100046. doi: 10.1016/j.mcpro.2021.100046.
Recent advances in mass spectrometry (MS)-based proteomics have vastly increased the quality and scope of biological information that can be derived from human samples. These advances have rendered current workflows increasingly applicable in biomedical and clinical contexts. As proteomics is poised to take an important role in the clinic, associated ethical responsibilities increase in tandem with impacts on the health, privacy, and wellbeing of individuals. We conducted and here report a systematic literature review of ethical issues in clinical proteomics. We add our perspectives from a background of bioethics, the results of our accompanying paper extracting individual-sensitive results from patient samples, and the literature addressing similar issues in genomics. The spectrum of potential issues ranges from patient re-identification to incidental findings of clinical significance. The latter can be divided into actionable and unactionable findings. Some of these have the potential to be employed in discriminatory or privacy-infringing ways. However, incidental findings may also have great positive potential. A plasma proteome profile, for instance, could inform on the general health or disease status of an individual regardless of the narrow diagnostic question that prompted it. We suggest that early discussion of ethical issues in clinical proteomics can ensure that eventual healthcare practices and regulations reflect the considered judgment of the community and anticipate opportunities and problems that may arise as the technology matures.
基于质谱（MS）的蛋白质组学的最新进展极大地提高了可从人体样本中获取的生物信息的质量和范围。这些进展使当前的工作流程在生物医学和临床环境中越来越适用。随着蛋白质组学有望在临床中发挥重要作用，相关的伦理责任也随之增加，这对个人的健康、隐私和福祉产生影响。我们进行了一项关于临床蛋白质组学伦理问题的系统文献综述，并在此报告结果。我们从生物伦理学背景出发，结合我们在另一篇论文中从患者样本中提取个人敏感结果的研究结果，以及基因组学中涉及类似问题的文献，阐述我们的观点。潜在问题的范围从患者重新识别到具有临床意义的偶然发现。后者可分为可采取行动的发现和不可采取行动的发现。其中一些发现有可能被用于歧视性或侵犯隐私的方式。然而，偶然发现也可能具有巨大的积极潜力。例如，血浆蛋白质组图谱可以反映一个人的总体健康状况或疾病状态，而不管引发检测的具体狭窄诊断问题是什么。我们建议，尽早讨论临床蛋白质组学中的伦理问题，可以确保最终的医疗实践和法规反映社会的审慎判断，并预见随着技术成熟可能出现的机遇和问题。
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