Pappone Carlo, Micaglio Emanuele, Locati Emanuela T, Monasky Michelle M
Arrhythmology and Electrophysiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Eur Heart J Suppl. 2020 Nov 18;22(Suppl L):L105-L109. doi: 10.1093/eurheartj/suaa146. eCollection 2020 Nov.
Sudden cardiac death results from arrhythmias commonly caused by channelopathies and cardiomyopathies, often due to several genetic factors. An emerging concept is that these disease states may in fact overlap, with variants in traditionally classified 'cardiomyopathy genes' resulting in 'channelopathies phenotypes'. Another important concept is the influence of both genetic and non-genetic factors in disease expression, leading to the utilization of systems biology approaches, such as genomics/epigenomics, transcriptomics, proteomics, metabolomics, lipidomics, and glycomics, to understand the disease severity and progression and to determine the prognosis and the best course of treatment. In fact, our group has discovered significant differences in metabolites, proteins, and lipids between controls and Brugada syndrome patients. Omics approaches are useful in overcoming the dogma that both channelopathies and cardiomyopathies exist as Mendelian disorders (caused by a mutation in a single gene). This shift in understanding could lead to new diagnostic and therapeutic approaches.
心脏性猝死通常由通道病和心肌病引起的心律失常导致,这往往是由多种遗传因素造成的。一个新出现的概念是,这些疾病状态实际上可能相互重叠,传统分类的“心肌病基因”中的变异会导致“通道病表型”。另一个重要概念是遗传和非遗传因素对疾病表现的影响,这促使人们利用系统生物学方法,如基因组学/表观基因组学、转录组学、蛋白质组学、代谢组学、脂质组学和糖组学,来了解疾病的严重程度和进展,并确定预后和最佳治疗方案。事实上,我们的研究小组已经发现,对照组和 Brugada 综合征患者在代谢物、蛋白质和脂质方面存在显著差异。组学方法有助于打破通道病和心肌病都是孟德尔疾病(由单个基因突变引起)的教条。这种认识上的转变可能会带来新的诊断和治疗方法。