在三全医学背景下对眼部和全身性疾病特异性人泪液生物标志物的质谱分析。
Mass spectrometry analysis of human tear fluid biomarkers specific for ocular and systemic diseases in the context of 3P medicine.
作者信息
Zhan Xianquan, Li Jiajia, Guo Yuna, Golubnitschaja Olga
机构信息
Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, 440 Jiyan Road, Jinan, 250117 Shandong China.
Medical Science and Technology Innovation Center, Shandong First Medical University, 6699 Qingdao Road, Jinan, 250117 Shandong China.
出版信息
EPMA J. 2021 Dec 3;12(4):449-475. doi: 10.1007/s13167-021-00265-y. eCollection 2021 Dec.
Over the last two decades, a large number of non-communicable/chronic disorders reached an epidemic level on a global scale such as diabetes mellitus type 2, cardio-vascular disease, several types of malignancies, neurological and eye pathologies-all exerted system's enormous socio-economic burden to primary, secondary, and tertiary healthcare. The paradigm change from reactive to predictive, preventive, and personalized medicine (3PM/PPPM) has been declared as an essential transformation of the overall healthcare approach to benefit the patient and society at large. To this end, specific biomarker panels are instrumental for a cost-effective predictive approach of individualized prevention and treatments tailored to the person. The source of biomarkers is crucial for specificity and reliability of diagnostic tests and treatment targets. Furthermore, any diagnostic approach preferentially should be noninvasive to increase availability of the biomaterial, and to decrease risks of potential complications as well as concomitant costs. These requirements are clearly fulfilled by tear fluid, which represents a precious source of biomarker panels. The well-justified principle of a "sick eye in a sick body" makes comprehensive tear fluid biomarker profiling highly relevant not only for diagnostics of eye pathologies but also for prediction, prognosis, and treatment monitoring of systemic diseases. One prominent example is the Sicca syndrome linked to a cascade of severe complications that include dry eye, neurologic, and oncologic diseases. In this review, protein profiles in tear fluid are highlighted and corresponding biomarkers are exemplified for several relevant pathologies, including dry eye disease, diabetic retinopathy, cancers, and neurological disorders. Corresponding analytical approaches such as sample pre-processing, differential proteomics, electrophoretic techniques, high-performance liquid chromatography (HPLC), enzyme-linked immuno-sorbent assay (ELISA), microarrays, and mass spectrometry (MS) methodology are detailed. Consequently, we proposed the overall strategies based on the tear fluid biomarkers application for 3P medicine practice. In the context of 3P medicine, tear fluid analytical pathways are considered to predict disease development, to target preventive measures, and to create treatment algorithms tailored to individual patient profiles.
在过去二十年中,大量非传染性/慢性疾病在全球范围内达到了流行程度,如2型糖尿病、心血管疾病、几种类型的恶性肿瘤、神经和眼部疾病,所有这些都给初级、二级和三级医疗保健带来了巨大的社会经济负担。从反应性医学向预测性、预防性和个性化医学(3PM/PPPM)的范式转变已被宣布为整体医疗保健方法的一项根本性变革,以造福患者和整个社会。为此,特定的生物标志物组合对于针对个人的具有成本效益的个性化预防和治疗预测方法至关重要。生物标志物的来源对于诊断测试和治疗靶点的特异性和可靠性至关重要。此外,任何诊断方法最好应是非侵入性的,以增加生物材料的可获得性,并降低潜在并发症的风险以及相关成本。泪液显然满足了这些要求,泪液是生物标志物组合的宝贵来源。“病体中的病眼”这一合理原则使得全面的泪液生物标志物分析不仅与眼部疾病的诊断高度相关,而且对于全身性疾病的预测、预后和治疗监测也高度相关。一个突出的例子是与一系列严重并发症相关的干燥综合征,这些并发症包括干眼症、神经疾病和肿瘤疾病。在本综述中,突出了泪液中的蛋白质谱,并举例说明了几种相关疾病(包括干眼病、糖尿病性视网膜病变、癌症和神经疾病)的相应生物标志物。详细介绍了相应的分析方法,如样品预处理、差异蛋白质组学、电泳技术、高效液相色谱(HPLC)、酶联免疫吸附测定(ELISA)、微阵列和质谱(MS)方法。因此,我们提出了基于泪液生物标志物应用于3P医学实践的总体策略。在3P医学的背景下,泪液分析途径被认为可预测疾病发展、确定预防措施目标,并创建针对个体患者概况的治疗算法。