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脓毒症中的组学复杂性:个性化医疗方法的局限性

The Omics Complexity in Sepsis: The Limits of the Personalized Medicine Approach.

作者信息

Isac Sebastian, Isac Teodora, Tanasescu Maria Daniela, Pavel Bogdan, Andreescu Cristina Veronica, Badea Andrada-Georgiana, Ojog Damiana, Teodorescu Geani-Danut, Laceanu Anca, Trifan Cristian-Bogdan, Droc Gabriela

机构信息

Department of Physiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Department of Anesthesiology and Intensive Care I, Fundeni Clinical Institute, 022328 Bucharest, Romania.

出版信息

J Pers Med. 2024 Feb 20;14(3):225. doi: 10.3390/jpm14030225.

Abstract

Sepsis is one of the most common causes of morbidity and mortality worldwide. Despite the remarkable advances in modern medicine throughout the last century, the mortality rates associated with sepsis have remained significantly elevated, both in high- and low-income countries. The main difficulty in the diagnosis and treatment of septic patients is the tremendous heterogeneity of this condition. The vast heterogeneity that characterizes sepsis ranges from the clinical presentation to the biological aspects of the disease. Evidence-based medicine approaches sepsis as a homogenous syndrome and does not consider the individual discrepancies between septic patients. This approach may contribute to the poor outcomes of septic patients. In recent years, personalized medicine has gained significant interest. This novel form of medicine underlines the importance of understanding the genetic, epigenetic, and molecular basis of a disease in order to provide a more tailored approach for the patient. The study of "omics", such as cytomics, genomics, epigenomics, transcriptomics, proteomics, and metabolomics, provides a deeper comprehension of the complex interactions between the host, the disease, and the environment. The aim of this review is to summarize the potential role of a personalized approach in sepsis management, considering the interactions between various "omics".

摘要

脓毒症是全球发病和死亡的最常见原因之一。尽管在上个世纪现代医学取得了显著进展,但在高收入和低收入国家,与脓毒症相关的死亡率仍然显著升高。脓毒症患者诊断和治疗的主要困难在于这种病症的巨大异质性。脓毒症的巨大异质性体现在从临床表现到疾病生物学方面的各个层面。循证医学将脓毒症视为一种同质综合征,并未考虑脓毒症患者之间的个体差异。这种方法可能导致脓毒症患者的不良预后。近年来,个性化医疗引起了广泛关注。这种新型医学强调了理解疾病的遗传、表观遗传和分子基础的重要性,以便为患者提供更具针对性的治疗方法。对“组学”的研究,如细胞组学、基因组学、表观基因组学、转录组学、蛋白质组学和代谢组学,能更深入地理解宿主、疾病和环境之间的复杂相互作用。本综述的目的是考虑各种“组学”之间的相互作用,总结个性化方法在脓毒症管理中的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e968/10971110/771e6cc7d79e/jpm-14-00225-g001.jpg

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