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创伤性脑损伤康复组学研究:基于生物标志物的精准医疗方法在残疾人群中的典范应用

TBI Rehabilomics Research: an Exemplar of a Biomarker-Based Approach to Precision Care for Populations with Disability.

机构信息

Department of Physical Medicine and Rehabilitation, University of Pittsburgh, 3471 Fifth Avenue Suite 202, Kaufman Building, Pittsburgh, PA, 15213, USA.

出版信息

Curr Neurol Neurosci Rep. 2017 Sep 19;17(11):84. doi: 10.1007/s11910-017-0791-5.

Abstract

PURPOSE OF REVIEW

The purpose of this review is to summarize how "-omics" technologies can inform rehabilitation-relevant outcomes for a range of populations with neurologically related disability by including outcome metrics linked to the World Health Organization's International Classification of Functioning, Disability, and Health (WHO-ICF) domains of impairments in body function, activity limitations, and participation restrictions.

RECENT FINDINGS

To date, nearly every area of medicine uses biomarkers in some capacity to aid in understanding how personal biology informs clinical care. "-Omics"-based approaches use high throughput genomics, proteomics, and transcriptomics assay platforms to tailor and personalize treatments for subgroups of similar individuals based on these results. The recent Precision Medicine Initiative (PMI), sponsored by the National Institutes of Health (NIH), has propelled biomarker-based and genomics research to the forefront of many translational research and care programs addressing a variety of medical populations. Yet, the literature is sparse on precision medicine approaches for those with neurologically related and other disability. We demonstrate how the Rehabilomics Research model represents a translational framework for programs of precision rehabilitation research and care focused on linking personal biology to the biopsychosocial constructs that represent the WHO-ICF model and multidimensional outcome. We provide multiple exemplars from our own research program involving individuals with moderate-to-severe traumatic brain injury (TBI) to demonstrate how genomics and other biomarkers can be identified and assessed for their capacity to assist with personalized (precision) neurorehabilitation care and management.

摘要

综述目的

本综述旨在总结“组学”技术如何通过纳入与世界卫生组织(WHO)功能、残疾和健康国际分类(WHO-ICF)损伤、活动受限和参与受限领域相关的结果指标,为具有神经相关残疾的各种人群提供与康复相关的结果。

最近的发现

迄今为止,几乎医学的每个领域都在某种程度上使用生物标志物来帮助理解个人生物学如何为临床护理提供信息。基于“组学”的方法使用高通量基因组学、蛋白质组学和转录组学检测平台,根据这些结果为类似个体的亚组定制和个性化治疗。最近由美国国立卫生研究院(NIH)发起的精准医学倡议(PMI)将基于生物标志物和基因组学的研究推到了许多针对各种医学人群的转化研究和护理计划的前沿。然而,针对神经相关和其他残疾人群的精准医学方法的文献却很少。我们展示了 Rehabilomics 研究模型如何代表一个转化框架,用于精准康复研究和护理计划,该计划旨在将个人生物学与代表 WHO-ICF 模型和多维结果的生物心理社会结构联系起来。我们提供了我们自己的涉及中度至重度创伤性脑损伤(TBI)个体的研究计划的多个示例,以展示如何识别和评估基因组学和其他生物标志物,以帮助个性化(精准)神经康复护理和管理。

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