Pub Date : 2022-07-01Epub Date: 2022-06-24DOI: 10.2217/pme-2021-0059
Rafael López-Castro, Tania García-Peña, Xabier Mielgo-Rubio, Mariona Riudavets, Cristina Teixidó, Noelia Vilariño, Felipe Couñago, Laura Mezquita
In recent years, major advances have been achieved in our understanding of non-small-cell lung cancer (NSCLC) with oncogenic driver alterations and in the specific treatment of these with tyrosine kinase inhibitors. Currently, state-of-the-art management of patients with NSCLC (particularly adenocarcinoma or non-adenocarcinoma but with mild tobacco exposure) consists of the determination of EGFR, ALK, ROS1 and BRAF status, as they have US FDA and EMA approved targeted therapies. The increase in molecular knowledge of NSCLC and the development of drugs against other targets has settled new therapeutic indications. In this review we have incorporated the development around MET, KRAS and NTRK in the diagnosis of NSCLC given the therapeutic potential that they represent, as well as the drugs approved for these indications.
{"title":"Targeting molecular alterations in non-small-cell lung cancer: what's next?","authors":"Rafael López-Castro, Tania García-Peña, Xabier Mielgo-Rubio, Mariona Riudavets, Cristina Teixidó, Noelia Vilariño, Felipe Couñago, Laura Mezquita","doi":"10.2217/pme-2021-0059","DOIUrl":"https://doi.org/10.2217/pme-2021-0059","url":null,"abstract":"<p><p>In recent years, major advances have been achieved in our understanding of non-small-cell lung cancer (NSCLC) with oncogenic driver alterations and in the specific treatment of these with tyrosine kinase inhibitors. Currently, state-of-the-art management of patients with NSCLC (particularly adenocarcinoma or non-adenocarcinoma but with mild tobacco exposure) consists of the determination of <i>EGFR</i>, <i>ALK</i>, <i>ROS1</i> and <i>BRAF</i> status, as they have US FDA and EMA approved targeted therapies. The increase in molecular knowledge of NSCLC and the development of drugs against other targets has settled new therapeutic indications. In this review we have incorporated the development around MET, KRAS and NTRK in the diagnosis of NSCLC given the therapeutic potential that they represent, as well as the drugs approved for these indications.</p>","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":" ","pages":"341-359"},"PeriodicalIF":2.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40395483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01Epub Date: 2022-06-28DOI: 10.2217/pme-2021-0003
Guanhao Zheng, Jiaqi Cai, Shenghui Zhou, Ning Du, Hao Bai, Juan He, Xiaolan Bian
Aim: To observe the difference in the risk of polymyxin B (PMB)-induced acute kidney injury (AKI) with or without dose adjustment based on the patients renal function. Materials & methods: This retrospective cohort analysis was carried out in 115 patients treated with PMB from November 2018 to October 2019. Results: No significant difference in the incidence of AKI as well as secondary outcomes was observed between these two groups (47.5 vs 37.14%; p = 0.304). Conclusion: Dosing adjustment based on renal function does not significantly lower the risk of PMB-induced AKI. A non adjusted dosing strategy for PMB is recommended in patients exhibiting various levels of renal impairment.
目的:观察多粘菌素B (PMB)引起的急性肾损伤(AKI)发生风险根据患者肾功能调整剂量与不调整剂量的差异。材料与方法:对2018年11月至2019年10月接受PMB治疗的115例患者进行回顾性队列分析。结果:两组AKI发生率及次要结局无显著差异(47.5% vs 37.14%;p = 0.304)。结论:基于肾功能的剂量调整并不能显著降低pmb诱发AKI的风险。对于表现出不同程度肾功能损害的患者，建议采用非调整的PMB给药策略。
{"title":"Risk of polymyxin B-induced acute kidney injury with a non adjusted dose versus adjusted dose based on renal function.","authors":"Guanhao Zheng, Jiaqi Cai, Shenghui Zhou, Ning Du, Hao Bai, Juan He, Xiaolan Bian","doi":"10.2217/pme-2021-0003","DOIUrl":"https://doi.org/10.2217/pme-2021-0003","url":null,"abstract":"<p><p><b>Aim:</b> To observe the difference in the risk of polymyxin B (PMB)-induced acute kidney injury (AKI) with or without dose adjustment based on the patients renal function. <b>Materials & methods:</b> This retrospective cohort analysis was carried out in 115 patients treated with PMB from November 2018 to October 2019. <b>Results:</b> No significant difference in the incidence of AKI as well as secondary outcomes was observed between these two groups (47.5 vs 37.14%; p = 0.304). <b>Conclusion:</b> Dosing adjustment based on renal function does not significantly lower the risk of PMB-induced AKI. A non adjusted dosing strategy for PMB is recommended in patients exhibiting various levels of renal impairment.</p>","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":" ","pages":"307-314"},"PeriodicalIF":2.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40403216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yunima Sapkota, Soniya Dulal, P. Gyawali, Ajnish Ghimire, Prabakaran Shankar
{"title":"Personalized medicine in Nepal: current scenario and challenges.","authors":"Yunima Sapkota, Soniya Dulal, P. Gyawali, Ajnish Ghimire, Prabakaran Shankar","doi":"10.2217/pme-2022-0002","DOIUrl":"https://doi.org/10.2217/pme-2022-0002","url":null,"abstract":"","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47619154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Adeleke, Aidan Haslam, A. Choy, S. Diaz-Cano, J. Galante, C. Mikropoulos, S. Boussios
We present the case of a patient with Lynch syndrome and metastatic colorectal carcinoma (mCRC). The initial immunohistochemistry (IHC) test for deficient mismatch repair gave a false negative result. However, the same mutation has accurately has been detected with IHC in other cancers with microsatellite instability (MSI) This supports the determining role of somatic missense mutations in MMR IHC. MSI-PCR testing confirmed MSI and the patient benefited from nivolumab with a complete metabolic response. We explain the rationale for immunotherapy in mCRC, current testing strategies and discuss future developments in MSI testing. We advocate for upfront testing using both IHC and MSI-PCR to direct therapy in mCRC, and a greater understanding of IHC and MSI-PCR testing pitfalls.
{"title":"Microsatellite instability testing in colorectal patients with Lynch syndrome: lessons learned from a case report and how to avoid such pitfalls.","authors":"S. Adeleke, Aidan Haslam, A. Choy, S. Diaz-Cano, J. Galante, C. Mikropoulos, S. Boussios","doi":"10.2217/pme-2021-0128","DOIUrl":"https://doi.org/10.2217/pme-2021-0128","url":null,"abstract":"We present the case of a patient with Lynch syndrome and metastatic colorectal carcinoma (mCRC). The initial immunohistochemistry (IHC) test for deficient mismatch repair gave a false negative result. However, the same mutation has accurately has been detected with IHC in other cancers with microsatellite instability (MSI) This supports the determining role of somatic missense mutations in MMR IHC. MSI-PCR testing confirmed MSI and the patient benefited from nivolumab with a complete metabolic response. We explain the rationale for immunotherapy in mCRC, current testing strategies and discuss future developments in MSI testing. We advocate for upfront testing using both IHC and MSI-PCR to direct therapy in mCRC, and a greater understanding of IHC and MSI-PCR testing pitfalls.","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43872545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Johnson, V. Dissanayake, B. Korf, Meredith Towery, R. Haspel
Aim: Global implementation of genomic medicine will require education of healthcare providers. There are limited international needs assessment data to guide curriculum development. Materials & methods: Genomics education experts developed and distributed a survey to individuals with knowledge of country-specific needs: 113 completed surveys (19% response rate) from 34 countries. A high percentage of respondents ranked non genetics physicians as the #1 target for genetics education. Over 70% indicated a need for moderate/extensive modification in physician training. The majority considered germline and somatic topics and targeting primary care and specialist providers equally important. Conclusion: Regardless of country economic level, there is a clear need for genomics education of healthcare providers. The study results can be used to focus future genomic medicine education efforts.
{"title":"An international genomics health workforce education priorities assessment.","authors":"D. Johnson, V. Dissanayake, B. Korf, Meredith Towery, R. Haspel","doi":"10.2217/pme-2021-0094","DOIUrl":"https://doi.org/10.2217/pme-2021-0094","url":null,"abstract":"Aim: Global implementation of genomic medicine will require education of healthcare providers. There are limited international needs assessment data to guide curriculum development. Materials & methods: Genomics education experts developed and distributed a survey to individuals with knowledge of country-specific needs: 113 completed surveys (19% response rate) from 34 countries. A high percentage of respondents ranked non genetics physicians as the #1 target for genetics education. Over 70% indicated a need for moderate/extensive modification in physician training. The majority considered germline and somatic topics and targeting primary care and specialist providers equally important. Conclusion: Regardless of country economic level, there is a clear need for genomics education of healthcare providers. The study results can be used to focus future genomic medicine education efforts.","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48809850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01Epub Date: 2022-02-04DOI: 10.2217/pme-2021-0174
William B Wong, Daniele Anina, Chia-Wei Lin, Devon V Adams
Aim: Commercial plan coverage policies for multigene panel tests may vary and could result in geographic variation in coverage due to the fragmented nature of the commercial insurance market. This study aimed to characterize the alignment of multigene panel tests coverage policies to that of clinical guidelines, overall and by state. Materials & methods: We reviewed NCCN Guidelines® for four tumors. Public coverage policies were identified via web search. Payer policies included those with the largest or second largest number of commercial lives in each state. Policies were classified as 'more restrictive' or 'consistent' with the guidelines. Results: Of 38 plans/policies reviewed, 71% were classified as 'more restrictive' than the guidelines, with variation in the number of commercial lives by state. Among these, 52% restricted on panel size and 63% restricted in all or select tumors. Conclusion: Most coverage policies were more restrictive. Clinical guideline clarity and state policies may improve alignment to guidelines and geographic variations.
{"title":"Alignment of health plan coverage policies for somatic multigene panel testing with clinical guidelines in select solid tumors.","authors":"William B Wong, Daniele Anina, Chia-Wei Lin, Devon V Adams","doi":"10.2217/pme-2021-0174","DOIUrl":"https://doi.org/10.2217/pme-2021-0174","url":null,"abstract":"<p><p><b>Aim:</b> Commercial plan coverage policies for multigene panel tests may vary and could result in geographic variation in coverage due to the fragmented nature of the commercial insurance market. This study aimed to characterize the alignment of multigene panel tests coverage policies to that of clinical guidelines, overall and by state. <b>Materials & methods:</b> We reviewed NCCN Guidelines<sup>®</sup> for four tumors. Public coverage policies were identified via web search. Payer policies included those with the largest or second largest number of commercial lives in each state. Policies were classified as 'more restrictive' or 'consistent' with the guidelines. <b>Results:</b> Of 38 plans/policies reviewed, 71% were classified as 'more restrictive' than the guidelines, with variation in the number of commercial lives by state. Among these, 52% restricted on panel size and 63% restricted in all or select tumors. <b>Conclusion:</b> Most coverage policies were more restrictive. Clinical guideline clarity and state policies may improve alignment to guidelines and geographic variations.</p>","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":"19 3","pages":"171-180"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39750516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01Epub Date: 2022-01-31DOI: 10.2217/pme-2021-0133
Jianmin Huang, Yanfang Yun, Haiyan Chen, Guixin Yang, Yongming Jiang, Yaoxin Pan, Shengshan Yuan, Jianjun Huang, Li Su, Yingning Wu, Dong Lu, Anding Xu, Xuebin Li
Aim: The authors aimed to investigate whether polymorphisms of PON-1 were associated with the susceptibility to and severity of ischemic stroke (IS). Methods: In this study, 302 IS patients and 303 healthy controls were enrolled. Polymorphisms rs854560 and rs854572 of PON-1 were detected using SNaPshot single-nucleotide polymorphism typing technology. Results: The rs854572 polymorphism of the PON-1 gene showed a significant correlation with IS, and its GG genotype reduced the risk of IS (recessive model, p = 0.001). The GG genotype was also associated with mild stroke (p = 0.032). No association was observed between rs854560 and IS. Conclusion:PON-1 rs854572 polymorphism was related to the risk of IS and could be a biomarker to access the severity of IS.
{"title":"Association of <i>PON-1</i> polymorphism with susceptibility to and severity of ischemic stroke in the Chinese population.","authors":"Jianmin Huang, Yanfang Yun, Haiyan Chen, Guixin Yang, Yongming Jiang, Yaoxin Pan, Shengshan Yuan, Jianjun Huang, Li Su, Yingning Wu, Dong Lu, Anding Xu, Xuebin Li","doi":"10.2217/pme-2021-0133","DOIUrl":"https://doi.org/10.2217/pme-2021-0133","url":null,"abstract":"<p><p><b>Aim:</b> The authors aimed to investigate whether polymorphisms of <i>PON-1</i> were associated with the susceptibility to and severity of ischemic stroke (IS). <b>Methods:</b> In this study, 302 IS patients and 303 healthy controls were enrolled. Polymorphisms rs854560 and rs854572 of <i>PON-1</i> were detected using SNaPshot single-nucleotide polymorphism typing technology. <b>Results:</b> The rs854572 polymorphism of the <i>PON-1</i> gene showed a significant correlation with IS, and its GG genotype reduced the risk of IS (recessive model, p = 0.001). The GG genotype was also associated with mild stroke (p = 0.032). No association was observed between rs854560 and IS. <b>Conclusion:</b><i>PON-1</i> rs854572 polymorphism was related to the risk of IS and could be a biomarker to access the severity of IS.</p>","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":"19 3","pages":"219-228"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39870835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-01Epub Date: 2022-02-17DOI: 10.2217/pme-2021-0152
Vacis Tatarunas, Ali Aldujeli, Zemyna Kurnickaite, Laurynas Maciulevicius, Marius Burkanas, Jonas Venius, Ieva Ciapiene, Vilius Skipskis, Rita Norvilaite, Agne Giedraitiene, Ramunas Unikas, Giedre Baksyte, Olivija Gustiene, Gintare Sakalyte, Vaiva Lesauskaite
Aims: The goals of this study were to develop a new technique that could pave the way for a quicker determination of CYP4F2 rs3093135 and CYP2C19 rs4244285 variants directly from a patient's blood and to attempt to apply this technique in clinical practice. Patients & methods: The study included 144 consecutive patients admitted with ST elevation myocardial infarction. A blood-direct PCR and real-time PCR were used to detect variants of interest. Results & conclusion: Patients with bleeding events had the CYP2C19 GG (*1*1) variant more frequently than patients without bleeding events. The CYP4F2 TT variant was more frequently detected in patients with bleeding events 3 months after hospitalization.
{"title":"Blood direct PCR: impact of <i>CYP2C19</i> and <i>CYP4F2</i> variants for bleeding prediction in ST-elevation myocardial infarction patients with ticagrelor.","authors":"Vacis Tatarunas, Ali Aldujeli, Zemyna Kurnickaite, Laurynas Maciulevicius, Marius Burkanas, Jonas Venius, Ieva Ciapiene, Vilius Skipskis, Rita Norvilaite, Agne Giedraitiene, Ramunas Unikas, Giedre Baksyte, Olivija Gustiene, Gintare Sakalyte, Vaiva Lesauskaite","doi":"10.2217/pme-2021-0152","DOIUrl":"https://doi.org/10.2217/pme-2021-0152","url":null,"abstract":"<p><p><b>Aims:</b> The goals of this study were to develop a new technique that could pave the way for a quicker determination of <i>CYP4F2</i> rs3093135 and <i>CYP2C19</i> rs4244285 variants directly from a patient's blood and to attempt to apply this technique in clinical practice. <b>Patients & methods:</b> The study included 144 consecutive patients admitted with ST elevation myocardial infarction. A blood-direct PCR and real-time PCR were used to detect variants of interest. <b>Results & conclusion:</b> Patients with bleeding events had the <i>CYP2C19</i> GG (*1*1) variant more frequently than patients without bleeding events. The <i>CYP4F2</i> TT variant was more frequently detected in patients with bleeding events 3 months after hospitalization.</p>","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":"19 3","pages":"207-217"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39928624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: To investigate the effects of SKA3 on cell proliferation and metastasis in non-small-cell lung cancer (NSCLC) and its underlying mechanism. Methods: Immunohistochemistry was employed to analyze the expression of SKA3 in NSCLC. CCK-8 assay, EdU assay, Transwell assay and flow cytometry analysis were employed to assess cell proliferation, metastatic potential and apoptosis in vitro, respectively. A lung metastasis model was used to evaluate metastasis of NSCLC cells in vivo. A luciferase reporter gene assay was conducted to verify the targeting relationship. Results: SKA3 exhibited high expression in NSCLC tissues and cells. Overexpression of SKA3 remarkably accelerated cell proliferation and metastasis and suppressed apoptosis of NSCLC cells and promoted lung metastasis in a mouse model. miR-128-3p repressed SKA3 expression by targeting it. Conclusion: miR-128-3p inhibited the progression of NSCLC through targeting SKA3.
{"title":"<i>SKA3</i>, negatively regulated by <i>miR-128-3p</i>, promotes the progression of non-small-cell lung cancer.","authors":"Linlin Xie, Shaofei Cheng, Zhengyang Fan, Hongyang Sang, Qianping Li, Song Wu","doi":"10.2217/pme-2020-0095","DOIUrl":"https://doi.org/10.2217/pme-2020-0095","url":null,"abstract":"Aim: To investigate the effects of SKA3 on cell proliferation and metastasis in non-small-cell lung cancer (NSCLC) and its underlying mechanism. Methods: Immunohistochemistry was employed to analyze the expression of SKA3 in NSCLC. CCK-8 assay, EdU assay, Transwell assay and flow cytometry analysis were employed to assess cell proliferation, metastatic potential and apoptosis in vitro, respectively. A lung metastasis model was used to evaluate metastasis of NSCLC cells in vivo. A luciferase reporter gene assay was conducted to verify the targeting relationship. Results: SKA3 exhibited high expression in NSCLC tissues and cells. Overexpression of SKA3 remarkably accelerated cell proliferation and metastasis and suppressed apoptosis of NSCLC cells and promoted lung metastasis in a mouse model. miR-128-3p repressed SKA3 expression by targeting it. Conclusion: miR-128-3p inhibited the progression of NSCLC through targeting SKA3.","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":"19 3","pages":"193-205"},"PeriodicalIF":2.3,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39425147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Limkakeng, L. Rowlette, A. Hatch, A. Nixon, O. Ilkayeva, D. Corcoran, J. Modliszewski, S. M. Griffin, G. Ginsburg, D. Voora
Both transcriptomics and metabolomics hold promise for identifying acute coronary syndrome (ACS) but they have not been used in combination, nor have dynamic changes in levels been assessed as a diagnostic tool. We assessed integrated analysis of peripheral blood miRNA and metabolite analytes to distinguish patients with myocardial ischemia on cardiac stress testing. We isolated and quantified miRNA and metabolites before and after stress testing from seven patients with myocardial ischemia and 1:1 matched controls. The combined miRNA and metabolomic data were analyzed jointly in a supervised, dimension-reducing discriminant analysis. We implemented a baseline model (T0) and a stress-delta model. This novel integrative analysis of the baseline levels of metabolites and miRNA expression showed modest performance for distinguishing cases from controls. The stress-delta model showed worse performance. This pilot study shows potential for an integrated precision medicine approach to cardiac stress testing.
{"title":"A precision medicine approach to stress testing using metabolomics and microribonucleic acids.","authors":"A. Limkakeng, L. Rowlette, A. Hatch, A. Nixon, O. Ilkayeva, D. Corcoran, J. Modliszewski, S. M. Griffin, G. Ginsburg, D. Voora","doi":"10.2217/pme-2021-0021","DOIUrl":"https://doi.org/10.2217/pme-2021-0021","url":null,"abstract":"Both transcriptomics and metabolomics hold promise for identifying acute coronary syndrome (ACS) but they have not been used in combination, nor have dynamic changes in levels been assessed as a diagnostic tool. We assessed integrated analysis of peripheral blood miRNA and metabolite analytes to distinguish patients with myocardial ischemia on cardiac stress testing. We isolated and quantified miRNA and metabolites before and after stress testing from seven patients with myocardial ischemia and 1:1 matched controls. The combined miRNA and metabolomic data were analyzed jointly in a supervised, dimension-reducing discriminant analysis. We implemented a baseline model (T0) and a stress-delta model. This novel integrative analysis of the baseline levels of metabolites and miRNA expression showed modest performance for distinguishing cases from controls. The stress-delta model showed worse performance. This pilot study shows potential for an integrated precision medicine approach to cardiac stress testing.","PeriodicalId":19753,"journal":{"name":"Personalized medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45780431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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