ari biomarkers inodiwa muhutano Vakava imwe yematombo emakona emishonga yemazuva ano. Kutenda kwavari, tinogona kuziva zviri kuitika "mukati" nguva refu zviratidzo zvakajeka zvisati zvaoneka, kurapwa kwakanaka, uye kutarisira njodzi dzaisazoonekwa kwemakore.
Mumakore achangopfuura, nekukwira kwe munhu uye nemazvo mushongaPfungwa yemabhaomarkers yatora hofori kusvetukira kumberi: isu hatichatauri chete nezve cholesterol kana glucose, asiwo nezve telomeres, DNA methylation, microbiota, uye yakaoma genomic profiles. Izvi zviri kushandura nzira yatinodzivirira nayo, yekuongorora, uye kubata zvese kubva kuzvirwere zvemoyo kusvika kugomarara, pamwe nezvirwere zvisingawanzo uye kuchembera nguva isati yakwana.
Chii chaizvo chinonzi biomarker uye nei ichikosha zvakanyanya?
Mumashoko akareruka, biomarker is a measurable biological character (morekuru, sero, mufananidzo, physiological sign…) inoratidza maitiro ari mumuviri: inogona kuve yakajairika mamiriro, chirwere, kana mhinduro kumushonga. Hachifaniri kungova chinhu chiri muropa; inogona kuva puroteni, metabolite, chidimbu cheDNA, mufananidzo weMRI, kana kunyange chimiro chemuviri.
Mundima yekiriniki, basa rinowanzoitwa kunyanya nema biomarkers quantifiable biological Inowanikwa muropa, weti, tsvina, kana mamwe matishu: mapuroteni (akadai setroponin, CRP, kana mahormone), metabolites (glucose, lipids, uric acid), uye nucleic acids (majini, shanduko, masiginecha e genomic). Asi kune zvakare ekufungidzira, anoshanda, mechaniki, kana kunyangwe epfungwa uye maitiro biomarkers, kunyangwe pano isu tichatarisa zvakanyanya kune zvipenyu.
A yakanaka biomarker inofanira kuva yakananga, inonzwira tsitsi, inogona kudhindwa, uye ine chekuita nekirinikiNdiko kuti, inofanira kunyatsoona mamiriro chaiwo, kunyatsosiyanisa kubva kune vamwe, kupa migumisiro inowirirana mumarabhoritari akasiyana, uye kupa ruzivo runobatsira kusarudza zvekuita nemurwere (kuongororwa, kurapwa, kutevera, kana kudzivirira).
Uyezve, kukosha kweiyo biomarker hakufungirwe: inofanirwa kuti zviratidzwe nezvidzidzo zvakasimbaKutanga padanho rekuongorora (kuti bvunzo inoyera zvakanaka zvayakataura kuti inoyera) uyezve padanho rekiriniki (kuti inonyatso kubatanidzwa nemhedzisiro yakakosha: kutanga kwechirwere, mhinduro yekurapa, matambudziko, kufa, nezvimwewo).
Mhando dzebiomarkers zvinoenderana nebasa ravo rekiriniki
Kuti udzivise kurasika musango rema acronyms uye mazita asinganzwisisike, zvinobatsira kuti unzwisise kuti biomarkers inowanzoiswa mumapoka maererano Chii chavanoshandiswa pakuita?Chiratidzo chimwe chete chinogona kukwana muchikamu chinopfuura chimwe, asi nekuda kwezvinangwa zvekiriniki mabasa akati wandei anosiyaniswa.
Mukurapa chaiko, mapoka mana makuru anokurukurwa: kushushikana kana njodzi, kuongororwa, kufungidzira uye kufanotaura kwemhinduro yekurapa kana kuchengetedzwaMukuita kwemazuva ese, izvi zvinowedzerwa nekutarisa kana kutevedzera-makamaka uye biomarker yemhinduro yemishonga.
Biomarkers ye susceptibility kana predisposition Vanoratidza mukana wekuti munhu azova nechirwere mune ramangwana. Mienzaniso yemhando yepamusoro shanduko muBRCA1 uye BRCA2, iyo inowedzera njodzi yekenza yemazamu neyeovarian, kana mamwe mapolymorphism ane hukama nezvirwere zvemetabolism kana neurodegenerative.
Biomarkers ye kuongororwa Vanoshumira kusimbisa kana kubvisa chimwe chirwere. Muenzaniso unozivikanwa ndeye troponin mu acute myocardial infarction, kana PSA (prostate-specific antigen) mune inofungidzirwa kenza yeprostate, pamwe chete nekuchinja kwakasiyana kana kusaina kwemajini mumamota anotsanangura imwe subtype.
Biomarkers fungidziro Vanopa ruzivo pamusoro pekugona kushanduka kwechirwere (hasha, njodzi yekudzokazve, kupona). PSA mazinga mukenza yeprostate, Ki-67 mugomarara rezamu, kana mamwe tumor genomic profiles mienzaniso yakajairika; zviratidzo zvekuzvimba kusingaperi kana kukuvara kwenhengo zvinogonawo kuwira muboka iri.
Biomarkers kufungidzira Vanotibvumira kutarisira kuti murwere achapindura (kana kuti kwete) kune imwe nzira yekurapa kana kuti achasangana nemigumisiro yakawanda. Nyaya yeparadigmatic ndeye HER2 mukenza yemazamu, iyo inofanotaura kushanda kwemishonga inotarirwa yakadai setrastuzumab; kana KRAS/NRAS kuchinja kwegomarara remukati, iro rinotarisa kushandiswa kwemamwe masoja ekudzivirira chirwere.
Pakupedzisira, iyo biomarkers ye mhinduro yemishonga kana kutarisa Vanoongorora kuti muviri uri kuita sei pakurapwa. Kuyera glucose yeropa kutarisa kushanda kwekurapa kwechirwere cheshuga, procalcitonin mukushanduka kwe sepsis, kana CA-125 panguva yekurapa kenza ye ovarian mienzaniso yakajeka.
Maitiro ekutora biomarker kubva murabhoritari kuenda kukiriniki
Nekuda kwekuti muongorori anoona angangoita biomarker muchidzidzo che omics hazvireve kuti ichave yakagadzirira kushandiswa muzvipatara zuva rinotevera. Iyo nzira yakareba uye inosanganisira ... matanho mana makuru: kuwanikwa, kusimudzira, kusimbiswa, uye kuratidzwa kwekiriniki utility.
Muchikamu che kuwanikwa Mamorekuru evamiriri anoonekwa achishandisa genomics, transcriptomics, proteomics, kana metabolomics maturusi. Izvo zvinodikanwa kutsanangura chaizvo izvo zvinofanirwa kuyerwa (gene, puroteni, metabolite), mumhando ipi yemuenzaniso (ropa, tishu, weti, tsvina, nezvimwewo), uye kuti inomiririra nzira ipi yehupenyu (kuongororwa, kufungidzira, mhinduro, nezvimwewo). Izvo zvakakosha kuti pave nekubvumirana kwesainzi kuti iyo biomarker inoratidza iyo pathophysiological phenomenon inotarisirwa kubata.
Kunotevera kunouya iyo kubudiriraApa ndipo apo nzira yekuongorora yekuyera kuyera biomarker inogadzirwa uye yakagadziridzwa: chaiyo nzira, calibration, kudzora kwemhando, miganhu yekuona, sampuli kugadzikana, etc. Ichi chikamu dzimwe nguva hachikosheswi nekuti chinopedza nguva uye zviwanikwa, asi zvakakosha kuti bvunzo ishande pasi pemamiriro ezvinhu chaiwo.
Zvadaro zvinouya kusimbiswaiyo ine zvikamu zviviri: kuongorora uye kliniki. Analytical kusimbiswa kunosimbisa kuti bvunzo nemazvo, chaizvo, uye nenzira inoyera muongorori wekufarira mukati meiyo yakatarwa renji, uye kuti mhedzisiro inoramba yakagadzikana pasi pemamiriro akasiyana uye mumarabhoritari akasiyana.
Kusimbiswa kwekiriniki kunotarisa pakuratidza kuti pane a kushamwaridzana kwakasimba pakati peiyo biomarker uye mhedzisiro yekiriniki zvakakodzera (chirwere chekuongorora, kufambira mberi, mhinduro yekurapa, kufa, nezvimwewo). Maparamita akadai sekunzwa, hunhu, fungidziro tsika, pakati-pakati reproducibility, uye kusarura kusarura kunoongororwa uchishandisa ROC curves uye nzvimbo iri pasi pe curve (AUC).
Pakupedzisira, zvakakodzera kuratidza kliniki utilityKubatanidza iyi biomarker mukutarisira murwere kunoshandura sarudzo uye inovandudza mhedzisiro kana ichienzaniswa nekusaishandisa. Mune mamwe mazwi, haingofanotaura zvakanaka chete, asi inobvumirawo kurapwa kuri nani, inodzivirira matambudziko, inoderedza chepfu, uye inoita kuti zvishandiswe zvakanyanya kushandisa zviwanikwa.
Methodological matambudziko mukusimbisa biomarker
Kusimbisa biomarker hakusi nyore sekumhanyisa akati wandei ekukurumidza ongororo yenhamba. Pane zvinhu zvehunyanzvi zvinonyanya kuomesa zvinhu, uye kana zvikasatariswa, pane njodzi ye... inflate results kana kuunza biases izvo zvinobva zvashandura zvikanganiso zvekiriniki.
Imwe yematambudziko akajairika ndeye mukati-chidzidzo kuwiriranaKazhinji, kuyerwa kwakawanda kweiyo biomarker imwe chete inowanikwa mumurwere (panguva dzakasiyana, kubva kune akasiyana bundu samples, nezvimwewo). Izvi zvakacherechedzwa hazvina kuzvimiririra, uye kuzviongorora sekunge zvaive kunowedzera njodzi yekunyepa. Kuti udzivise izvi, mamodhi enhamba anotarisisa chimiro chekubatanidza anoshandiswa, senge yakasanganiswa mitsetse mhando kana generalized equations equations.
Imwe musoro wemusoro ndeye kuwandaMaitiro eOmics anobvumira kuongororwa panguva imwe chete yemakumi kana mazana emaki, nzira dzakasiyana dzekuyera imwe neimwe, uye akawanda akachekwa-mapoinzi ekuenderera mberi biomarker. Kana bvunzo dzakawanda dzisina kurongeka dzekufungidzira dzichiitwa, mukana wekuwana hukama hwenhema unowedzera zvakanyanya.
Kudzora dambudziko iri, nzira dzekugadzirisa iyo mhando I yekukanganisa rate dzinoshandiswa, senge Bonferroni kururamisa (kunyanya kuchengetedza, kuderedza simba) kana nzira dzinobva pane manyepo ekuwanikwa mwero (FDR), yakadai seyo nzira yeBenjamini-Hochberg, iyo inoshanda nemafungiro e-q-value (inotarisirwa chikamu chezvinyorwa zvenhema pakati pezvakawanikwa zvakakosha).
Panewo kuwanda padzinoongororwa migumisiro yemakiriniki akawanda muchidzidzo chimwechete (kupona kwese, kufambira mberi-kusina kupona, mhinduro yeradiological, chirwere chakagadzikana, nezvimwewo) pasina kusimbisa hutungamiri hwakajeka kana kugadzirisa kuongorora. Izvi zvinoomesera kududzira uye zvinoita kuti zvinyanye kunetsa kusvika pakubvumirana pakubatsira chaiko kweiyo biomarker.
Pamwe chete neizvi zvinoonekwa kusarudza kusarura uye kukanganisaIzvi zvinonyanya kuwanda muzvidzidzo zvekudzokera kumashure nemasampuli akachengetwa. Misiyano yakarongeka pakati pemapoka ekuenzanisa (somuenzaniso, varwere vane mazinga akasiyana ebiomarker avo vanosiyanawo nezera, chirwere chechirwere, kana kurapwa kwakagamuchirwa) vanogona kukanganisa masangano. Kuti uderedze izvi, mhando dzakasiyana-siyana, dzinofananidzwa nezvinhu zvakakosha, kana kuti propensity scores inoshandiswa, iyo inofananidzira zvishoma mamiriro ekuenzanisa kwekuedza.
Uyezve, iyo yakakwana yekudzidza dhizaini inoenderana nerudzi rwebiomarker. fungidziro Ivo vanogona kutanga kusimbiswa zvekare, asi nekukurumidza kana gare gare ivo vanoda multicenter kusimbiswa uye inotarisirwa miedzo yekusimbisa yavo yekiriniki yekushandisa. kufungidzira Ivo vanotonyanya kuda: ivo vanoda zviyedzo zvakadzorwa zvine dhizaini yekudyidzana, kana kuti yakanyatso itwa yekuongorora yakadzokororwa yezvidzidzo zvekare, kuratidza kuti mhedzisiro yekurapa inoshanduka zvichienderana nechimiro cheiyo biomarker.
Yakakosha biomarkers yekuongorora hutano mamiriro uye hupenyu hurefu
Kupfuura mamaki ane hunyanzvi, kune seti ye biomarkers iyo yakakosha kune Kutora mhepo yepasi rose yehutano nekuchembera zvemunhu. Mamwe anozivikanwa zvakanyanya uye anokumbirwa mune chero ongororo yekutanga, uye mamwe ari epamberi asi ari kuwedzera kuwanikwa.
Yekutanga block ine ma parameters. anthropometric uye kuumbwa kwemuviri. Kurema, kunyange zvazvo zvingaita sezviri pachena, ndeimwe yeakanakisa kufanotaura kwehutano uye hupenyu hurefu, nguva dzose inodudzirwa maererano nekukwirira uchishandisa body mass index (BMI). Hunhu huri pamusoro pe30 hunobatanidzwa nekurasikirwa kwakanyanya kwehupenyu hwekutarisira, nepo kuchengetedza hutano hwakasiyana hwakabatana nenjodzi yakaderera yezvirwere zvisingaperi.
El abdominal circumference Inopa rumwe ruzivo nezve visceral mafuta, ayo ane ngozi zvakanyanya kupfuura subcutaneous mafuta. Mafuta akawanda emukati-mudumbu anoshandura hormonal function (estrogen, cortisol, insulin), inosimudzira systemic kuzvimba, uye inobatanidzwa nehurombo hwehupenyu, kuremara, uye njodzi yakawedzera yechirwere chemoyo. Matanho akadai seakanyatso kurongeka kutsanya kwepakati kana mwero calorie restriction zvakabatanidzwa neakagadziridzwa maprofile mune aya mamaki.
Mundima ye metabolic, iyo kutsanya glucose Insulin kuramba uye glycated hemoglobin (HbA1c) zviratidzo zvakakosha zvekuongorora nguva pfupi-uye yepakati-yenguva glycemic control, zvichiteerana. Mazinga akakwirira anoratidza insulin kuramba uye njodzi yakawedzera yechirwere cheshuga, kukurumidza kuchembera, kukuvara kwevascular, uye kufa. HbA1c, kunyanya, inoratidza maitiro eglucose mukati memwedzi 2-3 yapfuura uye ndeimwe yezvinyorwa zvinobatsira zvakanyanya pakunzwisisa "glycemic weather" yemuviri.
Iyo lipid profile zvakare haina mubvunzo kana uchitaura nezvayo Cardiovascular ngozi uye hupenyu hurefuHDL ("yakanaka" cholesterol), LDL ("yakaipa" cholesterol), triglycerides, lipoprotein (a), uye homocysteine ​​​​inotibvumira kufungidzira mukana wechirwere chetachiona uye zviitiko zvakadai sekurwadziwa kwemoyo kana sitiroko. Lipoprotein (a), iyo inonyanya kukonzerwa ne genetics, inoratidza mhuri yevascular ngozi uye yakaoma kuchinja; yakakwira homocysteine ​​​​mazinga anoratidza yakakura oxidative kusagadzikana uye endothelial kukuvara.
Low-giredhi kuzvimba mamakisi, akadai C-reactive protein (CRP) Iyo ultrasensitive antibody uye fibrinogen inoshandiswa kuyera iyo iri pasi pekuzvimba chiitiko chine chekuita nekuchembera nguva isati yakwana, atherosclerosis, uye hurombo hurombo muzvirwere zvakawanda. Nenzira yakanaka, dzinofanira kunge dzakaderera sezvinobvira, kunyange zvazvo dzichigona kusimuka kwenguva pfupi nekuda kwehutachiona, kushungurudzika, kana kushungurudzika kwakanyanya.
Yepamberi biomarkers ine chekuita nekuchembera uye mitochondria
Mumunda we kukwegura zvakanaka uye mushonga wekudziviriraMamwe ma biomarker akaomarara akawana mukurumbira, zvichibvumira fungidziro yezera rebiological uye njodzi yekuipa kweramangwana.
La kureba kwetelomere Telomeres yave yakakurumbira sechiratidzo chekuchembera kweserura. Iwo anodzokorora DNA kutevedzana kumagumo emakromosomes anovadzivirira kubva pakusakara uye kubvaruka. Nechikamu chega chega chesero, vanopfupisa, uye kana vasvika pachikumbaridzo chakakomba, sero rinopinda senescence kana kufa. Matelomere akareba anowanzobatanidzwa nehupenyu hurefu uye huwandu hwezvirwere zvisingaperi.
Chikamu chakakosha chehurefu hwetelomere chinotemerwa ne geneticsNekudaro, zvinhu zvakaita sekushushikana kusingaperi, kusarara zvakanaka, kufutisa, hyperglycemia inoramba iripo, kusadya zvisina kunaka, uye mararamiro ekusagara anobatsirawo mukupfupisa. Sezvineiwo, kurovedza muviri zvine mwero uye nguva dzose, nzira dzekudzora kushushikana (kufungisisa, yoga, kufema zvine mutsindo), uye mamwe makomisheni echisikigo anogona kubatsira kuchengetedza kana, mune dzimwe nguva, kunyange kurebesa telomere kureba.
La DNA methylation Ndiwo mumwe mutambi akakosha. Kuwedzerwa kana kubviswa kwemapoka e-methyl munzvimbo dzakananga dzejenome kunogadzirisa kutaura kwemajini pasina kushandura kutevedzana, kuumba izvo zvinozivikanwa seepigenome. Nezera, muenzaniso wepasi rose hypomethylation uye hypermethylation yemuno munzvimbo dzakatarwa inoonekwa, yakabatana nezvirwere zvisingaperi. Izvi zvakabvumira kugadzirwa kwe epigenetic wachi dzinofungidzira zera rebiology.
Epigenome iyo yakanyanyisa methylated mune dzimwe nzvimbo inobatanidzwa upenyu hupfupiShanduko mukudya, maekisesaizi, kuratidzwa kune muchetura, kushushikana, uye kunaka kwekurara kunogona kuenzanisa aya mapatani. Pamusoro pezvo, zvimwe zvekuwedzera (zvakadai seN-acetylcysteine ​​​​uye mamwe maredox modulators) zvakadzidzwa sezvishandiso zvinogona kukanganisa methylation, kunyangwe kutsvagurudza kwakawanda kuchiri kudikanwa.
Mundima yesimba remagetsi, zvinotevera zvinomira pachena: NAD + NAD+ (nicotinamide adenine dinucleotide) uye glutathione. NAD + yakakosha cofactor kune mitochondrial simba metabolism uye DNA kugadzirisa. Kuchengeta mazinga akakwana kwakakosha kunonoka kuderera kwemitochondrial uye, nekudaro, kushanda kuchembera. Tsvagiridzo irikuenderera mberi muNAD + precursors uye mamwe metabolic activators.
El glutathione Glutathione ndiyo huru intracellular antioxidant. Vamwe vanhu, nekuda kweiyo genetics, vanoigadzira muhuwandu husina kukwana uye vanotapukirwa nekukuvara kweoxidative uye kusingaperi kuzvimba. Kuona yakaderera glutathione mazinga anogona kutungamira nzira dzinotsigira (chikafu, chakananga chekuwedzera, intravenous therapies) kudzorera redox chiyero uye kudzivirira mitochondrial basa.
Makiyi eropa biomarkers: yakafara pani kuti uone iyo yose mufananidzo
Kana iwe uchida kuita ongororo yakazara yehutano uye chirwere njodzi, hazvina kukwana kutarisa maviri kana matatu ega manhamba. Pane yakakura ye ropa biomarkers Kana ichidudzirwa nemazvo, inopa mufananidzo wakakwana.
Munzvimbo yekuzvimba, kuwedzera kune CRP uye fibrinogen, iyo D-dimer Iyo inobvumira kuongororwa kweanoshanda kana ichangoburwa thrombotic maitiro. Muchikamu chemoyo uye chemetabolism, glucose yekutsanya, basal insulin, HbA1c, cholesterol yakazara, HDL, LDL, triglycerides, homocysteine, uric acid, uye zviratidzo zvakasiyana-siyana zvechiropa (ALT, AST, GGT, alkaline phosphatase, bilirubin) inoumba musimboti.
Iron-inoenderana parameters-serum iron, ferritin, uye transferrin saturation-inobatsira kuona zvose. kushomeka senge iron kuwandisaZvose zvine zvazvinoreva kuneta, kugona kushanda, njodzi yemwoyo, uye kukuvara kwenhengo. Yakakwira ferritin, semuenzaniso, yakave yakabatana nezvose zvisingaperi kuzvimba uye njodzi yakawedzera yechirwere cheshuga uye chirwere chemoyo.
El kukwana kweropa (CBC) Inopa ruzivo pamusoro pemasero matsvuku eropa (kuverenga, hemoglobin, hematocrit, MCV, MCH, MCHC), masero machena eropa, uye maplatelet. Nhamba idzi dzinobvumira kuonekwa kweanemias, maitiro ekuzvimba kana kutapukira, hematological disorders, uye kuchinjwa kwekugona kuvhara. Sezvineiwo, zvimwe zvidzidzo zvakaona kuti leukocyte uye maplatelet kukosha kumucheto kwezasi kwereferensi renji, asi mukati memiganho yakajairwa, inosanganiswa nekufa kwakaderera kwese.
Muvarume, the prostate-specific antigen (PSA) Inoramba iri mucherechedzo wekuongorora uye kuongorora kenza yeprostate, kunyangwe nhasi ichiwedzerwa nemamwe mabhaibheri akanyanya sePCA3 kana SelectMDx (muweti) kunatsa njodzi yemamota akakosha ekiriniki uye kudzivirira zvisingakodzeri mabiopsies.
Iyo hormonal axis inouyawo mukutamba: testosterone, estrogens, progesterone, FSH, LH, TSH, yemahara T3, yemahara T4, antithyroid antibodies (senge anti-TPO), cortisol, DHEA, uye insulin-yakafanana kukura factor 1 (IGF-1) inobatsira kunzwisisa zviri nani endocrine chimiro uye mhinduro yekushushikanapamwe chete nezvinogona kukonzera kuderera kwesimba, kuchinja uremu, kuchinja kwechinyamusi, zvinetso zvembereko, kana kuti kusaenda kumwedzi.
Kupfuura ropa: metabolomics, amino acids, uye mafuta acids
Kunyange zvazvo kuongororwa ropa kwechinyakare chiri chishandiso chinoshandiswa zvakanyanya, pane bvunzo dzepamusoro dzinobvumira kuongororwa kwakadzama kwe metabolic profile uye zvinovaka muviri zvakadzama.
Iyo inonzi test ye organic acids muweti (OAT) Inoongorora metabolites inokonzerwa nenzira dzakasiyana dzemetabolism. Kuburikidza neaya mamakisi, zvinokwanisika kukanganisa kushanda kwemitochondria, kuvepo kweiyo oxidative kusagadzikana, intestinal dysbiosis, shanduko muurotransmitter synthesis, kana kushomeka kwemavhitamini uye cofactors.
Profiles amino acids (mazhinji ayo anosanganisirwa muorganic acid mabhatiri) anobvumira kuongororwa kweakakosha, asina-akakosha, uye anodiwa amino acids. Izvi zvinobatsira kunzwisisa kuri nani kwekuvandudzwa kwetishu, mhinduro yekudzivirira muviri, detoxification, kugadzirwa kwe enzyme, synthesis yehomoni, uye kugadzirwa kwesimba.
Mukufanana, kudzidza kwe mafuta acids muropa (yakazara, monounsaturated, uye polyunsaturated, kusanganisira omega-3, -6, uye -9) inoshandiswa kufungidzira kuenzanisa kwekuputika, njodzi yemwoyo, hutano hwekudya maererano nemafuta, uye kushanda kweimwe enzymatic nzira (senge delta-6 desaturase). Indices yakadai se "omega-3 index" yakabatanidzwa nekudzivirirwa kubva kune zviitiko zvemoyo.
Idzi nzira dzakabatanidzwa-metabolomics, amino acid profiling, uye fatty acid analysis-chikamu chechiratidzo chakafara. hutano hunoshanda uye hwemunhu, iyo inotsvaga kuona kusaenzana isati yashandura kuva chirwere chakarongeka.
Microbiota uye microbiome: intestinal biomarkers inoshandura zvese
Ura hunogara pakati pe500 ne1.000 emarudzi akasiyana-siyana emabhakitiriya, pamwe chete nemavhairasi, fungi, uye mamwe ma microorganisms. Uyu muunganidzwa wemamicroorganisms unonzi gut microbiota. microbiotauye huwandu hwema genomes avo, iyo microbiome. Nhasi tinoziva kuti kuumbwa kwayo uye kusiyana-siyana kunopesvedzera kugaya, micronutrient absorption, vhitamini synthesis, immune system regulation, uye systemic kuzvimba.
Yepamberi microbiota bvunzo, yakavakirwa pahunyanzvi hwakadai semultiplex PCR kana MALDI-TOF spectroscopy, inobvumira kuzivikanwa kwakaringana kwehutachiona huripo, kuwanda kwavo, uye kuvapo kwehutachiona kana kusaenzana (dysbiosis). Mamwe mapaneru anosanganisira a Dysbiosis Index iyo inopfupisa munhamba kubva pa1 kusvika ku5 kuti chimiro chemurwere chinotsauka kubva patani inoonekwa senormobiotic.
Mhando iyi yekuongorora inonyanya kukosha mu zvisingaperi zviratidzo zvekugaya (kuzvimba, manyoka, kudzimbirwa, kurwadziwa mudumbu), zvirwere zvomudumbu zvinozvimba, kutsamwa kwe bowel syndrome, autoimmunity, allergies, kusashivirira kwechikafu, kushomeka kwekudya kusingatsananguriki, uye kuzvimba kwegiredhi shoma.
Uyezve, iyo microbiota. Inoshanduka nokukurumidza zvikuru mukupindura kudya uye chinhu chakakodzera kune iyo kuchengetedza chikafuMienzaniso yemhuka yakaratidza kuti kuchinja kwechimbichimbi kwekudya kunogona kuchinja zvakanyanya kuumbwa kwebhakitiriya mukati memaawa kana mazuva mashoma. Muvanhu, kunyangwe nguva chaidzo dzichisiyana, pfungwa yakajairika yakafanana: kugadzirisa kudya kune mapatani akapfuma mufiber, chikafu chakaviriswa, uye chikafu chemhando yepamusoro zvinowanzobatanidzwa nekuvandudzwa mukusiyana uye kushanda kwegut microbiota.
Kuve nechinangwa microbiota biomarkers inofambisa kuvakwa kwe zvirongwa zvekurapa zvakasiyana-siyana (zvinovaka muviri, probiotics, prebiotics, phytotherapy, mararamiro ekuchinja) uye inobvumira kutarisa kana dysbiosis iri kunyatsogadziriswa nekufamba kwenguva.
Genetic uye epigenetic biomarkers mune chaiyo mushonga
Kuongororwa kweGenetic kwakavhura musuwo wemushonga wakawanda wakasarudzika. Nekuongorora DNA, zvinokwanisika kuona kusiyana uye kuchinja iyo inotarisisa njodzi yezvirwere (senge BRCA1/2 mugomarara rezamu uye ovarian, kana kuchinjwa kweDNA kugadzirisa majini mune mamwe mamota), mhinduro kune mamwe madhiragi (pharmacogenomics) kana maitiro ekuenda kune metabolic, yemwoyo kana neurological matambudziko.
Mune oncology, yakaoma genomic biomarker mapaneru anobvumira zviri nani kukamurwa kwebundu, kusarudzwa kweanonangwa marapirwo, sarudzo dzine chekuita nekukodzera kwechinyakare chemotherapy, immunotherapy, kana musanganiswa marapirwo, uye fungidziro yemukana wekudzokazve. KRAS, NRAS, EGFR, ALK, BRAF, TP53, uye HER2 angori mamwe emajini akatama kubva mumarabhoritari ekutsvaga kuenda kukiriniki yemazuva ese.
Mukufanana, the epigenetic miedzo Ivo vari kutanga kushandiswa semahwindo akasarudzika muzera rebiological uye nemhedzisiro yemararamiro pane gene expression. Nekuongorora DNA methylation mapatani kumazana kana zviuru zvesaiti chaiyo, akasiyana epigenetic wachi (seya yaHorvath, Hannum, kana Weidner) inofungidzira kuti makore mangani ezera remunhu akaenzaniswa nezera rake renguva.
Zvishandiso izvi zviri kuzviisa semushonga wepamusoro-soro kumishonga yekudzivirira uye zvirongwa zvehupenyu hurefu, sezvavanobvumira. simbisa zvine chinangwa kana mararamiro achichinja (chikafu, kurara, kurovedza muviri, kudzora kushushikana, zvinowedzerwa) zviri "kumutsidzira" muviri pachikamu chemolecular kana kwete.
Mukuwedzera, kune miedzo yakananga inobva kune glycans (shuga inoputira mapuroteni akadai se immunoglobulin G) iyo inoongorora chirwere chisingaperi chepasi-giredhi chinopisa uye yakatsanangurwa sezviratidzo zvinonzwisisika zvekukwegura, kubatanidza genetic, epigenetic uye zvakatipoteredza zvikamu.
Biomarkers mune oncology, cardiology, itsvo, chiropa uye sepsis
Mune oncology, biomarkers anga ari echokwadi shanduko. Mumamota akasimba, mamaki aripo muropa, matishu, kana zvinwiwa (senge shanduko chaiyo, mapuroteni akawandisa, siginecha ye transcriptomic, kana kutenderera bundu DNA) inobvumira. kuona gomarara nekukurumidza, kurongedza zvirinani, kugadzirisa marapirwo, uye kutarisa mhinduro.
Zvinofungidzirwa kuti ruzhinji rwevarwere vegomarara vanozoda imwe nzira yekuongororwa biomarker pane imwe nguva panguva yekurapwa kwavo kuti vawane chaiyo marapirwo. Izvi zvakagadzira kudiwa kweiyo official biomarker catalogs padanho renyika yehutano system kuti ive vimbiso kuenzana pakuwana uye kuenzanisa mupiro wekuongorora mune akasiyana hunyanzvi (onco-hematology, nhaka yemoyo chirwere, congenital metabolic chirwere, neuromuscular pathologies, neurodevelopmental kusagadzikana, nezvimwewo).
Mune cardiology, zviratidzo zvakadai se troponins Izvo zvakakosha pakuongorora acute myocardial infarction, nepo natriuretic peptides (BNP, NT-proBNP) inobatsira kuongorora uye kutarisa kutadza kwemoyo. High-sensitivity CRP inopa ruzivo pamusoro pechikamu chinoputira chehutano hwemwoyo, uye kana yakabatanidzwa ne lipid profile uye zvimwe zvinhu, inovandudza njodzi stratification.
Mune nephrology, creatinine uye cystatin C ndiwo matombo emakona ekufungidzira glomerular filtration rate, asi yekutanga biomarkers yakaiswa. acute itsvo kukuvara senge NGAL kana proadrenomedullin. Muhepatology, transaminases (ALT, AST), alkaline phosphatase, GGT uye bilirubin inobvumira kuonekwa kwe cytolysis, cholestasis uye kuchinjwa kwekushanda kwechiropa.
Muchirevo chehutachiona hwakanyanya uye sepsis, biomarkers senge procalcitoninMamwe ma interleukins (IL-6, IL-8) uye proadrenomedullin zvakare anobatsira kusiyanisa utachiona hwehutachiona kubva kune mamwe maitiro, kuongorora kuoma, kutungamira kushandiswa kwemishonga inorwisa mabhakitiriya, uye kufungidzira kufungidzira. Kubatanidza iyi data nezvakawanikwa zvekiriniki uye kumwe kuedzwa kwerabhoritari kwakakosha pakuita sarudzo nekukurumidza mumamiriro ezvinhu akaoma.
Biomarkers muzvirwere zvisingawanzo uye dzimwe nzvimbo dziri kubuda
Muzvirwere zvisingawanzo, kuve neakavimbika biomarkers anogona kuita mutsauko pakati kutarisa kunoshanda uye kuedza kwakachena uye kukanganisaMune lysosomal zvirwere zvakadai seGaucher chirwere, LysoGB1 inoshandiswa sechiratidzo chechiitiko chechirwere uye mhinduro yekurapa. Muchirwere cheNiemann-Pick, 7-ketocholesterol inoshandiswa kutarisa lipid kuunganidza uye kushanda kwekurapa.
Iyi mienzaniso inoratidza kuti biomarkers inonyanya kukosha sei kana chirwere chisingawanzo, mufananidzo wekiriniki wakaoma, uye kurapwa kunodhura zvakanyanya. Vanobvumira gadzirisa dose, kuona kukundikana kwekurapa nekukurumidza uye kudzivirira kupindira kusingakoshi kana kunokuvadza.
La kuwedzera kwezvinyorwa zvepamutemo Kushandiswa kwebiomarkers muhurongwa hwehutano hweveruzhinji kunosanganisirawo nzvimbo dzakadai sekufema, renal uye urogenital zvirwere, kugaya, dermatological, endocrine, nhaka yezvirwere zvehematological, immunodeficiencies, autoimmunity, fetal abnormalities uye kubereka kusagadzikana, pakati pezvimwe.
Kuti zvese izvi zvishande, kuve neiyo tekinoroji haina kukwana: yakajeka yekudzora sisitimu, agile uye humbowo-hwakavakirwa kuvandudza maitiro, uye proactivity mukugadzirisa njodzi dzekuongororaMari yakakwana, kudyidzana pakati penharaunda dzinozvimiririra kana matunhu, uye pachena maererano nenzvimbo dzipi dzinogona kuita bvunzo dzipi uye pasi pemamiriro api.
Kutorwa pamwe chete, iyo inodiwa biomarker muhutano inopa yakanyanya kunaka uye yakawedzera nzira yekunzwisisa zviri kuitika mumuviri wedu, kubva pakuzvimba chinyararire kana insulin kuramba kune yepedyo biology yebundu kana chiyero chaicho icho masero edu anokura; zviyere nguva nenguvaKududzira maitiro ayo nekufamba kwenguva uye nekuisanganisa nenhoroondo yezvekurapa, mararamiro, uye genetics inotibvumira kubva mukurapa unoshanda, wakanangana nekudzima moto, kune zvechokwadi inodzivirira uye yemunhu mushonga, uko sarudzo dzinoitwa nedata riri muruoko uye nzvimbo yakakwana yekufambisa kushandura nzira yechirwere uye kurebesa, nemhando, makore ehupenyu.
