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Paving the way for precision medicine v2.0 in intensive care by profiling necroinflammation in biofluids

Tom Vanden Berghe (UGent) and Eric Hoste (UGent)
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Abstract
Current clinical diagnosis is typically based on a combination of approaches including clinical examination of the patient, clinical experience, physiologic and/or genetic parameters, high-tech diagnostic medical imaging, and an extended list of laboratory values mostly determined in biofluids such as blood and urine. One could consider this as precision medicine v1.0. However, recent advances in technology and better understanding of molecular mechanisms underlying disease will allow us to better characterize patients in the future. These improvements will enable us to distinguish patients who have similar clinical presentations but different cellular and molecular responses. Treatments will be able to be chosen more "precisely", resulting in more appropriate therapy, precision medicine v2.0. In this review, we will reflect on the potential added value of recent advances in technology and a better molecular understanding of necrosis and inflammation for improving diagnosis and treatment of critically ill patients. We give a brief overview on the mutual interplay between necrosis and inflammation, which are two crucial detrimental factors in organ and/or systemic dysfunction. One of the challenges for the future will thus be the cellular and molecular profiling of necroinflammation in biofluids. The huge amount of data generated by profiling biomolecules and single cells through, for example, different omic-approaches is needed for data mining methods to allow patient-clustering and identify novel biomarkers. The real-time monitoring of biomarkers will allow continuous (re)evaluation of treatment strategies using machine learning models. Ultimately, we may be able to offer precision therapies specifically designed to target the molecular set-up of an individual patient, as has begun to be done in cancer therapeutics.
Keywords
ACUTE KIDNEY INJURY, CRITICALLY-ILL PATIENTS, GELATINASE-ASSOCIATED LIPOCALIN, NEUTROPHIL EXTRACELLULAR TRAPS, SEPTIC SHOCK, CELL-DEATH, CARDIAC-SURGERY, SEVERE SEPSIS, PROGNOSTIC BIOMARKER, ORGAN DYSFUNCTION

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Citation

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MLA
Vanden Berghe, Tom, and Eric Hoste. “Paving the Way for Precision Medicine V2.0 in Intensive Care by Profiling Necroinflammation in Biofluids.” CELL DEATH AND DIFFERENTIATION 26.1 (2019): 83–98. Print.
APA
Vanden Berghe, T., & Hoste, E. (2019). Paving the way for precision medicine v2.0 in intensive care by profiling necroinflammation in biofluids. CELL DEATH AND DIFFERENTIATION, 26(1), 83–98.
Chicago author-date
Vanden Berghe, Tom, and Eric Hoste. 2019. “Paving the Way for Precision Medicine V2.0 in Intensive Care by Profiling Necroinflammation in Biofluids.” Cell Death and Differentiation 26 (1): 83–98.
Chicago author-date (all authors)
Vanden Berghe, Tom, and Eric Hoste. 2019. “Paving the Way for Precision Medicine V2.0 in Intensive Care by Profiling Necroinflammation in Biofluids.” Cell Death and Differentiation 26 (1): 83–98.
Vancouver
1.
Vanden Berghe T, Hoste E. Paving the way for precision medicine v2.0 in intensive care by profiling necroinflammation in biofluids. CELL DEATH AND DIFFERENTIATION. 2019;26(1):83–98.
IEEE
[1]
T. Vanden Berghe and E. Hoste, “Paving the way for precision medicine v2.0 in intensive care by profiling necroinflammation in biofluids,” CELL DEATH AND DIFFERENTIATION, vol. 26, no. 1, pp. 83–98, 2019.
@article{8573712,
  abstract     = {Current clinical diagnosis is typically based on a combination of approaches including clinical examination of the patient, clinical experience, physiologic and/or genetic parameters, high-tech diagnostic medical imaging, and an extended list of laboratory values mostly determined in biofluids such as blood and urine. One could consider this as precision medicine v1.0. However, recent advances in technology and better understanding of molecular mechanisms underlying disease will allow us to better characterize patients in the future. These improvements will enable us to distinguish patients who have similar clinical presentations but different cellular and molecular responses. Treatments will be able to be chosen more "precisely", resulting in more appropriate therapy, precision medicine v2.0. In this review, we will reflect on the potential added value of recent advances in technology and a better molecular understanding of necrosis and inflammation for improving diagnosis and treatment of critically ill patients. We give a brief overview on the mutual interplay between necrosis and inflammation, which are two crucial detrimental factors in organ and/or systemic dysfunction. One of the challenges for the future will thus be the cellular and molecular profiling of necroinflammation in biofluids. The huge amount of data generated by profiling biomolecules and single cells through, for example, different omic-approaches is needed for data mining methods to allow patient-clustering and identify novel biomarkers. The real-time monitoring of biomarkers will allow continuous (re)evaluation of treatment strategies using machine learning models. Ultimately, we may be able to offer precision therapies specifically designed to target the molecular set-up of an individual patient, as has begun to be done in cancer therapeutics.},
  author       = {Vanden Berghe, Tom and Hoste, Eric},
  issn         = {1350-9047},
  journal      = {CELL DEATH AND DIFFERENTIATION},
  keywords     = {ACUTE KIDNEY INJURY,CRITICALLY-ILL PATIENTS,GELATINASE-ASSOCIATED LIPOCALIN,NEUTROPHIL EXTRACELLULAR TRAPS,SEPTIC SHOCK,CELL-DEATH,CARDIAC-SURGERY,SEVERE SEPSIS,PROGNOSTIC BIOMARKER,ORGAN DYSFUNCTION},
  language     = {eng},
  number       = {1},
  pages        = {83--98},
  title        = {Paving the way for precision medicine v2.0 in intensive care by profiling necroinflammation in biofluids},
  url          = {http://dx.doi.org/10.1038/s41418-018-0196-2},
  volume       = {26},
  year         = {2019},
}

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