Personalizing treatments for patients based on cardiovascular phenotyping.

IF 1 Q4 PHARMACOLOGY & PHARMACY
Jane A Leopold
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Abstract

Introduction: Cardiovascular disease persists as the leading cause of death worldwide despite continued advances in diagnostics and therapeutics. Our current approach to patients with cardiovascular disease is rooted in reductionism, which presupposes that all patients share a similar phenotype and will respond the same to therapy; however, this is unlikely as cardiovascular diseases exhibit complex heterogeneous phenotypes.

Areas covered: With the advent of high-throughput platforms for omics testing, phenotyping cardiovascular diseases has advanced to incorporate large-scale molecular data with classical history, physical examination, and laboratory results. Findings from genomics, proteomics, and metabolomics profiling have been used to define more precise cardiovascular phenotypes and predict adverse outcomes in population-based and disease-specific patient cohorts. These molecular data have also been utilized to inform drug efficacy based on a patient's unique phenotype.

Expert opinion: Multiscale phenotyping of cardiovascular disease has revealed diversity among patients that can be used to personalize pharmacotherapies and predict outcomes. Nonetheless, precision phenotyping for cardiovascular disease remains a nascent field that has not yet translated into widespread clinical practice despite its many potential advantages for patient care. Future endeavors that demonstrate improved pharmacotherapeutic responses and associated reduction in adverse events will facilitate mainstream adoption of precision cardiovascular phenotyping.

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基于心血管表型的患者个性化治疗。
导言:尽管在诊断和治疗方面不断取得进展,但心血管疾病仍然是世界范围内死亡的主要原因。我们目前对心血管疾病患者的治疗方法根植于还原论,其前提是所有患者具有相似的表型,并且对治疗的反应相同;然而,这是不可能的,因为心血管疾病表现出复杂的异质性表型。涉及领域:随着高通量组学检测平台的出现,心血管疾病的表型分型已经发展到将大规模分子数据与经典病史、体检和实验室结果相结合。基因组学、蛋白质组学和代谢组学分析的发现已被用于定义更精确的心血管表型,并预测基于人群和疾病特异性患者队列的不良后果。这些分子数据也被用来告知基于患者独特表型的药物疗效。专家意见:心血管疾病的多尺度表型分析揭示了患者之间的多样性,可用于个性化药物治疗和预测预后。尽管如此,心血管疾病的精确表型仍然是一个新兴领域,尽管它对患者护理有许多潜在的优势,但尚未转化为广泛的临床实践。未来的努力表明改善的药物治疗反应和相关的不良事件减少将促进精确心血管表型的主流采用。
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来源期刊
CiteScore
2.30
自引率
0.00%
发文量
9
期刊介绍: Expert Review of Precision Medicine and Drug Development publishes primarily review articles covering the development and clinical application of medicine to be used in a personalized therapy setting; in addition, the journal also publishes original research and commentary-style articles. In an era where medicine is recognizing that a one-size-fits-all approach is not always appropriate, it has become necessary to identify patients responsive to treatments and treat patient populations using a tailored approach. Areas covered include: Development and application of drugs targeted to specific genotypes and populations, as well as advanced diagnostic technologies and significant biomarkers that aid in this. Clinical trials and case studies within personalized therapy and drug development. Screening, prediction and prevention of disease, prediction of adverse events, treatment monitoring, effects of metabolomics and microbiomics on treatment. Secondary population research, genome-wide association studies, disease–gene association studies, personal genome technologies. Ethical and cost–benefit issues, the impact to healthcare and business infrastructure, and regulatory issues.
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