I-Los ama-biomarker adingekayo empilweni Sebephenduke elinye lamatshe ayisisekelo emithi yesimanje. Ngenxa yabo, singakwazi ukwazi ukuthi kwenzekani “ngaphakathi” esikhathini eside ngaphambi kokuba kuvele izimpawu ezicacile, ukwelashwa okucushwe kahle, futhi silindele izingozi ebeziyohlala zinganakwa iminyaka.
Eminyakeni yamuva, ngokunyuka kwe umuthi womuntu siqu kanye nokunembaUmqondo wama-biomarker uthathe igxathu elikhulu eliya phambili: asisakhulumi nge-cholesterol noma i-glucose kuphela, kodwa futhi ngama-telomere, i-DNA methylation, i-microbiota, kanye namaphrofayili e-genomic ayinkimbinkimbi. Lokhu kushintsha indlela esivimba ngayo, sihlonze, futhi siphathe yonke into kusukela ezifweni zenhliziyo kuya kumdlavuza, kanye nezifo ezingavamile nokuguga ngaphambi kwesikhathi.
Iyini ngempela i-biomarker futhi kungani ibaluleke kangaka?
Ngamagama alula, i-biomarker iyi- isici sebhayoloji esilinganisekayo (i-molecule, iseli, isithombe, isignali ye-physiological…) ebonisa inqubo emzimbeni: ingaba isimo esivamile, isifo, noma impendulo yokwelashwa. Akudingeki ukuthi kube yinto nje esegazini; kungaba iphrotheni, i-metabolite, ucezu lwe-DNA, isithombe se-MRI, noma ipharamitha ebonakalayo.
Emkhakheni wezokwelapha, umsebenzi uvame ukwenziwa ngokuyinhloko ngama-biomarker quantifiable biological Okukhona egazini, umchamo, indle, noma ezinye izicubu: amaprotheni (njenge-troponin, i-CRP, noma amahomoni), ama-metabolite (ushukela, i-lipids, i-uric acid), nama-nucleic acid (izakhi zofuzo, izinguquko, amasignesha e-genomic). Kodwa kukhona futhi ama-biomarker e-imaging, functional, mechanical, noma angokwengqondo nokuziphatha, nakuba lapha sizogxila kakhulu kwezemvelo.
I-biomarker enhle kufanele ibe okuqondile, okuzwelayo, okuphindaphindekayo, futhi okubalulekile ngokomtholampiloOkungukuthi, kufanele sikhombe ngokunembile isimo esithile, sihlukanise ngokucacile kwezinye, sinikeze imiphumela engaguquki kumalabhorethri ahlukene, futhi sinikeze ulwazi oluwusizo lokunquma ukuthi yini okufanele yenziwe ngesiguli (ukuxilongwa, ukwelashwa, ukulandelela, noma ukuvimbela).
Ngaphezu kwalokho, ukuba wusizo kwe-biomarker akucatshangwa: kufanele ukuze kuboniswe ngezifundo eziqinileOkokuqala ezingeni lokuhlaziya (ukuthi ukuhlolwa kukala kahle lokho elikushoyo ukuthi kulinganisa) bese kuba ezingeni lomtholampilo (ukuthi empeleni kuhlotshaniswa nemiphumela ebalulekile: ukuqala kwesifo, ukusabela kokwelapha, izinkinga, ukufa, njll.).
Izinhlobo zama-biomarker ngokuya ngomsebenzi wazo womtholampilo
Ukuze ugweme ukulahleka ehlathini lama-acronyms namagama angajwayelekile, kuyasiza ukuqonda ukuthi ama-biomarker avame ukuqoqwa ngokuya nge- Zisetshenziselwa ini ekusebenzeni?Umaka owodwa ungangena esigabeni esingaphezu kwesisodwa, kodwa ngezinjongo zomtholampilo kuyahlukaniswa imisebenzi eminingana ebalulekile.
Emuthini wokunemba, amaqembu amane amakhulu axoxwa ngawo: ukuthambekela noma ubungozi, ukuxilongwa, ukubikezela kanye nokubikezela kwempendulo yokwelapha noma ukuphephaEkusebenzeni kwansuku zonke, lezi ziphelezelwa amamaki okuqapha noma okulandelela kanye nama-biomarker wempendulo yemithi.
Ama-Biomarkers we ukuba nokwenzeka noma ukubikezelwa Zibonisa ukuthi kungenzeka ukuthi umuntu uzoba nesifo esikhathini esizayo. Izibonelo zakudala izinguquko ku-BRCA1 ne-BRCA2, okwandisa ingozi yomdlavuza webele nowe-ovary, noma ama-polymorphisms athile ahlobene ne-metabolic noma izifo ze-neurodegenerative.
Ama-Biomarkers we ukuxilongwa Basebenza ukuqinisekisa noma ukukhipha isifo esithile. Isibonelo esaziwa kakhulu i-troponin ku-acute myocardial infarction, noma i-PSA (i-prostate-specific antigen) ekusoleni umdlavuza wendlala yesinye, kanye nokuguqulwa okuthile noma amasignesha ofuzo kumathumba achaza uhlobo oluthile oluncane.
Ama-Biomarkers izibikezelo Banikeza ulwazi mayelana nokuvela okungenzeka kwalesi sifo (ulaka, ingozi yokuphinda, ukusinda). Amazinga e-PSA kumdlavuza wendlala yesinye, i-Ki-67 kumdlavuza webele, noma amaphrofayili athile e-tumor genomic ayizibonelo ezijwayelekile; izimpawu zokuvuvukala okungapheli noma ukulimala kwesitho nazo zingawela kuleli qembu.
Ama-Biomarkers ukubikezela Zisivumela ukuthi silindele ukuthi isiguli sizophendula (noma cha) ekwelashweni okuthile noma sizobhekana nemiphumela engemihle eyengeziwe. Icala le-paradigmatic yi-HER2 kumdlavuza webele, obikezela ukusebenza kahle kwemithi yokwelapha ehlosiwe njenge-trastuzumab; noma ukuguqulwa kwe-KRAS/NRAS kumdlavuza we-colorectal, okunquma ukusetshenziswa kwamasosha omzimba athile e-monoclonal.
Ekugcineni, ama-biomarker we impendulo noma ukuqapha ngokwemithi Bahlola indlela umzimba osabela ngayo ekwelashweni. Ukulinganisa ushukela wegazi ukuze kuqashwe ukusebenza kokwelashwa kwesifo sikashukela, i-procalcitonin ekuguqukeni kwe-sepsis, noma i-CA-125 phakathi nokwelashwa komdlavuza wesibeletho yizibonelo ezicacile.
Inqubo yokuthatha i-biomarker isuka elabhorethri uyiyise emtholampilo
Ngenxa yokuthi umcwaningi uthola i-biomarker engaba khona ocwaningweni lwe-omics akusho ukuthi izobe isilungele ukusetshenziswa ezibhedlela ngosuku olulandelayo. Inqubo yinde futhi ibandakanya... izigaba ezine ezinkulu: ukutholwa, ukuthuthukiswa, ukuqinisekiswa, kanye nokuboniswa kosizo lomtholampilo.
Esigabeni se ukutholakala Ama-molecule ekhandidethi akhonjwa kusetshenziswa i-genomics, i-transcriptomics, i-proteomics, noma amathuluzi e-metabolomics. Kuyadingeka ukuchaza kahle ukuthi yini okufanele ilinganiswe (ufuzo, amaprotheni, i-metabolite), kuluphi uhlobo lwesampula (igazi, izicubu, umchamo, indle, njll.), nokuthi imele yiphi inqubo yezinto eziphilayo (ukuxilongwa, ukubikezela, ukusabela, njll.). Kubalulekile ukuthi kube nokuvumelana kwesayensi ukuthi i-biomarker ikhombisa i-pathophysiological phenomenon ehloselwe ukuyithwebula.
Okulandelayo kuza i ukuthuthukiswaYilapho indlela yokuhlaziya yokulinganisa ngokuthembekile i-biomarker yakhelwe futhi yathuthukiswa: indlela ethile, ukulinganisa, izilawuli zekhwalithi, imikhawulo yokutholwa, ukuqina kwesampula, njll. Lesi sigaba ngezinye izikhathi asibhekwa njengenani eliphansi ngoba sisebenzisa isikhathi nezisetshenziswa, kodwa kubalulekile ukuze ukuhlola kusebenze ngaphansi kwezimo zomhlaba wangempela.
Bese kufika i ukuqinisekiswaenezingxenye ezimbili: ezokuhlaziya nezomtholampilo. Ukuqinisekiswa kokuhlaziya kuqinisekisa ukuthi ukuhlolwa kulinganisa ngokunembile, ngokunembile, nangokukhiqiza kabusha i-analyte yentshisekelo ngaphakathi kwebanga lokuhlushwa elicacisiwe, nokuthi imiphumela ihlala izinzile ngaphansi kwezimo ezihlukene nasemalabhorethri ahlukene.
Ukuqinisekiswa komtholampilo kugxile ekuboniseni ukuthi kukhona a ubudlelwane obuqinile phakathi kwe-biomarker nomphumela womtholampilo okubalulekile (ukuxilongwa kwezifo, ukuqhubeka, impendulo yokwelashwa, ukufa, njll.). Amapharamitha anjengokuzwela, ukucaciswa, amanani aqagelayo, ukuphindaphindeka phakathi kwesikhungo, namandla okubandlulula ayahlolwa kusetshenziswa amajika e-ROC nendawo engaphansi kwejika (AUC).
Okokugcina, kuyadingeka ukubonisa usizo lomtholampiloUkufaka le biomarker ekuphathweni kwesiguli kushintsha izinqumo futhi kuthuthukisa imiphumela uma kuqhathaniswa nokungayisebenzisi. Ngamanye amazwi, ayibikezeli kahle kuphela, kodwa futhi ivumela ukwelashwa okungcono, igwema izinkinga, inciphisa ubuthi, futhi yenze ukusetshenziswa kahle kwezinsiza.
Izinselelo zendlela yokuqinisekisa i-biomarker
Ukuqinisekisa i-biomarker akulula njengokusebenzisa ukuhlaziya kwezibalo ezimbalwa okusheshayo. Kunezinkinga zobuchwepheshe ezenza izinto zibe nzima kakhulu, futhi uma zinganakwa, kunengozi... khulisa imiphumela noma wethule ukuchema ezibe sezihumusha zibe amaphutha emitholampilo.
Enye yezinkinga ezivamile yi- ukuhlobana kwangaphakathi kwesihlokoImvamisa, izilinganiso eziningi ze-biomarker efanayo zitholwa esigulini (ngezikhathi ezihlukene, kumasampula ahlukene wesimila, njll.). Lokhu kubuka akuzimele, futhi ukukuhlaziya njengokungathi kwandisa ingozi yemibono engamanga. Ukuze ugweme lokhu, amamodeli ezibalo acabangela ukwakheka kokuhlobanisa asetshenziswa, njengamamodeli alayini axubile noma izilinganiso zokulinganisa ezijwayelekile.
Elinye ikhanda elibuhlungu yi ubuningiAmasu we-Omics avumela ukuhlolwa ngasikhathi sinye kwezimaka eziningi noma amakhulu, izindlela ezihlukene zokulinganisa ngakunye, kanye namaphoyinti amaningi asikiwe kuma-biomarker aqhubekayo. Uma kwenziwa izivivinyo eziningi ze-hypothesis ezingalungisiwe, amathuba okuthola izinhlangano ezingamanga akhula kakhulu.
Ukulawula le nkinga, kusetshenziswa izindlela zokulungisa izinga lephutha lohlobo lwe-I, njengokulungiswa kwe-Bonferroni (okungaguquki kakhulu, kunciphisa amandla) noma izindlela ezisuselwe izinga lokutholwa okungamanga (FDR), njengenqubo ka-Benjamini-Hochberg, esebenza nomqondo wenani elingu-q (ingxenye elindelekile yemibono engamanga phakathi kokutholwe okubalulekile).
Kukhona futhi ukuphindaphindeka uma zihlaziywa imiphumela eminingi yomtholampilo esifundweni esifanayo (ukusinda sekukonke, ukusinda okungenanqubekela-phambili, impendulo ye-radiological, isifo esizinzile, njll.) ngaphandle kokusungula i-hierarchy ecacile noma ukulungisa ukuhlaziya. Lokhu kwenza kube nzima ukutolika futhi kwenza kube nzima kakhulu ukufinyelela ukuvumelana ngokusebenziseka kwangempela kwe-biomarker.
Ngokuhambisana nalokhu kuvela i ukukhethwa kokukhetha nokudidayoLezi zivame kakhulu ocwaningweni lokubheka emuva ngamasampula agciniwe. Umehluko ohlelekile phakathi kwamaqembu okuqhathanisa (isibonelo, iziguli ezinamaleveli ahlukene we-biomarker nazo ezihluka ngeminyaka, isigaba sesifo, noma ukwelashwa okutholiwe) kungahlanekezela izinhlangano. Ukuze kuncishiswe lokhu, kusetshenziswa amamodeli we-multivariate, afana nezici ezibalulekile, noma izikolo zokuthambekela ezisetshenziswayo, ezilingisa ngokwengxenye izimo zesilingo esingahleliwe.
Ngaphezu kwalokho, idizayini yocwaningo efanele incike ohlotsheni lwe-biomarker. izibikezelo Zingaqala ukuqinisekiswa ngokubuyela emuva, kodwa ngokuhamba kwesikhathi zidinga ukuqinisekiswa kwezindawo eziningi kanye nokuhlolwa okuzokwenzeka ukuze kuqinisekiswe ukusetshenziswa kwazo komtholampilo. ukubikezela Zidinga kakhulu: zidinga izivivinyo ezilawulwa ngokungahleliwe ezinomklamo wokusebenzelana, noma okungenani ukuhlaziya okwenziwe kahle kakhulu kwezifundo zangaphambilini, ukukhombisa ukuthi umphumela wokwelashwa uyashintsha ngokuya ngesimo se-biomarker.
Ama-biomarker abalulekile okuhlola isimo sezempilo nokuphila isikhathi eside
Ngaphandle komaka abakhethekile kakhulu, kunesethi yama-biomarker abalulekile Ukuthatha umoya womhlaba wonke wezempilo nokuguga womuntu. Ezinye zaziwa kakhulu futhi zicelwa kunoma yikuphi ukuhlaziya okuyisisekelo, kanti ezinye zithuthuke kakhulu kodwa ziya ngokuya zifinyeleleka.
Ibhulokhi yokuqala iqukethe amapharamitha. i-anthropometric kanye nokwakheka komzimba. Isisindo, nakuba singase sibonakale sisobala, singesinye sezibikezelo ezingcono kakhulu zezempilo nokuphila isikhathi eside, okuhlala kuhunyushwa maqondana nokuphakama kusetshenziswa inkomba yesisindo somzimba (BMI). Amanani angaphezu kuka-30 ahlotshaniswa nokulahlekelwa okukhulu kwesikhathi sokuphila, kuyilapho ukulondoloza uhla olunempilo kuxhunyaniswa nengozi ephansi yezifo ezingapheli.
El umjikelezo wesisu Inikeza ulwazi olwengeziwe mayelana namafutha e-visceral, ayingozi kakhulu kunamafutha angaphansi kwesikhumba. Amafutha amaningi angaphakathi kwesisu ashintsha ukusebenza kwe-hormonal (i-estrogen, i-cortisol, i-insulin), ikhuthaza ukuvuvukala kwesistimu, futhi ixhunywe nezinga lempilo elimpofu, ukukhubazeka, kanye nengozi eyengeziwe yesifo senhliziyo. Amasu anjengokuzila ukudla okuhleliwe okuhlelwe kahle noma ukukhawulelwa kwekhalori emaphakathi ahlotshaniswe namaphrofayela athuthukisiwe kulawa maki.
Emkhakheni we-metabolic, i- ushukela wegazi Ukumelana ne-insulin kanye ne-glycated hemoglobin (HbA1c) yizinkomba ezibalulekile zokuhlola ukulawulwa kwe-glycemic yesikhathi esifushane nesimaphakathi, ngokulandelana. Amazinga aphakeme akhombisa ukumelana ne-insulin kanye nengozi eyengeziwe yesifo sikashukela, ukuguga okusheshayo, ukulimala kwemithambo, nokufa. I-HbA1c, ikakhulukazi, ibonisa ukuziphatha kwe-glucose ezinyangeni ezingu-2-3 ezedlule futhi ingenye yezimpawu ze-biomarker eziwusizo kakhulu zokuqonda "isimo sezulu se-glycemic" yomzimba.
Iphrofayili ye-lipid nayo ayingabazeki lapho ukhuluma ngayo Ingozi yenhliziyo nokuphila isikhathi esideI-HDL (i-cholesterol “enhle”), i-LDL (i-cholesterol “embi”), i-triglycerides, i-lipoprotein(a), ne-homocysteine kusivumela ukuba silinganisele amathuba okuba nesifo se-arterial kanye nemicimbi efana nokuhlaselwa yinhliziyo noma unhlangothi. I-Lipoprotein(a), ethonywa kakhulu izakhi zofuzo, ikhombisa ingozi yemithambo yomndeni futhi okunzima ukuyishintsha; amazinga aphezulu e-homocysteine akhombisa ukucindezelwa okukhulu kwe-oxidative kanye nokulimala kwe-endothelial.
Omaka bezinga eliphansi lokuvuvukala, njenge I-C-reactive protein (CRP) I-ultrasensitive antibody kanye ne-fibrinogen isetshenziselwa ukukala umsebenzi wokuvuvukala ongaphansi ohambisana nokuguga ngaphambi kwesikhathi, i-atherosclerosis, kanye nokubikezela okumpofu kwezifo eziningi. Ngokufanelekile, kufanele zibe phansi ngangokunokwenzeka, nakuba zingakhuphuka okwesikhashana ngenxa yezifo, ukuhlukumezeka, noma ukucindezeleka okukhulu.
Ama-biomarker athuthukisiwe ahlobene nokuguga kanye ne-mitochondria
Emkhakheni we ukuguga kahle kanye nemithi yokuvimbelaAma-biomarker athuthuke kakhulu athole ukuvelela, okuvumela ukulinganiswa okunembe kakhudlwana kweminyaka yezinto eziphilayo kanye nobungozi bokuwohloka kwesikhathi esizayo.
La ubude be-telomere I-telomeres isidumile njengenkomba yokuguga kwamaselula. Ziwukulandelana kwe-DNA okuphindaphindayo ekugcineni kwama-chromosome okubavikela ekugugeni. Ngokuhlukaniswa kweseli ngalinye, bayafinyeza, futhi lapho befika embundwini obalulekile, ingqamuzana lingena ku-senescence noma liyafa. Ama-telomere amade ngokuvamile ahlotshaniswa nokuphila isikhathi eside kanye nezinga eliphansi lezifo ezingelapheki.
Ingxenye ebalulekile yobude be-telomere inqunywa yi- izakhi zofuzoKodwa-ke, izici ezinjengokucindezeleka okungapheli, ukungalali kahle, ukukhuluphala, i-hyperglycemia eqhubekayo, ukudla okungenamsoco, nendlela yokuphila yokungawuvivinyi nakho kunomthelela ekufinyezeni. Ngakolunye uhlangothi, ukuvivinya umzimba okusesilinganisweni nokuvamile, amasu okulawula ukucindezeleka (ukuzindla, i-yoga, ukuphefumula kwengqondo), kanye nezinhlanganisela ezithile zemvelo kungasiza ukulondoloza noma, kwezinye izimo, ngisho nokwandisa ubude be-telomere.
La I-DNA methylation Ngomunye umdlali obalulekile. Ukwengezwa noma ukususwa kwamaqembu e-methyl ezindaweni ezithile ze-genome kushintsha ukusho kofuzo ngaphandle kokushintsha ukulandelana, ukwakha lokho okwaziwa ngokuthi i-epigenome. Ngokukhula, iphethini ye-hypomethylation yomhlaba wonke kanye ne-hypermethylation yendawo ezindaweni ezithile iyabonwa, ehambisana nezifo ezingapheli. Lokhu kuvumele ukuthuthukiswa kwamawashi e-epigenetic alinganisela iminyaka yezinto eziphilayo.
I-epigenome ene-methylated ngokweqile kumasayithi athile ihlotshaniswa nayo ubude bempilo obufushaneIzinguquko zokudla, ukuvivinya umzimba, ukuchayeka ebuthini, ingcindezi, nekhwalithi yokulala kungashintsha la maphethini. Ngaphezu kwalokho, ezinye izithasiselo (ezifana ne-N-acetylcysteine kanye nezinye i-redox modulators) ziye zacutshungulwa njengamathuluzi angaba nomthelela ku-methylation, nakuba kusadingeka ucwaningo olwengeziwe.
Emkhakheni wamandla eselula, okulandelayo kuyagqama: NAD + I-NAD+ (nicotinamide adenine dinucleotide) kanye ne-glutathione. I-NAD+ iyi-cofactor ebalulekile ye-mitochondrial energy metabolism kanye nokulungiswa kwe-DNA. Ukugcina amazinga anele kubalulekile ukuze kubambezeleke ukuwohloka kwe-mitochondrial futhi, ngenxa yalokho, ukuguga okusebenzayo. Ucwaningo luyaqhubeka kuma-precursors e-NAD+ nezinye izishoshovu ze-metabolic.
El i-glutathione I-Glutathione iyi-antioxidant eyinhloko ye-intracellular. Abanye abantu, ngenxa yezakhi zofuzo, bayikhiqiza ngamanani aphansi futhi basengozini yokulimala kwe-oxidative kanye nokuvuvukala okungapheli. Ukuthola amazinga aphansi e-glutathione kungaqondisa amasu asekelayo (ukudla okunomsoco, izithasiselo ezithile, ukwelapha nge-intravenous) ukubuyisela ibhalansi ye-redox nokuvikela umsebenzi we-mitochondrial.
Izimpawu zegazi ezingukhiye: iphaneli ebanzi ukuze ubone isithombe sonke
Uma ufuna ukwenza ukuhlolwa okuphelele kwengozi yezempilo nempilo, akwanele ukubheka izibalo ezimbili noma ezintathu ezihlukene. Iphaneli ebanzi ye ama-biomarker egazi Uma ihunyushwa ngendlela efanele, inikeza isithombe esiphelele kakhulu.
Endaweni yokuvuvukala, ngaphezu kwe-CRP ne-fibrinogen, i- I-D-dimer Ivumela ukuhlolwa kwezinqubo ze-thrombotic ezisebenzayo noma zakamuva. Emkhakheni wenhliziyo nemithambo yegazi, i-glucose esheshayo, i-basal insulin, i-HbA1c, i-cholesterol ephelele, i-HDL, i-LDL, i-triglycerides, i-homocysteine, i-uric acid, nezinkomba ezihlukahlukene zesibindi (ALT, AST, GGT, alkaline phosphatase, bilirubin) zakha umnyombo.
Amapharamitha ahlobene ne-iron—i-serum iron, i-ferritin, ne-transferrin saturation—isiza ukubona kokubili ukuntula okufana nokugcwala kwensimbiZombili zinemithelela ebalulekile yokukhathala, amandla okusebenza, ingozi yenhliziyo nemithambo yegazi, nokulimala kwezitho. I-ferritin ephakeme, isibonelo, iye yahlotshaniswa kokubili ukuvuvukala okungapheli kanye nengozi eyengeziwe yesifo sikashukela nesifo senhliziyo.
El isibalo segazi esiphelele (CBC) Inikeza ulwazi ngamaseli abomvu egazi (ukubala, i-hemoglobin, i-hematocrit, i-MCV, i-MCH, i-MCHC), amangqamuzana egazi amhlophe, nama-platelet. Lezi zibalo zivumela ukutholwa kwe-anemia, izinqubo zokuvuvukala noma ezithathelwanayo, ukuphazamiseka kwe-hematological, nokuguqulwa kwekhono lokujiyisa. Kuyathakazelisa ukuthi olunye ucwaningo luye lwaqaphela ukuthi amanani e-leukocyte nama-platelet ekugcineni okuphansi kohlu lwereferensi, kodwa ngaphakathi kwemingcele evamile, ahlotshaniswa nokufa okuphansi okuphelele.
Emadodeni, i i-prostate-specific antigen (PSA) Kuhlala kuwuphawu lokuhlolwa nokuqapha umdlavuza wendlala yesinye, nakuba namuhla kuhambisana nama-biomarker aqondile afana ne-PCA3 noma i-SelectMDx (emchameni) ukuze kucwengwe ubungozi bezimila ezibalulekile emtholampilo futhi kugwenywe ama-biopsies angadingekile.
I-axis ye-hormonal nayo iqala ukusebenza: i-testosterone, i-estrogens, i-progesterone, i-FSH, i-LH, i-TSH, i-T3 yamahhala, i-T4 yamahhala, amasosha omzimba e-antithyroid (afana ne-anti-TPO), i-cortisol, i-DHEA, kanye ne-insulin-like growth factor 1 (IGF-1) isiza ukuqonda kangcono isimo se-endocrine kanye nempendulo yokucindezelekakanye nezimbangela ezingabangela amandla aphansi, ukushintsha kwesisindo, ukushintshashintsha kwemizwelo, izinkinga zokuzala, noma ukuphazamiseka kokuya esikhathini.
Ngaphandle kwegazi: i-metabolomics, ama-amino acid, nama-fatty acids
Nakuba ukuhlolwa kwegazi okuvamile kuyithuluzi elisetshenziswa kakhulu, kukhona ukuhlolwa okuthuthukisiwe okuvumela ukuhlaziywa okujulile kwe iphrofayili ye-metabolic kanye nokudla okunomsoco ngemininingwane eminingi.
Okuthiwa ukuhlolwa kwe ama-acids e-organic emchameni (OAT) Ihlaziya ama-metabolites avela ezindleleni ezihlukene ze-metabolic. Ngalezi zimpawu, kungenzeka ukuthi kubonakale isimo sokusebenza se-mitochondria, ukuba khona kwengcindezi ye-oxidative, i-dysbiosis yamathumbu, ukuguqulwa kwe-neurotransmitter synthesis, noma ukuntuleka kwamavithamini nama-cofactors.
Amaphrofayli ama-amino acid (amaningi awo afakwe kumabhethri e-asidi ephilayo) avumela ukuhlolwa kwama-amino acid abalulekile, angabalulekile, futhi adingeka ngokwemibandela. Lokhu kuwusizo ekuqondeni kangcono ukuvuselelwa kwezicubu, ukuphendula kwamasosha omzimba, ukukhishwa ubuthi emzimbeni, ukukhiqizwa kwama-enzyme, ukuhlanganiswa kwamahomoni, nokukhiqizwa kwamandla.
Ngokuhambisanayo, isifundo se ama-fatty acids egazini (igcwele, i-monounsaturated, ne-polyunsaturated, okuhlanganisa i-omega-3, -6, kanye -9) isetshenziselwa ukulinganisa ibhalansi yokuvuvukala, ingozi yenhliziyo nemithambo yegazi, ikhwalithi yokudla ngokwamafutha, kanye nokusebenza kahle kwezindlela ezithile ze-enzymatic (njenge-delta-6 desaturase). Izinkomba ezifana ne-"omega-3 index" ziye zaxhunyaniswa nokuvikelwa ezenzakalweni zenhliziyo.
Lezi zindlela ezihlanganisiwe-i-metabolomics, iphrofayili ye-amino acid, nokuhlaziywa kwe-fatty acid-ziyingxenye yombono obanzi. impilo esebenzayo neqondene nawe, efuna ukuthola ukungalingani ngaphambi kokuba ihumushe isifo esihleliwe.
I-Microbiota kanye ne-microbiome: ama-biomarker wamathumbu ashintsha yonke into
Ithumbu liyikhaya lezinhlobo zamabhaktheriya ezihlukene phakathi kuka-500 no-1.000, kanye namagciwane, isikhunta, nezinye izilwanyana ezincane. Leli qoqo lama-microorganisms libizwa ngokuthi i-gut microbiota. microbiotakanye nesamba sezakhi zabo zofuzo, i-microbiome. Namuhla siyazi ukuthi ukwakheka nokuhlukahluka kwawo kuthonya ngokuqondile ukugaya, ukumuncwa kwe-micronutrient, ukuhlanganiswa kwamavithamini, ukulawulwa kwamasosha omzimba, nokuvuvukala kwesistimu.
Ukuhlolwa kwe-microbiota okuthuthukisiwe, okusekelwe kumasu afana ne-multiplex PCR noma i-MALDI-TOF spectroscopy, kuvumela ukuhlonzwa okunembe kahle kwama-microorganisms akhona, ubuningi bawo obuhlobene, kanye nokuba khona kwamagciwane noma ukungalingani (dysbiosis). Amanye amaphaneli ahlanganisa a Dysbiosis Index okufingqa ngenombolo ukusuka ku-1 kuye ku-5 ukuthi iphrofayili yesiguli ichezuka kangakanani kuphethini ebhekwa njenge-normobiotic.
Lolu hlobo lokuhlaziya luwusizo ikakhulukazi ku izimpawu ezingapheli zokugaya ukudla (ukuqunjelwa, isifo sohudo, ukuqunjelwa, ubuhlungu besisu), izifo zamathumbu ezivuvukalayo, i-autoimmunity syndrome, ukungezwani komzimba nezinto ezithile, ukungabekezelelani kokudla, ukuntula ukudla okunomsoco okungaqondakali, nokuvuvukala kwebanga eliphansi.
Ngaphezu kwalokho, i-microbiota. Ishintsha ngokushesha kakhulu ekuphenduleni ukudla futhi kuyisici esifanelekile se ukuphepha kokudlaAmamodeli ezilwane abonise ukuthi ukushintsha okungazelelwe ekudleni kungashintsha kakhulu ukwakheka kwamagciwane phakathi namahora noma izinsuku ezimbalwa. Kubantu, nakuba izikhathi eziqondile zihluka, umqondo ojwayelekile uyafana: ukulungisa ukudla kuhambisane namaphethini anothe nge-fiber, ukudla okuvutshiwe, kanye nemisoco yekhwalithi kuvame ukuhlotshaniswa nentuthuko ekwahlukahlukaneni nokusebenza kwe-gut microbiota.
Ukuba nenhloso ye-microbiota biomarkers kusiza ukwakhiwa kwe izinhlelo zokwelashwa ezizimele (ukudla okunomsoco, ama-probiotics, ama-prebiotics, i-phytotherapy, izinguquko zokuphila) futhi ivumela ukuqapha ukuthi i-dysbiosis empeleni iyalungiswa yini ngokuhamba kwesikhathi.
Ama-biomarker we-Genetic kanye ne-epigenetic emthini wokunemba
Ukuhlolwa kwezakhi zofuzo kuvuleke umnyango wemithi yomuntu siqu kakhulu. Ngokuhlaziya i-DNA, kungenzeka ukuhlonza okuhlukile nokuguqulwa ezinquma ubungozi bezifo (ezifana ne-BRCA1/2 kumdlavuza webele kanye nesibeletho, noma izinguquko kuzakhi zofuzo zokulungisa i-DNA kwezinye izimila), impendulo emithini ethile (i-pharmacogenomics) noma ukuthambekela ezinkingeni ze-metabolic, zenhliziyo nemithambo yegazi noma zemizwa.
Ku-oncology, amaphaneli ayinkimbinkimbi we-genomic biomarker avumela ukuhlukaniswa okungcono kwesimila, ukukhethwa kwezindlela zokwelapha ezihlosiwe, izinqumo eziphathelene nokufaneleka kwe-chemotherapy evamile, i-immunotherapy, noma inhlanganisela yokwelapha, kanye nesilinganiso sokungenzeka ukuphindeka. I-KRAS, i-NRAS, i-EGFR, i-ALK, i-BRAF, i-TP53, ne-HER2 ezinye nje zezakhi zofuzo ezisuke zisuka ezindaweni zokucwaninga zaya ekusebenzeni komtholampilo kwansuku zonke.
Ngokuhambisanayo, i- ukuhlolwa kwe-epigenetic Ziyaqala ukusetshenziswa njengamafasitela akhethekile enkathini yezinto eziphilayo kanye nomthelela wangempela wendlela yokuphila ekubonisweni kofuzo. Ngokuhlaziya amaphethini e-DNA methylation kumakhulu noma izinkulungwane zamasayithi athile, amawashi e-epigenetic ahlukene (njengalawo ka-Horvath, Hannum, noma Weidner) alinganisela ukuthi mingaki iminyaka yobudala umuntu ngokwebhayoloji uma eqhathaniswa neminyaka yakhe yokulandelana kwezikhathi.
Lawa mathuluzi azibeka njengenani eliphezulu elihambisana nemithi yokuvimbela kanye nezinhlelo zokuphila isikhathi eside, njengoba evumela. qinisekisa ngokuyikho kungakhathaliseki ukuthi izinguquko zendlela yokuphila (ukudla, ukulala, ukuvivinya umzimba, ukulawula ukucindezeleka, izithasiselo) "ziyawuvuselela" umzimba ezingeni lamangqamuzana noma cha.
Ngaphezu kwalokho, kunokuhlolwa okuqondile okusekelwe kuma-glycans (ushukela ogqokisa amaprotheni afana ne-immunoglobulin G) okuhlola isimo esingapheli sokuvuvukala kwebanga eliphansi futhi kuye kwahlongozwa njengezimpawu ezibucayi zenqubo yokuguga, okuhlanganisa izingxenye zofuzo, i-epigenetic kanye nemvelo.
Ama-Biomarkers ku-oncology, i-cardiology, izinso, isibindi kanye ne-sepsis
Ku-oncology, ama-biomarker abe yinguquko yangempela. Kumathumba aqinile, izimpawu ezikhona egazini, izicubu, noma uketshezi (njengokuguqulwa okuthile, ukuvezwa ngokweqile kwamaprotheni, amasignesha e-transcriptomic, noma i-DNA yesimila esijikelezayo) kuyavumela. ukubona umdlavuza kusenesikhathi, ukuwuhlukanisa kangcono, ukulungisa ukwelashwa, nokuqapha impendulo.
Kulinganiselwa ukuthi iningi leziguli ezinomdlavuza zizodinga uhlobo oluthile lokuhlolwa kwe-biomarker ngesikhathi esithile phakathi nokwelashwa kwazo ukuze zifinyelele izindlela zokwelapha ezinembayo. Lokhu kudale isidingo samakhathalogi ama-biomarker asemthethweni ezingeni lesistimu yezempilo kazwelonke ukuze kuqinisekiswe ukulingana ekufinyeleleni kanye nokulinganisa ukunikezwa kokuxilonga ezintweni ezikhethekile (i-onco-hematology, izifo zenhliziyo zofuzo, izifo ze-metabolic zokuzalwa, izifo ze-neuromuscular, ukuphazamiseka kwe-neurodevelopmental, njll.).
Ku-cardiology, izimpawu ezifana ama-troponin Abalulekile ekuxilongeni i-acute myocardial infarction, kuyilapho i-natriuretic peptides (BNP, NT-proBNP) isiza ukuhlola nokuqapha ukwehluleka kwenhliziyo. I-High-sensitivity CRP inikeza ulwazi mayelana nengxenye yokuvuvukala yengozi yenhliziyo, futhi uma ihlanganiswa nephrofayili ye-lipid nezinye izici, ithuthukisa ukuhlukaniswa kwengozi.
Ku-nephrology, i-creatinine ne-cystatin C zingamatshe ekhona okulinganisa izinga lokuhlunga kwe-glomerular, kodwa ama-biomarker angaphambili afakiwe. ukulimala kwezinso okukhulu njenge-NGAL noma i-proadrenomedullin. Ku-hepatology, i-transaminase (ALT, AST), i-alkaline phosphatase, i-GGT ne-bilirubin ivumela ukutholwa kwe-cytolysis, i-cholestasis kanye noshintsho ekusebenzeni kokwenziwa kwesibindi.
Esimweni sezifo ezinzima kanye ne-sepsis, ama-biomarker afana procalcitoninAmanye ama-interleukins (IL-6, IL-8) kanye ne-proadrenomedullin aphinde asize ukuhlukanisa ukutheleleka kwamagciwane kwezinye izinqubo, ukuhlola ukuqina, ukuqondisa ukusetshenziswa kwama-antibiotic, nokulinganisa ukubikezela. Ukuhlanganisa le datha nokutholwe emitholampilo nokunye ukuhlola kwaselabhorethri kuyisihluthulelo sokwenza izinqumo ezisheshayo ezimeni ezibucayi.
Ama-Biomarker ezifweni ezingavamile nakwezinye izindawo ezisafufusa
Ezifweni ezingavamile, ukuba nama-biomarker athembekile kungenza umehluko phakathi ukuqapha okusebenzayo kanye nokuhlola okumsulwa namaphuthaEzifweni ze-lysosomal ezifana nesifo se-Gaucher, i-LysoGB1 isetshenziswa njengophawu lomsebenzi wesifo kanye nokusabela kokwelashwa. Esifo i-Niemann-Pick, i-7-ketocholesterol isetshenziselwa ukuqapha ukuqoqwa kwe-lipid kanye nempumelelo yokwelapha.
Lezi zibonelo zibonisa indlela ama-biomarker abaluleke ngayo ikakhulukazi lapho isifo singandile, isithombe somtholampilo siyinkimbinkimbi, futhi ukwelashwa kubiza kakhulu. Bavumela lungisa umthamo, ukuthola ukwehluleka kokwelapha kusenesikhathi nokugwema ukungenelela okungadingekile noma okungase kube yingozi.
La ukunwetshwa kwamakhathalogi asemthethweni Ukusetshenziswa kwama-biomarker ezinhlelweni zezempilo zomphakathi kuhlanganisa nezindawo ezifana nezifo zokuphefumula, izinso kanye ne-urogenital, ukugaya ukudla, i-dermatological, i-endocrine, izifo ze-hematological zofuzo, i-immunodeficiencies, i-autoimmunity, ukukhubazeka kwe-fetus kanye nokuphazamiseka kokuzala, phakathi kokunye.
Ukuze konke lokhu kusebenze, ukuba nobuchwepheshe akwanele: uhlaka olucacile lokulawula, izinqubo zokuvuselela ezisekelwe ebufakazini, futhi ukukhuthala ekulawuleni ubungozi bokuxilongauxhaso olwanele, ukuxhumana phakathi kwemiphakathi ezimele noma izifunda, kanye nokubeka izinto obala mayelana nokuthi yiziphi izikhungo ezingenza ukuthi yiziphi izivivinyo futhi ngaphansi kwaziphi izimo.
Kuhlanganiswe ndawonye, ama-biomarker adingekayo empilweni anikeza indlela ecwebezelayo nethuthuke kakhulu yokuqonda okwenzeka emzimbeni wethu, kusukela ekuvuvukeni okuthule noma ukumelana ne-insulin kuya ku-biology eseduze yesimila noma izinga langempela amangqamuzana ethu aguga ngalo; zilinganise ngezikhathi ezithileUkutolika ukuthambekela kwayo ngokuhamba kwesikhathi nokukuhlanganisa nomlando wezokwelapha, indlela yokuphila, kanye nezakhi zofuzo kusivumela ukuthi sisuke ekwelashweni okusebenzayo, sigxile ekucimeni imililo, siye emuthini wokuvimbela ngempela futhi oqondene nomuntu uqobo, lapho izinqumo zenziwa ngedatha esandleni nendawo eyanele yokuqondisa ukuguqula inkambo yesifo futhi andise, ngekhwalithi, iminyaka yokuphila.
