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Genomics in Critical Illness

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Abstract

The term “genomics” has morphed into an umbrella term to describe broadly the large-scale study of genes, gene products, gene variants, and their impact on health and disease. This chapter reviews the impact of genomics on critical illness and injury. The chapter will also review other “omics” such as proteomics, pharmacogenomics, epigenetics, lipidomics, and metabolomics. Gene association studies attempt to link gene variants with susceptibility to and outcomes from various forms of critical illness. Genome wide expression studies have been leveraged to elucidate novel therapeutic pathways and targets, gene expression-based subclasses of critical illness, and the discovery of candidate diagnostic and stratification biomarkers. Other “omics” disciplines are also leading to novel insights regarding the pathobiology of critical illness. For example, the discovery of neutrophil gelatinase-associated lipocalin as an early biomarker of acute kidney injury is based on trancriptomic and proteomic studies involving animals models. Comparative genomics has led to the discovery of important signaling mechanisms relevant to critical illness. For example, the discovery of Toll-like receptor 4 as the primary receptor for lipopolysaccharide is the product of comparative genomics. Finally, epigenetics is beginning to provide clues as to why recovery from critical illness may be associated for prolonged risk for subsequent critical illness. Overall, genomics-centered studies continue to evolve in the field of critical care medicine and hold the promise of substantially advancing our understanding and approach to various forms of critical illness.

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Authors and Affiliations

  1. Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Hector R. Wong MD

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Correspondence to Hector R. Wong MD .

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  1. Div. of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

    Derek S. Wheeler

  2. Div. of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

    Hector R. Wong

  3. University of Michigan Medical School, Ann Arbor, Michigan, USA

    Thomas P. Shanley

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Wong, H.R. (2014). Genomics in Critical Illness. In: Wheeler, D., Wong, H., Shanley, T. (eds) Pediatric Critical Care Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-6362-6_20

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