Translating Asthma: Dissecting the Role of Metabolomics, Genomics and Personalized Medicine

Review Article

Abstract

The management of asthma has largely stagnated over the last 25 years, but we are at the dawning of a new age wherein -omics technology can help us manage the disease objectively and rationally. Even in this new scientific age, getting the basics of asthma management right remains essential. The new technologies which can be applied to multiple biological samples include genomics (study of the genome), transcriptomics (gene transcription), lipidomics, proteomics and metabolomics (lipids, proteins and metabolites, respectively) and breathomics, using exhaled breath as a source of biomarkers, which is of particular interest in view of its non-invasive nature in pediatrics. Important applications will include the diagnosis of airways disease, including its components; the pathways driving airway pathology; monitoring the response to treatment; and measuring future risk (asthma attacks, poor lung growth trajectory). With the advent of a wide range of novel biologicals to treat asthma, −omics technology to personalize therapy will be especially important. The U-BIOPRED (Europe) and SARP (USA) groups have been most active in this field, especially using bronchoscopically obtained samples to perform cluster analyses to define new asthma endotypes. However, stability over time and consistency between investigators is imperfect. This is perhaps unsurprising; results of biomarker studies in asthma will be a composite of the underlying disease, the (variable) effects of adverse drivers such as allergen exposure and pollution, the effects of treatment, and the effects of adherence or otherwise to treatment. Ultimately, the aim should be an exhaled breath based tool with a rapid result that can be used as a routine in the clinic. However, at the moment, there are as yet no clinical applications in children of –omics technology.

Keywords

Biomarker Transcriptomics Bronchial biopsy Bronchial brushings Induced sputum Airway inflammation Asthma phenotype Endotype 

Abbreviations

Lipidomics

Large scale study of lipid composition of a biological system

Machine learning

Technique used to discern patterns objectively in a given dataset

Metabolomics

Analysis of the metabolome at a given time point

Microarray

Microscopic DNA spots containing a specific sequence, on a solid surface, which with hybridiisation to cDNA or cRNA targets allows the study of a large number of gene expression simultaneously

Molecular network

Representation of interactions between molecules, generating potential pathways

Proteomics

Study of the total protein components of an organism

RNA sequencing

Deep sequencing of cDNA with high resolution using modern, high-throughput, next generation techniques

Transcriptomics

The study of all synthesised RNA molecules, including non-coding RNAs

VOCs

Volatile organic compounds, usually measured in exhaled breath, of lung or systemic origin

Notes

Acknowledgements

The author thanks all the members of the Royal Brompton Severe Asthma Team.

Compliance with Ethical Standards

Conflict of Interest

None.

Source of Funding

AB is an NIHR Senior Investigator and additionally was supported by the NIHR Respiratory Disease Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College London.

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Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  1. 1.Department of Pediatrics, Imperial CollegeLondonUK
  2. 2.Department of Pediatric RespirologyNational Heart and Lung InstituteLondonUK
  3. 3.Department of Pediatric Respiratory Medicine, Royal Brompton Harefield NHS Foundation TrustLondonUK

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