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Bupp CP, English BK, Rajasekaran S, Prokop JW. Introduction to Personalized Medicine in Pediatrics. Pediatr Ann 2022; 51:e381-e386. [PMID: 36215089 DOI: 10.3928/19382359-20220803-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Exciting new developments in biomedical and computational sciences provide an extraordinary and unparalleled opportunity to compile, connect, and analyze multiple types of "big data," driving the development of personalized medicine. These insights must begin in early life (ie, pregnancy, neonatal, and infancy) and focus on early prevention, diagnosis, and intervention-areas of medicine where pediatricians are poised to lead the way to a personalized medicine future. The rapid growth of genomics (including pharmacogenomics), transcriptomics, and related "omics" has revolutionized the diagnosis of rare monogenic disorders. It is now clarifying the pathogenesis of complex conditions ranging from autism spectrum disorder to asthma. Collaborations between clinicians and basic scientists integrating multiomics approaches in evaluating children with severe illness are transforming the fields of perinatal, neonatal, and pediatric critical care medicine. Improvements in rapid diagnostic and prognostic information suggest that pediatric personalized medicine is under way and has an exciting future. [Pediatr Ann. 2022;51(10):e381-e386.].
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Leimanis-Laurens M, Wolfrum E, Ferguson K, Grunwell JR, Sanfilippo D, Prokop JW, Lydic TA, Rajasekaran S. Hexosylceramides and Glycerophosphatidylcholine GPC(36:1) Increase in Multi-Organ Dysfunction Syndrome Patients with Pediatric Intensive Care Unit Admission over 8-Day Hospitalization. J Pers Med 2021; 11:339. [PMID: 33923179 PMCID: PMC8145972 DOI: 10.3390/jpm11050339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 12/21/2022] Open
Abstract
Glycero- and sphingo-lipids are important in plasma membrane structure, caloric storage and signaling. An un-targeted lipidomics approach for a cohort of critically ill pediatric intensive care unit (PICU) patients undergoing multi-organ dysfunction syndrome (MODS) was compared to sedation controls. After IRB approval, patients meeting the criteria for MODS were screened, consented (n = 24), and blood samples were collected from the PICU at HDVCH, Michigan; eight patients needed veno-arterial extracorporeal membrane oxygenation (VA ECMO). Sedation controls were presenting for routine sedation (n = 4). Plasma lipid profiles were determined by nano-electrospray (nESI) direct infusion high resolution/accurate mass spectrometry (MS) and tandem mass spectrometry (MS/MS). Biostatistics analysis was performed using R v 3.6.0. Sixty-one patient samples over three time points revealed a ceramide metabolite, hexosylceramide (Hex-Cer) was high across all time points (mean 1.63-3.19%; vs. controls 0.22%). Fourteen species statistically differentiated from sedation controls (p-value ≤ 0.05); sphingomyelin (SM) [SM(d18:1/23:0), SM(d18:1/22:0), SM(d18:1/23:1), SM(d18:1/21:0), SM(d18:1/24:0)]; and glycerophosphotidylcholine (GPC) [GPC(36:01), GPC(18:00), GPC(O:34:02), GPC(18:02), GPC(38:05), GPC(O:34:03), GPC(16:00), GPC(40:05), GPC(O:36:03)]. Hex-Cer has been shown to be involved in viral infection and may be at play during acute illness. GPC(36:01) was elevated in all MODS patients at all time points and is associated with inflammation and brain injury.
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Affiliation(s)
- Mara Leimanis-Laurens
- Pediatric Critical Care Unit, Helen DeVos Children’s Hospital, Grand Rapids, MI 49503, USA; (K.F.); (D.S.); (S.R.)
- Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, Life Sciences Bldg., 1355 Bogue Street, East Lansing, MI 48824, USA;
| | - Emily Wolfrum
- Bioinformatics & Biostatistics Core, Van Andel Institute, Grand Rapids, MI 49503, USA;
| | - Karen Ferguson
- Pediatric Critical Care Unit, Helen DeVos Children’s Hospital, Grand Rapids, MI 49503, USA; (K.F.); (D.S.); (S.R.)
| | - Jocelyn R. Grunwell
- Pediatric Critical Care Medicine, Emory University & Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA;
| | - Dominic Sanfilippo
- Pediatric Critical Care Unit, Helen DeVos Children’s Hospital, Grand Rapids, MI 49503, USA; (K.F.); (D.S.); (S.R.)
- Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, Life Sciences Bldg., 1355 Bogue Street, East Lansing, MI 48824, USA;
| | - Jeremy W. Prokop
- Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, Life Sciences Bldg., 1355 Bogue Street, East Lansing, MI 48824, USA;
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA
| | - Todd A. Lydic
- Collaborative Mass Spectrometry Core, Department of Physiology, Michigan State University, East Lansing, MI 48824, USA;
| | - Surender Rajasekaran
- Pediatric Critical Care Unit, Helen DeVos Children’s Hospital, Grand Rapids, MI 49503, USA; (K.F.); (D.S.); (S.R.)
- Department of Pediatric and Human Development, College of Human Medicine, Michigan State University, Life Sciences Bldg., 1355 Bogue Street, East Lansing, MI 48824, USA;
- Office of Research, Spectrum Health, Grand Rapids, MI 49503, USA
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