Abstract
The technical, statistical, and methodological challenges of handling human genomic information and translating it into reliable tools applicable in clinical decision-making must overcome one major hurdle preventing the widespread use of genomics in clinical medicine, and that is translating basic science discoveries into new and better patient-centered treatments. Over the past 30 years a cadre of clinicians and researchers alike has described the genomic and proteomic response to inflammation and severe injury in leukocyte populations from humans with cancer and trauma. Now is the time to take advantage of the large scientific database of information and use it to implement a diagnostic test for predicting outcome and appropriateness for therapy in the critically ill trauma patient, cancer patient, or acute care surgery patient. The future of improved outcomes is rooted in new genomic diagnostics that can accurately identify patients who may benefit from therapies aimed at disease prevention and not just therapeutic reaction. Rather than focus on disease treatment, we as physicians should focus on patient-centered disease identification before the symptomatology and sequelae are manifest and rampant. By applying genomics and other high-throughput technologies, clinicians and researchers will have a robust platform for using the human transcriptome as a reliable and convenient diagnostic tool to not only treat but also prevent disease in the clinical setting.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kristensen VN, Lingjaerde OC, Russnes HG, Vollan HK, Frigessi A, Borresen-Dale AL. Principles and methods of integrative genomic analyses in cancer. Nat Rev Cancer. 2014;14(5):299–313.
Greenberg ES, Chong KK, Huynh KT, Tanaka R, Hoon DS. Epigenetic biomarkers in skin cancer. Cancer Lett. 2014;342(2):170–7.
Roychowdhury S, Chinnaiyan AM. Advancing precision medicine for prostate cancer through genomics. J Clin Oncol. 2013;31(15):1866–73.
Lohr JG, Adalsteinsson VA, Cibulskis K, Choudhury AD, Rosenberg M, Cruz-Gordillo P, et al. Whole-exome sequencing of circulating tumor cells provides a window into metastatic prostate cancer. Nat Biotechnol. 2014;32:479–84.
Previati M, Manfrini M, Galasso M, Zerbinati C, Palatini J, Gasparini P, et al. Next generation analysis of breast cancer genomes for precision medicine. Cancer Lett. 2013;339(1):1–7.
McCauley JL, Abreu MT. Genetics in diagnosing and managing inflammatory bowel disease. Gastroenterol Clin North Am. 2012;41(2):513–22.
Jostins L, Ripke S, Weersma RK, Duerr RH, McGovern DP, Hui KY, et al. Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease. Nature. 2012;491(7422):119–24.
Xiao W, Mindrinos MN, Seok J, Cuschieri J, Cuenca AG, Gao H, et al. A genomic storm in critically injured humans. J Exp Med. 2011;208(13):2581–90.
Cuenca AG, Gentile LF, Lopez MC, Ungaro R, Liu H, Xiao W, et al. Development of a genomic metric that can be rapidly used to predict clinical outcome in severely injured trauma patients. Crit Care Med. 2013;41(5):1175–85.
Thompson CM, Park CH, Maier RV, O'Keefe GE. Traumatic injury, early gene expression, and gram-negative bacteremia. Crit Care Med. 2014;42(6):1397–405.
Cobb JP, Moore EE, Hayden DL, Minei JP, Cuschieri J, Yang J, et al. Validation of the riboleukogram to detect ventilator-associated pneumonia after severe injury. Ann Surg. 2009;250(4):531–9.
Xu W, Seok J, Mindrinos MN, Schweitzer AC, Jiang H, Wilhelmy J, et al. Human transcriptome array for high-throughput clinical studies. Proc Natl Acad Sci U S A. 2011;108(9):3707–12.
Kotz KT, Xiao W, Miller-Graziano C, Qian WJ, Russom A, Warner EA, et al. Clinical microfluidics for neutrophil genomics and proteomics. Nat Med. 2010;16(9):1042–7.
Warner EA, Kotz KT, Ungaro RF, Abouhamze AS, Lopez MC, Cuenca AG, et al. Microfluidics-based capture of human neutrophils for expression analysis in blood and bronchoalveolar lavage. Lab Invest. 2011;91(12):1787–95.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Delano, M.J., Maier, R.V. (2015). Genomics in Surgery, Trauma, and Critical Care: How Do We Control the Future?. In: Latifi, R., Rhee, P., Gruessner, R. (eds) Technological Advances in Surgery, Trauma and Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2671-8_3
Download citation
DOI: https://doi.org/10.1007/978-1-4939-2671-8_3
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-2670-1
Online ISBN: 978-1-4939-2671-8
eBook Packages: MedicineMedicine (R0)