Clinical OMICs - Issue 5 - (Page 22)

Clinical OMICs SNAPSHOT The Promise of Panomics: Decoding Biological Networks to Identify Pathways Involved in Complex Diseases Szilard Voros, M.D. T echnological advances such as high-throughput sequencing are transforming medicine from symptombased diagnosis and treatment to personalized medicine as scientists employ novel rapid genomic methodologies to gain a broader comprehension of disease and disease progression. As next-generation sequencing becomes more rapid, researchers are turning toward large-scale panomics, the collective use of all omics such as genomics, epigenomics, transcriptomics, proteomics, metabolomics, lipidomics and lipoprotein proteomics, to better understand, identify, and treat complex disease. Genomics has been a cornerstone in understanding disease, and the sequencing of the human genome has led to the identification of numerous disease biomarkers through genome-wide association studies (GWAS).1 It was the goal of these studies that these biomarkers would serve to predict individual disease risk, enable early detection of disease, help make treatment decisions, and identify new therapeutic targets. In reality, however, only a few have gone on to become established in clinical practice.1, 2 For example in human GWAS studies for heart failure at SZILARD VOROS, M.D., is co-founder and CEO of G3 (Global Genomics Group) (info@globalgenomicsgroup.com) 22 Clinical OMICs June 12, 2014 least 35 biomarkers have been identified but only natriuretic peptides have moved into clinical practice, where they are limited primarily for use as a diagnostic tool.2 The limited success of genomics alone to provide a broader understanding of disease has resulted in Pharma and Biotech realizing that more comprehensive disease analysis using systems biology is required to understand the multidimensional biological networks involved in complex disease. For example, atherosclerosis, the underlying cause of coronary artery disease, is a complex disease with both heritable and environmental factors that involves multiple cell types and interactions of many different molecular pathways. In human GWAS studies of coronary artery disease (CAD), out of the 3 billion base pairs and about 20,000 to 25,000 genes only 46 genomic loci have reached genome-wide significance.3 It has been recognized that the core of many of the problems with GWAS and underlying much of the missing heritability is the issue of phenotype resolution.4 Consequently, researchers have begun to utilize systems biology-based approaches that integrate many multiscale types of biological information including genomics, epigenomics, transcriptomics, proteomics, metabolomics, lipidomics, and lipoprotein proteomics. This data is then used to develop predictive and actionable models of the biology and pathobiology underlying complex diseases such as atherosclerosis, cancer, and neurodegenerative disease. Importantly, the chance for success with clinical candiwww.clinicalomics.com http://www.clinicalomics.com

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Clinical OMICs - Issue 5