Personalized medicine: applying 'omics' to lung fibrosis

Abstract

Idiopathic pulmonary fibrosis (IPF), the most common fibrotic lung disease, is a chronic disease of unknown etiology with a very high mortality. Personalized medicine focuses on the use of the individual's molecular and 'omic' (i.e., genomic, epigenomic and proteomic) information to direct more efficient and cost-effective strategies for prevention, diagnosis, outcome prediction and treatment of diseases. In this review, we describe the use and promise of applying 'omic' technologies to the familial and sporadic forms of IPF as a means to personalize diagnosis and outcome prediction in IPF. The validation and implementation of such approaches will be crucial to personalize IPF patient care, prioritize lung transplant and stratify patients for drug studies, as well as, in the future, predict response to therapies as they emerge.

Figure 1. Whole human gene-expression representation (29,807 gene probes) of four idiopathic pulmonary fibrosis patients, at four different time points

Red denotes gene upregulation, blue denotes downregulation and green indicates no change in gene expression. (A) demonstrate the similarities and dynamic changes across subsequent office visits of two IPF patients with evidence of disease progression measured by a decline of more than 10% of the FVC% predicted between the first and last visit. A different pattern can be observed in two patients with stable disease in (B), suggesting that peripheral blood mononuclear cell gene expression can be used to monitor disease progression and, potentially, outcome prediction in IPF. FVC: Forced vital capacity; IPF: Idiopathic pulmonary fibrosis.