Omics Science and Social Aspects in Detecting Biomarkers for Diagnosis, Risk Prediction, and Outcomes of Carotid Stenosis

Abstract

Carotid stenosis is characterized by the progressive narrowing of the carotid arteries due to the formation of atherosclerotic plaque, which can lead to stroke and death as major complications. Numerous biomarkers allow for its study and characterization, particularly those related to "omics" sciences. Through the most common research databases, we report representative studies about carotid stenosis biomarkers based on genomics, transcriptomics, proteomics, and metabolomics in a narrative review. To establish a priority among studies based on their internal validity, we used a quality assessment tool, the Scale for the Assessment of Narrative Review Articles (SANRA). Genes, transcriptomes, proteins, and metabolites can diagnose the disease, define plaque connotations, predict consequences after revascularization interventions, and associate carotid stenosis with other patient comorbidities. It also emerged that many aspects determining the patient's psychological and social sphere are implicated in carotid disease. In conclusion, when taking the multidisciplinary approach that combines human sciences with biological sciences, it is possible to comprehensively define a patient's health and thus improve their clinical management through precision medicine.

Keywords: biomarkers and social determinants of health; carotid artery stenosis; genomics; omics; prevention; progression; proteomics; transcriptomics.

Figure 1

Schematic representation of the research areas from which biomarkers of carotid stenosis can be obtained. Biomarkers can come from ‘‘omics‘‘ science, genomics, transcriptomics (RNA level), proteomics, and metabolomics. In addition, markers from epigenetics may also be valuable, considering the environmental context of the patient affected by carotid stenosis and disease-related risk factors (diet, low physical activity, smoking, and other comorbidities such as heart disease). Social determinants of health can be counted as new biomarkers, including all aspects related to the psychosocial well-being of the individual that have consequences for the onset of carotid stenosis: interactions with others, psychological stress, socio-cultural context, education, and financial income.