Biomarkers: New Tools of Modern Medicine

Over the last few decades there has been an explosion in the discovery of biomarkers for diagnosis, disease monitoring, and prognostic evaluation. In the April issue of Translational Research, entitled "Biomarkers: New Tools of Modern Medicine," an international group of medical experts explores the promise and challenges of biomarker discovery and highlights the latest advances in the use of biomarkers in various diseases.

In a commentary introducing this single-topic issue, Nikolaos G. Frangogiannis, MD, The Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, notes, "Although advanced technologies and hypothesis-driven approaches fueled by the '-omics' revolution continue to provide clinicians and researchers with an expanding list of candidate markers, very few are likely to survive the test as useful clinical tools."

Given the complexity of most common conditions, Dr. Frangogiannis says that multimarker approaches assessing the major aspects of the pathophysiology of the disease may be needed. "Development and implementation of such ambitious efforts will undoubtedly face many challenges, but may eventually fulfill the visionary goal of personalized medicine," he concludes.

Highlights:

Biomarkers: Hopes and Challenges in the Path from Discovery to Clinical Practice
Nikolaos G. Frangogiannis
This overview presents the major challenges in discovery, validation, and clinical implementation of new biomarkers, while discussing the transformative potential of biomarker-guided approaches in clinical practice.

Biomarkers in Acute Lung Injury
Maneesh Bhargava and Chris H. Wendt
The authors evaluate the role of biomarkers in acute respiratory distress syndrome (ARDS) and acute lung injury, including the likelihood that biomarker combinations may be more accurate in deriving clinically useful information in these complex disorders.

Peripheral Blood Biomarkers in Idiopathic Pulmonary Fibrosis
Rekha Vij and Imre Noth
This article reviews the evidence for peripheral blood biomarkers, which are easy to obtain, can be measured longitudinally, and have a high probability of achieving clinical utility for pulmonary fibrosis (IPF), a life-threatening lung disease.

Biomarkers in Chronic Obstructive Pulmonary Disease
Sharon R. Rosenberg and Ravi Kalhan
The authors review potential molecular, physiological, and imaging-based biomarkers that could be used to identify subtypes of chronic obstructive pulmonary disease, as well as information on disease activity and its clinical course.

Biomarkers of Heart Transplant Rejection: The Good, the Bad and the Ugly!
Carlos Alberto Labarrere and Beate R. Jaeger
This review discusses the search for accessible and effective biomarkers to detect patients at risk from serious complications after cardiac transplantation, such as acute cellular rejection, antibody-mediated rejection, and cardiac allograft vasculopathy.

Biomarkers in Acute Myocardial Injury
Devin W Kehl, Navaid Iqbal, Arrash Fard et al.
The authors summarize the current status of biomarkers available for rapid diagnosis of acute coronary syndromes, and discuss emerging evidence on promising new biomarkers which have shown the ability to improve prognosis and diagnosis compared to traditional markers.

Developing and Assessing Cardiovascular Biomarkers
Razvan Tudor Dadu, Vijay Nambi and Christie M. Ballantyne
The authors discuss strategies for the identification and development of new biomarkers to direct cardiovascular therapy and monitor therapeutic response. They focus on three biomarkers currently approved for use, as well as two new biomarkers that show promise in cardiovascular disease risk prediction and management.

Marking Renal Injury: Can We Move Beyond Serum Creatinine?
Jessica L. Slocum, Michael Heung, and Subramaniam Pennathur
The intense efforts to develop new markers for early diagnosis, prognostic evaluation, and treatment guidance in acute kidney injury are discussed, along with the barriers that must be overcome for wide-spread clinical implementation.

Genomic Biomarkers for Chronic Kidney Disease
Wenjun Ju, Shahaan Smith, and Matthias Kretzler
The great potential of genomic biomarkers in evaluation and treatment of patients with chronic renal disease is discussed, along with the challenges in predicting chronic kidney disease progression and the opportunities resulting from a molecular definition of the disease.

Biomarkers in Diabetes: Hemoglobin A1c, Vascular and Tissue Markers
Timothy Lyons and Arpita Basu
The authors focus on the established role of hemoglobin A1c (HbA1c) as an indicator of the presence and severity of hypoglycemia, and the development of new blood and tissue-based biomarkers that may enable the detection, prevention, and treatment of diabetes long before overt disease develops.

Biomarkers in Inflammatory Bowel Disease: Current Practices and Recent Advances
Heba N. Iskandar and Matthew A Ciorba
This article reviews the uses and limitations of currently available biomarkers and highlights recent advances in inflammatory bowel disease (IBD) biomarker discovery, including the potential of inflammatory markers to differentiate between IBD and non-inflammatory etiologies of diarrhea.

Biomarkers for Systemic Lupus Erythematosus
Joseph Ahearn, Chau-Ching Liu, Amy H. Kao, and Susan Manzi
The lack of reliable, specific biomarkers for systemic lupus erythematosus (SLE) hampers proper clinical management of patients and impedes development of new lupus therapeutics. The authors review recent progress in the development of biomarkers for diagnosis, disease activity, and specific organ involvement.

New Paradigms in Translational Science Research in Cancer Biomarkers
Paul Wagner and Sudhir Srivastava
Despite large investments, the introduction of cancer biomarkers for clinical practice remains slow. The authors address the inherent difficulties in the development of screening biomarkers and provide a systematic approach for discovery, verification, and validation of biomarkers that may be useful for cancer as well as many other conditions.

These articles appear in Translational Research, The Journal of Laboratory and Clinical Medicine, Volume 159, Issue 4 (April 2012) entitled "Biomarkers: New Tools of Modern Medicine," published by Elsevier.

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