Immune biomarkers in the spectrum of childhood noncommunicable diseases

Abstract

A biomarker is an accurately and reproducibly quantifiable biological characteristic that provides an objective measure of health status or disease. Benefits of biomarkers include identification of therapeutic targets, monitoring of clinical interventions, and development of personalized (or precision) medicine. Challenges to the use of biomarkers include optimizing sample collection, processing and storage, validation, and often the need for sophisticated laboratory and bioinformatics approaches. Biomarkers offer better understanding of disease processes and should benefit the early detection, treatment and management of multiple non-communicable diseases (NCDs). This review will consider the utility of biomarkers in allergic and other immune mediated diseases in childhood. Typically, biomarkers are used currently to provide mechanistic insight or an objective measure of disease severity with their future role in risk stratification/disease prediction speculative at best. There are many lessons to be learned from the biomarker strategies used for cancer where biomarkers are in routine clinical use and industry wide standardized approaches have been developed. Biomarker discovery and validation in childhood disease lags behind that for adults; given the early onset and therefore potential lifelong impact of many NCDs there should be more studies incorporating cohorts of children. Many pediatric biomarkers are at the discovery stage with a long path to evaluation and clinical implementation. The ultimate challenge will be optimisation of prevention strategies that can be implemented in children identified as being at risk of an NCD through the use of biomarkers.3

Fecal Calprotectin Levels Correlate With Main Domains of the Autism Diagnostic Interview-Revised (ADI-R) in a Sample of Individuals With Autism Spectrum Disorders From Slovakia

“…It is hypothesized, though, that different cut-off values of FC might be more adequate for patients with other conditions (Alibrahim et al 2015, Montalto et al 2013. This may apply also to ASD, since in association with this condition a chronic low grade inflammation has been reported (Skevaki et al 2016).…”

Subclinical lower airways correlates of chronic allergic and non‐allergic rhinitis

“…Biological markers are measurable indicators used to examine any aspects of health or disease. Any type of analyses can be considered a biomarker when it provides information about the pathophysiology of an underlying disease, the course and severity of an illness, and/or the response to treatment . Biomarkers obtained mainly from minimally invasive sampling such as exhaled breath condensate (EBC), nasal epithelial cells and secretions and peripheral blood measurements are used to predict or to monitor treatment response and very few used to estimate the disease risk and anticipate disease progression …”

Immune monitoring for precision medicine in allergy and asthma

“…Even if there are reproducible biological differences between subcategories of a disease, unless there are meaningful therapeutic options for each subcategory, or other advantages such as improved prognostication of the disease course, the clinical relevance of the classification will be questionable[4,37,38]. Validation of new classification schemes via testing of different therapies, such as monoclonal antibody drugs, will have major clinical and financial consequences for patients, and for companies developing novel therapies and “companion diagnostics” intended to evaluate whether a therapy would be effective in an individual patient.…”