LAUSR

Clinical proteomics has come a long way and is at a point where the expertise, technology, assays, and knowledge have matured sufficiently to begin enabling personalized and precision medicine. Although traditional laboratory medicine seems to be stuck in a bit of a rut, the field is now starting to take advantage of some of the approaches needed to monitor a person's dynamic state of health or disease. Unfortunately, these quantitative approaches have often been based on a “static” diagnostic model that focuses on a few basic protein changes describing what has happened, or genomic markers that might describe what possibly could happen in the future. Static markers are biomarkers that define a single disease entity or are used for a single clinical diagnosis are often limited; we can do better. Proteomics has the potential to determine the “dynamics” of an individual's health and this is the level of understanding we need to move toward. This requires an intimate knowledge and precise quantification of the important modified forms of proteins (proteoforms) within a proteome, and the recognition that proteoforms are dynamic and important to an individual's phenotype and crucial in determining the immediate present and potential future response to therapies. If we don't fully characterize and understand what we are measuring we could misdiagnose or lose an opportunity to have a biomarker(s) with a better selectivity toward a particular disease. This is also true for companion diagnostics. Unless the assays can capture the mechanism of the drug, which occurs most often at the proteome level, the assays could fail to guide good drug development and cause late stage failures of promising therapeutics, an increasingly acute problem for big pharmaceutical companies. We need to more fully map the proteins we are measuring and take advantage of their modified forms in our clinical …