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The paradigm change from reactive medical services to 3PM in ischemic stroke: a holistic approach utilising tear fluid multi-omics, mitochondria as a vital biosensor and AI-based multi-professional data interpretation
O. Golubnitschaja, J. Polivka, P. Potuznik, M. Pesta, I. Stetkarova, A. Mazurakova, L. Lackova, P. Kubatka, M. Kropp, G. Thumann, C. Erb, H. Fröhlich, W. Wang, B. Baban, M. Kapalla, N. Shapira, K. Richter, A. Karabatsiakis, I. Smokovski, LC....
Status neindexováno Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články
NLK
BioMedCentral Open Access
od 2012
PubMed Central
od 2010 do Před 1 rokem
Open Access Digital Library
od 2010-01-01
Open Access Digital Library
od 2011-01-01
- Publikační typ
- časopisecké články MeSH
Worldwide stroke is the second leading cause of death and the third leading cause of death and disability combined. The estimated global economic burden by stroke is over US$891 billion per year. Within three decades (1990-2019), the incidence increased by 70%, deaths by 43%, prevalence by 102%, and DALYs by 143%. Of over 100 million people affected by stroke, about 76% are ischemic stroke (IS) patients recorded worldwide. Contextually, ischemic stroke moves into particular focus of multi-professional groups including researchers, healthcare industry, economists, and policy-makers. Risk factors of ischemic stroke demonstrate sufficient space for cost-effective prevention interventions in primary (suboptimal health) and secondary (clinically manifested collateral disorders contributing to stroke risks) care. These risks are interrelated. For example, sedentary lifestyle and toxic environment both cause mitochondrial stress, systemic low-grade inflammation and accelerated ageing; inflammageing is a low-grade inflammation associated with accelerated ageing and poor stroke outcomes. Stress overload, decreased mitochondrial bioenergetics and hypomagnesaemia are associated with systemic vasospasm and ischemic lesions in heart and brain of all age groups including teenagers. Imbalanced dietary patterns poor in folate but rich in red and processed meat, refined grains, and sugary beverages are associated with hyperhomocysteinaemia, systemic inflammation, small vessel disease, and increased IS risks. Ongoing 3PM research towards vulnerable groups in the population promoted by the European Association for Predictive, Preventive and Personalised Medicine (EPMA) demonstrates promising results for the holistic patient-friendly non-invasive approach utilising tear fluid-based health risk assessment, mitochondria as a vital biosensor and AI-based multi-professional data interpretation as reported here by the EPMA expert group. Collected data demonstrate that IS-relevant risks and corresponding molecular pathways are interrelated. For examples, there is an evident overlap between molecular patterns involved in IS and diabetic retinopathy as an early indicator of IS risk in diabetic patients. Just to exemplify some of them such as the 5-aminolevulinic acid/pathway, which are also characteristic for an altered mitophagy patterns, insomnia, stress regulation and modulation of microbiota-gut-brain crosstalk. Further, ceramides are considered mediators of oxidative stress and inflammation in cardiometabolic disease, negatively affecting mitochondrial respiratory chain function and fission/fusion activity, altered sleep-wake behaviour, vascular stiffness and remodelling. Xanthine/pathway regulation is involved in mitochondrial homeostasis and stress-driven anxiety-like behaviour as well as molecular mechanisms of arterial stiffness. In order to assess individual health risks, an application of machine learning (AI tool) is essential for an accurate data interpretation performed by the multiparametric analysis. Aspects presented in the paper include the needs of young populations and elderly, personalised risk assessment in primary and secondary care, cost-efficacy, application of innovative technologies and screening programmes, advanced education measures for professionals and general population-all are essential pillars for the paradigm change from reactive medical services to 3PM in the overall IS management promoted by the EPMA.
Artificial Intelligence and Data Science Group Fraunhofer SCAI Sankt Augustin Germany
Beijing Municipal Key Laboratory of Clinical Epidemiology Capital Medical University Beijing China
Biomedical Centre Faculty of Medicine in Plzen Charles University Prague Czech Republic
Bonn Aachen International Center for IT University of Bonn 53115 Bonn Germany
Charité University Medicine Berlin Berlin Germany
CuraMed Tagesklinik Nürnberg GmbH Nuremberg Germany
Department of Biology Faculty of Medicine in Plzen Charles University Prague Czech Republic
Department of Nutrition School of Health Sciences Ashkelon Academic College Ashkelon Israel
Department of Psychology Clinical Psychology 2 University of Innsbruck Innsbruck Austria
Edith Cowan University Perth Australia
Experimental Ophthalmology University of Geneva 1205 Geneva Switzerland
Negentropic Systems Ružomberok Slovakia
Ophthalmology Department University Hospitals of Geneva 1205 Geneva Switzerland
PPPM Centre s r o Ruzomberok Slovakia
Private Institute of Applied Ophthalmology Berlin Germany
Technische Hochschule Nürnberg GSO Nuremberg Germany
University Clinic for Psychiatry and Psychotherapy Paracelsus Medical University Nuremberg Germany
Citace poskytuje Crossref.org
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