Satish P. RamachandraRao
The University of Trans-Disciplinary Health Sciences and Technology
Title: Exosomes and Precision Delivery of Personalized, Preventive Medicine
Biography
Biography: Satish P. RamachandraRao
Abstract
Multiple clinical and para-clinical research projects carried out at our Biomarkers Laboratory of the O’Brien Center for Acute Kidney Injury Research, UC San Diego School of Medicine demonstrate that the urinary exosome protein content of an individual is rather specific to the health or disease etiology of the subject. For the purpose of this personalized medicine conference, we have focused on one of these etiologies, namely Coronary Artery Bypass Grafting (CABG). Between 4 to 15 days after cardiac surgery insult, 4 out of 10 CABG surgeries result in Acute Kidney Injury (AKI). AKI is determined by elevation in serum creatinine (Scr). Scr elevation can only indicate kidney injury that has already occurred. Therefore, using only Scr elevation is of limited utility in either prediction or prevention of AKI episodes. Presently, AKI prevention in the clinic is thus an unmet clinical necessity.
Our data show that urinary exosome protein content can potentially discriminate between who among the cardiac surgery patients will develop AKI versus who will not, even before Scr elevation has taken place. We reason that this provides the clinician with an opportunity to help the patient prevent AKI phenotype precipitation. In this talk / meeting, the following will be highlighted: (a) how to utilize and develop this clinical opportunity into personalized preventive medicine strategy, (b) the constituent elements of this strategy, (c) the role of personalized omic integration analysis, (d) how to couple it with preventive therapy in principle guided by specific exosome biomarker analysis, and finally (e) the role of big data in precision delivery of personalized and preventive medicine. Further in addition, how exosome biomarker specificity can be expanded and utilized to achieve this precision delivery in other diseases or in healthy individuals in general, will be discussed.