Development of Biomarkers to Optimize Pediatric Patient Management: What Makes Children Different?

Abstract

Despite the frequent utilization of biomarkers in medical practice, there is a relative paucity of information regarding validated pediatric biomarkers. Frequently, biomarkers found to be efficacious in adults are extrapolated to the pediatric clinical setting without considering that the pathogenesis of many diseases is distinctly different in children, and ontogeny directly influences disease evolution and therapeutic response in children. New and innovative approaches are necessary to provide reliable, validated biomarkers that can be used to improve and advance pediatric medical care.

Reference Intervals for Urinary Renal Injury Biomarkers KIM-1 and NGAL in Healthy Children

“…Historically many pediatric reference intervals have been extrapolated from adult reference data. However, this is not appropriate when one considers the course of renal maturation and other developmental changes during childhood [10]. The aim of this study was to determine the urinary reference intervals for KIM-1 and NGAL in healthy children from both the UK and USA, and to assess the impact of factors including age, sex, ethnicity, time of day and analytical platform.…”

Challenges and New Frontiers in the Paediatric Drug Discovery and Development

“…Despite this, the discovery of paediatric biomarkers has been limited and to cover the resultant gap, extrapolation, in children, of biomarkers identified and employed successfully in adults has become a common practice. However, human development impacts almost all factors and systems from organ function to drug disposition including the commonly utilised biomarkers that are influenced by changes occurring from birth onwards [61]. Therefore, adult biomarkers are not always appropriate to a paediatric setting.…”

ABC Transporter Genes and Methotrexate Response in Rheumatoid Arthritis

“…Because it appears that laboratory measurements and reasons for discontinuation of MTX in the cohort were documented, the question of whether there were any associations between these SNP and MTX toxicity and toxicity-related discontinuation could be answered. It is important to note that this was a pediatric cohort, and such data, if available, will give important insights into whether MTX pharmacogenetic associations are comparable in pediatric and adult RA populations, a subject on which there is a paucity of data to date 3 . Unfortunately, the effect of race on such associations cannot be determined using this cohort, as it was racially homogeneous.…”