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A genetic tool with the potential to identify trauma and burn patients that are
most likely to become seriously ill has been tested in a wide range of experimen-
tal clinical settings using blood and tissue samples (Cobb et al. 2005 ). The
authors correlated molecular markers with white blood cell behavior, and ulti-
mately, with patient outcome. They were able to consistently analyze which
genes are active in patients with serious infections or traumatic injuries. The
major source of variance in apparent gene expression in the blood compartment
was found to be due to interindividual variance and not analytical noise. The
results reveal a notably high degree of reproducibility both with the analytical
processes and in the same subject. The magnitude of the interindividual variance
and the changes in gene expression produced by traumatic injury were somewhat
greater than the variance associated with the sample processing and analysis in
the same subject.
However, prior to adopting this approach in clinical practice, it will be necessary
to continue the experimental procedures in larger multicenter trials, following hun-
dreds of patients over time to describe the molecular profi le of healing in response
to burns and traumatic injury.
Personalized Medical Care of Astronauts During Space Flights
These differences among astronauts, as revealed by “Omics” technologies, can
be amplifi ed in extreme conditions, such as space fl ight. A better understanding
of individual differences may enable development of personalized countermea-
sure packages that optimize the safety and performance of each astronaut.
“Omics” will enhance our ability to: (1) more thoroughly describe the biological
response of humans in space; (2) describe molecular attributes of individual
astronauts that alter the risk profi le prior to entering the space environment; (3)
deploy Omics techniques in the development of personalized countermeasures;
and (4) develop a comprehensive Omics-based assessment and countermeasure
platform that will guide human space fl ight in the future (Schmidt and Goodwin
2013 ). Selected examples where biochemical individuality might signifi cantly
impact countermeasure development include gene and small molecule variants
associated with: (1) metabolism of therapeutic drugs used in space; (2) one car-
bon metabolism and DNA stability; (3) iron metabolism, oxidative stress and
damage, and DNA stability; and (4) essential input (Mg and Zn) effects on DNA
repair. Omics profi ling should serve as the basis for research in aerospace per-
sonalized medicine and explore methodological considerations to advance the
fi eld. Personalized medicine may become the standard of care for humans in
space in the future.
18 Personalized Approaches to Miscellaneous Problems in Healthcare