CYTOMICS AND PATHOLOGY
Single-cell–oriented microscopy provides the differential
analysis of dysfunctional cells in pathologic samples
versus cells in normal adjacent tissue, localized within or
between specimens and patients (11,12). Microscopic
analysis further ensures the direct observation of diseaseaffected
cells, whereas flow cytometric analysis of immunologic
indicator cells in peripheral blood frequently
represent only cellular and molecular correlates for tissueor
organ-associated diseases.
Therefore, predictive medicine by cytomics can be considered
a ‘‘cell-as-a-chip’’ test system, to provide multiparametric
data of diseased versus healthy conditions, whereas
in tissues the structural context of cell-to-cell relations can
be additionally acknowledged. The tissue cytometric
approach adds novel, as yet hardly appreciated information
that will permit the fine tuning of clinical diagnosis
and help to precisely predict disease courses in many
common and socially important diseases such as cancer
and cardiac and infectious diseases.
TISSUE CYTOMETRY AS AN IMPORTANT GOAL
The essential goal is to achieve a reliable and standardized
process of quantitative and cell-based tissue cytometry
that has recently been called tissomics (Fig. 2), a term
that acknowledges the cytometric (i.e., cell-based and stoichiometric)
analysis and the fact that the analysis is performed
on tissues (13). By intent, the term has been
selected to contrast with the traditional approach of histology,
being reflected by the term histomics, because histology
is generally associated with standard histopathologic
work that represents nonfluorescence techniques and
manual analysis. The histopathologic approach may further be nonquantitative and complicate standardization
efforts (14).
The close interaction of various specialists including
molecular biologists, protein chemists, pathologists, clinicians,
instrument developers, and software engineers will
be required to develop tissomics as a standard routine procedure
for predictive medicine by tissue biopsy analysis.
WHERE ARE WE HEADING?
The 3D analysis of cytomes requires high-throughput
techniques that cover at least two orders of magnitude:
3D within the cell to address the molecular basis of cellular
functionality and the cell in its 3D tissue environment
to seize the organizational structure of cytomes. Addressing both ‘‘dimensions’’ simultaneously constitutes a technological
challenge and will require entirely new
approaches within the scope of a Human Cytome Project.
The task will open new ways to look at diseases. It has the
potential for individualized disease course prediction and,
hence, for the development of novel, individualized strategies
for curative therapy and new therapeutic concepts.
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