Personalizing Care for Critically Ill Adults Using Omics: A Concise Review of Potential Clinical Applications

Round 1

Reviewer 1 Report

The manuscript focused on the application of omics in the critical care setting, focused on AKI, ARDS and sepsis. Overall, the manuscript represents a complete and precise review of the several studies on the topic; however, it is a very long report with only description of data without any interpretation. It could be more interesting to perform a literature review discussing the main pathways involved and the clinical meaning of the single pathway analyzed instead of a pure list. In addition, epigenetic made a significant contribute to AKI and sepsis and this part should be reported.

Author Response

Comment

The manuscript focused on the application of omics in the critical care setting, focused on AKI, ARDS and sepsis. Overall, the manuscript represents a complete and precise review of the several studies on the topic; however, it is a very long report with only description of data without any interpretation. It could be more interesting to perform a literature review discussing the main pathways involved and the clinical meaning of the single pathway analyzed instead of a pure list. In addition, epigenetic made a significant contribute to AKI and sepsis and this part should be reported.

Reply

Thank you for your advice. Given that the pathways are extremely varied, to aid understanding, I have classified the pathways according to clinical mechanisms of disease for each condition (AKI, ARDS, sepsis).

In addition, the contribution of epigenetics to AKI, ARDS and sepsis have been included in the section “6. Future directions of omics for critically ill patients”.

Reviewer 2 Report

Kay Choong See reviewed the application of omics in personalizing care for critically ill adults. The review pointed out that the current guidelines for critically ill patients use broad recommendations, which may not a be precise guidelines considering the heterogeneity of human diseases. The author then provided a substantial number of studies using omic data to identify novel markers underlying diseases including acute kidney injury, acute respiratory distress syndrome and sepsis. Clinical applications of omics are suggested to be accessible and affordable for frontline clinicians, and novel markers are suggested to conventional clinical biomarkers. Such application would advance the development of precision medicine. Overall, the review is in time and well-written. 

I have a one major comment. Since it is not easy to apply omics to clinic, the author needs to summarize the challenges (such as expense, computation, data management, data processing and data mining) in clinical application, and provide possible solutions to such challenges.

 

Minor:

Gene names should be in italic.

 

Author Response

Comment 1

Kay Choong See reviewed the application of omics in personalizing care for critically ill adults. The review pointed out that the current guidelines for critically ill patients use broad recommendations, which may not a be precise guidelines considering the heterogeneity of human diseases. The author then provided a substantial number of studies using omic data to identify novel markers underlying diseases including acute kidney injury, acute respiratory distress syndrome and sepsis. Clinical applications of omics are suggested to be accessible and affordable for frontline clinicians, and novel markers are suggested to conventional clinical biomarkers. Such application would advance the development of precision medicine. Overall, the review is in time and well-written.

Reply 1

Thank you for your kind considerations and comments.

Comment 2

I have a one major comment. Since it is not easy to apply omics to clinic, the author needs to summarize the challenges (such as expense, computation, data management, data processing and data mining) in clinical application, and provide possible solutions to such challenges.

Reply 2

A new section “7. Challenges in clinical application of omics for critically ill patients” has been added to summarize the challenges and solutions.

Comment 3

Minor: Gene names should be in italic.

Reply 3

Thank you for the reminder. Gene names have been italicized.

Round 2

Reviewer 1 Report

The revised version of the manuscript included a more organized distribution of the several paragraphs as compared to the previous manuscript. The paper could be published according to journal's priority.