WSC 2025 | Where is the field of stroke genomics moving?
Cristina Gallego-Fabrega, PhD, Sant Pau Research Institute, Barcelona, Spain, discusses the evolution of stroke genomics, highlighting the importance of incorporating other omics such as proteomics, transcriptomics, and epigenomics to gain a comprehensive understanding of the disease. Dr Gallego-Fabrega also discusses the value of studying longitudinal cohorts to capture dynamic changes over time. This interview took place at the 17th World Stroke Congress (WSC) in Barcelona, Spain.
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Transcript
So stroke genomics traditionally has focused only on studying genetics or genomics, so genetic mutations, studying a few genes at a time at the beginning and studying multiple genes later on in what we call GWAS or Genome-Wide Association studies. These studies have proven to be very useful because we have identified several genes that are associated with stroke risk or stroke outcome, especially the most prominent study, a more recent one, is the GIGASTROKE study that studied more than half a million samples...
So stroke genomics traditionally has focused only on studying genetics or genomics, so genetic mutations, studying a few genes at a time at the beginning and studying multiple genes later on in what we call GWAS or Genome-Wide Association studies. These studies have proven to be very useful because we have identified several genes that are associated with stroke risk or stroke outcome, especially the most prominent study, a more recent one, is the GIGASTROKE study that studied more than half a million samples. But genetics is only one part of the picture when we study a disease. There are many other molecules and many other things that are involved in a complex disease like a stroke. So studying other things like proteomics, transcriptomics, or epigenomics can help us fulfill the full picture. And not only studying those separately, which is something that the field has been moving towards in the later years, but the next step and what we want to focus on now is multi-omics integration, meaning not only studying these individual omics by themselves, but merging them together to see how they interact with each other to give us the real outcome of a stroke. Another way the field is moving forward is that stroke not only happens at the time when people have a stroke, but also you have long-time effects, especially for rehabilitation and recuperation. So we want to also study longitudinal cohorts. So not only when they come to the hospital, but a few days later, three months after the first stroke and later on. So we can capture those dynamic changes because, yes, genetics, what we started with, are stable through our lifespan. Proteomics, epigenomics, and other biomolecules are dynamic and they can change through time. So it’s important to study this in sequential order and in different timelines so we can see how they are modulated and how we can use those as therapeutic targets, not only as biomarkers, but also potential targets for treatment.
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