[Sharing sensitive research data in the practice of personalised medicine]. / Az érzékeny kutatási adatok megosztása a személyre szabott orvoslás gyakorlatában.

Fragmentation of health data and biomedical research data is a major obstacle for precision medicine based on data-driven decisions. The development of personalized medicine requires the efficient exploitation of health data resources that are extraordinary in size and complexity, but highly fragmented, as well as technologies that enable data sharing across institutions and even borders. Biobanks are both sample archives and data integration centers. The analysis of large biobank data warehouses in federated datasets promises to yield conclusions with higher statistical power. A prerequisite for data sharing is harmonization, i.e., the mapping of the unique clinical and molecular characteristics of samples into a unified data model and standard codes. These databases, which are aligned to a common schema, then make healthcare information available for privacy-preserving federated data sharing and learning. The re-evaluation of sensitive health data is inconceivable without the protection of privacy, the legal and conceptual framework for which is set out in the GDPR (General Data Protection Regulation) and the FAIR (findable, accessible, interoperable, reusable) principles. For biobanks in Europe, the BBMRI-ERIC (Biobanking and Biomolecular Research Infrastructure - European Research Infrastructure Consortium) research infrastructure develops common guidelines, which the Hungarian BBMRI Node joined in 2021. As the first step, a federation of biobanks can connect fragmented datasets, providing high-quality data sets motivated by multiple research goals. Extending the approach to real-word data could also allow for higher level evaluation of data generated in the real world of patient care, and thus take the evidence generated in clinical trials within a rigorous framework to a new level. In this publication, we present the potential of federated data sharing in the context of the Semmelweis University Biobanks joint project. Orv Hetil. 2023; 164(21): 811-819.

[The transition of children with rare diseases from pediatric to adult care]. / A ritka betegségben szenvedo gyermekek átvezetése a felnottellátásba.

Diagnostics for rare diseases have advanced as a result of technological advancement. Innovative treatments have also made it possible for children with rare disorders to survive into adulthood. Growing up is crucial for someone who has a chronic childhood illness since the change from pediatric to adult treatment comes with new difficulties that might feel like an extra burden from the condition. Transition in rare diseases poses more challenges than in common diseases, because not all health care providers in adult care may have the expertise needed to provide optimal patient care. In addition, longer illness courses and the requirement for adult care in diseases for which there is no prior experience will result from the increasing number of better therapies. Occasionally, new clinical symptoms may appear that are unknown to clinicians. Despite the importance they should have, the majority of rare diseases do not currently have standardized recommendations and standards for the transition phase. Every transfer to adult care should be unique and stick to a predetermined plan. A transition coordinator should ideally work with the pediatrician, the adult specialist, the patient, and parents to support patients during this transition. The needs analysis of caregivers is an essential part in the transition process, too. The parties need to be educated, a protocol outlining the process needs to be developed, and the necessary infrastructure must be in place to support an optimal transition. Orv Hetil. 2022; 163(51): 2021-2026.

[Extracellular vesicles and their role in hematological malignancies]. / Extracelluláris vesiculák és hematológiai malignitásokban játszott szerepük.

Extracellular vesicles are produced in all organisms. The most intensively investigated categories of extracellular vesicles include apoptotic bodies, microvesicles and exosomes. Among a very wide range of areas, their role has been confirmed in intercellular communication, immune response and angiogenesis (in both physiological and pathological conditions). Their alterations suggest the potential use of them as biomarkers. In this paper the authors give an insight into the research of extracellular vesicles in general, and then focus on published findings in hematological malignancies. Quantitative and qualitative changes of microvesicles and exosomes may have value in diagnostics, prognostics and minimal residual disease monitoring of hematological malignancies. The function of extracellular vesicles in downregulation of natural killer cells' activity has been demonstrated in acute myeloid leukemia. In chronic lymphocytic leukemia, microvesicles seem to play a role in drug resistance. Orv. Hetil., 2016, 157(35), 1379-1384.