Panel 3: Genomics, precision medicine and targeted therapies.

Objective: To review the most recent advances in human and bacterial genomics as applied to pathogenesis and clinical management of otitis media.
Data Sources: PubMed articles published since the last meeting in June 2015 up to June 2019.
Review Methods: A panel of experts in human and bacterial genomics of otitis media was formed. Each panel member reviewed the literature in their respective fields and wrote draft reviews. The reviews were shared with all panel members, and a merged draft was created. The panel met at the 20th International Symposium on Recent Advances in Otitis Media in June 2019, discussed the review and refined the content. A final draft was made, circulated, and approved by the panel members.
Conclusion: Trans-disciplinary approaches applying pan-omic technologies to identify human susceptibility to otitis media and to understand microbial population dynamics, patho-adaptation and virulence mechanisms are crucial to the development of novel, personalized therapeutics and prevention strategies for otitis media.
Implications for Practice: In the future otitis media prevention strategies may be augmented by mucosal immunization, combination vaccines targeting multiple pathogens, and modulation of the middle ear microbiome. Both treatment and vaccination may be tailored to an individual's otitis media phenotype as defined by molecular profiles obtained by using rapidly developing techniques in microbial and host genomics.
Competing Interests: Declaration of competing interest Dr. Allen F. Ryan is a Co-founder of and equity holder in Otonomy, Inc., a company that develops slow-release compounds for local delivery of medications to the middle and inner ear. The authors declare no competing interests.
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