Charlotte Suppli Ulrik1,2, Susanne Vijverberg3,4, Nicola A Hanania5, Zuzana Diamant6,7,8. 1. Hvidovre Hospital, Respiratory Research Unit Hvidovre, Hvidovre. 2. Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. 3. Department of Respiratory Medicine. 4. Department of Paediatric Pulmonology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands. 5. Airways Clinical Research Center, Section of Pulmonary and Care Medicine, Baylor College of Medicine, Houston, Texas, USA. 6. Department of Respiratory Medicine and Allergology, Skåne University Hospital, Institute for Clinical Science, Lund University, Lund, Sweden. 7. Department of Respiratory Medicine, Thomayer Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic. 8. Department Clin Pharm and Pharmacol, University Medical Center Groningen and QPS-NL, University Groningen, Groningen, The Netherlands.
Abstract
PURPOSE OF REVIEW: To provide an update on the implementation of precision medicine, based on treatable traits and mechanisms, in the daily clinical management of chronic airways diseases. RECENT FINDINGS: Recent insights into the complex and heterogeneous nature of chronic airway diseases including chronic obstructive pulmonary disease (COPD) and asthma identified several clinical and inflammatory phenotypes. This shifted the management focus of these diseases away from the prototypic disease labels and paved the way for developing novel targeted therapies.The concept of precision medicine aims to link the right patient to the right treatment, while minimizing the risk of adverse effects. Several treatable features ('treatable traits') have now been identified for these chronic airway diseases, including pulmonary, extra-pulmonary, and psychological/lifestyle/environmental traits. As the next step, innovative detection techniques should clarify underlying mechanisms and molecular pathways of these treatable traits and novel reliable point-of-care (composite) biomarkers to help predict responders to targeted therapies must be developed. SUMMARY: Precision medicine links the right patient to the right treatment. Identification of treatable traits in asthma and COPD will help optimize the treatment approach in these heterogeneous diseases. Furthermore, in-depth identification of underlying molecular pathways and reliable biomarkers in chronic airways diseases to guide targeted treatment in individual patients is in progress.
PURPOSE OF REVIEW: To provide an update on the implementation of precision medicine, based on treatable traits and mechanisms, in the daily clinical management of chronic airways diseases. RECENT FINDINGS: Recent insights into the complex and heterogeneous nature of chronic airway diseases including chronic obstructive pulmonary disease (COPD) and asthma identified several clinical and inflammatory phenotypes. This shifted the management focus of these diseases away from the prototypic disease labels and paved the way for developing novel targeted therapies.The concept of precision medicine aims to link the right patient to the right treatment, while minimizing the risk of adverse effects. Several treatable features ('treatable traits') have now been identified for these chronic airway diseases, including pulmonary, extra-pulmonary, and psychological/lifestyle/environmental traits. As the next step, innovative detection techniques should clarify underlying mechanisms and molecular pathways of these treatable traits and novel reliable point-of-care (composite) biomarkers to help predict responders to targeted therapies must be developed. SUMMARY: Precision medicine links the right patient to the right treatment. Identification of treatable traits in asthma and COPD will help optimize the treatment approach in these heterogeneous diseases. Furthermore, in-depth identification of underlying molecular pathways and reliable biomarkers in chronic airways diseases to guide targeted treatment in individual patients is in progress.
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