만성폐쇄성기도질환의 최적 치료를 위한 정밀의학적 접근
Precision medicine for the best treatment of chronic obstructive airway disease
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Bronchial asthma and chronic obstructive pulmonary disease (COPD) are 2 representative diseases of chronic obstructive inflammatory airway diseases, and both show a wide range of heterogeneity in their clinical features. Although one end of typical asthma and the other end of COPD are clearly different, both diseases share lots of similarities in biological aspects and clinical manifestations. Currently, 2 different guidelines exist for asthma and COPD management, respectively, and in many clinical situations it is not easy to manage patients especially who have both features and show refractoriness to available medications. Since the features of the diseases are remarkably diverse in terms of clinical courses, prognosis and responses to therapeutic drugs, there have been vigorous efforts to classify appropriate subtypes in order to improve management of the diseases. However, dichotomous thinking about asthma and COPD precludes precise classification of the diseases in the real world. In this article, thus, chronic obstructive airway disease (COAD) ranging from asthma particularly in adults to COPD is proposed as 1 target subject to analyze precise classification based on exact phenotyping and endotyping of the diseases. In the current article, the reasonable precision medicine approach is also suggested based on treatable traits of COAD to achieve the best treatment for COAD patients.
Abstract
Bronchial asthma and chronic obstructive pulmonary disease (COPD) are 2 representative diseases of chronic obstructive inflammatory airway diseases, and both show a wide range of heterogeneity in their clinical features. Although one end of typical asthma and the other end of COPD are clearly different, both diseases share lots of similarities in biological aspects and clinical manifestations. Currently, 2 different guidelines exist for asthma and COPD management, respectively, and in many clinical situations it is not easy to manage patients especially who have both features and show refractoriness to available medications. Since the features of the diseases are remarkably diverse in terms of clinical courses, prognosis and responses to therapeutic drugs, there have been vigorous efforts to classify appropriate subtypes in order to improve management of the diseases. However, dichotomous thinking about asthma and COPD precludes precise classification of the diseases in the real world. In this article, thus, chronic obstructive airway disease (COAD) ranging from asthma particularly in adults to COPD is proposed as 1 target subject to analyze precise classification based on exact phenotyping and endotyping of the diseases. In the current article, the reasonable precision medicine approach is also suggested based on treatable traits of COAD to achieve the best treatment for COAD patients.
참고문헌 (32)
- [URL]
- Reid L, "The role of chronic bronchitis in the production of "chronic obstructive pulmonary emphysema"", J Am Med Womens Assoc, 20, pp.633~638 (1965)
- Orie NG, "Bronchitis" (1961), Royal Van Gorcum
- Cosio BG, "Th-2 signature in chronic airway diseases: towards the extinction of asthma-COPD overlap syndrome?", Eur Respir J, 49 (2017)
- Kim TB, "The reality of an intermediate type between asthma and COPD in practice", Respir Care, 57, pp.1248~1253 (2012)[DOI]
- Wheaton AG, "Gender and asthma-chronic obstructive pulmonary disease overlap syndrome", J Asthma, 53, pp.720~731 (2016)[DOI]
- Gibson PG, "Inflammatory phenotypes in adult asthma: clinical applications", Clin Respir J, 3, pp.198~206 (2009)[DOI]
- Simpson JL, "Inflammatory subtypes in asthma: assessment and identification using induced sputum", Respirology, 11, pp.54~61 (2006)[DOI]
- Moore WC, "Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis", J Allergy Clin Immunol, 133, pp.1557~1563 (2014)[DOI]
- Wenzel S, "Severe asthma in adults", Am J Respir Crit Care Med, 172, pp.149~160 (2005)[DOI]
- Balzar S, "Transbronchial biopsy as a tool to evaluate small airways in asthma", Eur Respir J, 20, pp.254~259 (2002)[DOI]
- JACK A. ELIAS, "Airway Remodeling in Asthma", American Journal of Respiratory and Critical Care Medicine, 161(supplement_2), pp.S168~S171 (2000), American Thoracic Society[DOI]
- Boulet L, "Airway responsiveness and bronchial-wall thickness in asthma with or without fixed airflow obstruction", Am J Respir Crit Care Med, 152, pp.865~871 (1995)[DOI]
- Benayoun L, "Airway structural alterations selectively associated with severe asthma", Am J Respir Crit Care Med, 167, pp.1360~1368 (2003)[DOI]
- Busse WW, "Pathophysiology of severe asthma", J Allergy Clin Immunol, 106, pp.1033~1042 (2000)[DOI]
- Kim TB, "Identification of asthma clusters in two independent Korean adult asthma cohorts", Eur Respir J, 41, pp.1308~1314 (2013)[DOI]
- Moore WC, "Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program", Am J Respir Crit Care Med, 181, pp.315~323 (2010)[DOI]
- Hinks TS, "Multidimensional endotyping in patients with severe asthma reveals inflammatory heterogeneity in matrix metalloproteinases and chitinase 3-like protein 1", J Allergy Clin Immunol, 138, pp.61~75 (2016)[DOI]
- Kuo CS, "T-helper cell type 2 (Th2) and non-Th2 molecular phenotypes of asthma using sputum transcriptomics in U-BIOPRED", Eur Respir J, 49 (2017)
- Marichal T, "Homeostatic eosinophils: characteristics and functions", Front Med (Lausanne), 4, pp.101~ (2017)[DOI]
- Rothenberg ME, "A hidden residential cell in the lung", J Clin Invest, 126, pp.3185~3187 (2016)[DOI]
- Woodruff PG, "Current concepts in targeting chronic obstructive pulmonary disease pharmacotherapy: making progress towards personalised management", Lancet, 385, pp.1789~1798 (2015)[DOI]
- Bafadhel M, "Profiling of sputum inflammatory mediators in asthma and chronic obstructive pulmonary disease", Respiration, 83, pp.36~44 (2012)[DOI]
- Ghebre MA, "Biological clustering supports both "Dutch" and "British" hypotheses of asthma and chronic obstructive pulmonary disease", J Allergy Clin Immunol, 135, pp.63~72 (2015)[DOI]
- Bardin PG, "Managing asthma in the era of biological therapies", Lancet Respir Med, 5, pp.376~378 (2017)[DOI]
- Scanlon ST, "Type 2 innate lymphoid cells: new players in asthma and allergy", Curr Opin Immunol, 24, pp.707~712 (2012)[DOI]
- Sears MR, "Safe use of long-acting <TEX>${\beta}$<", TEX>-agonists: what have we learnt?, 2011, pp.10, 767~778
- Park HW, "Additive role of tiotropium in severe asthmatics and Arg16Gly in ADRB2 as a potential marker to predict response", Allergy, 64, pp.778~783 (2009)[DOI]
- Thomas M, "When is dual bronchodilation indicated in COPD?", Int J Chron Obstruct Pulmon Dis, 12, pp.2291~2305 (2017)[DOI]
- 조유숙, "Effective Strategies for Managing Asthma Exacerbations for Precision Medicine", Allergy, Asthma & Immunology Research, 9(6), pp.463~465 (2017), 대한천식알레르기학회
- Agusti A, "Treatable traits: toward precision medicine of chronic airway diseases", Eur Respir J, 47, pp.410~419 (2016)[DOI]