Bihlet Asger R, Karsdal Morten A, Bay-Jensen Anne-Christine, Read Simon, Kristensen Jacob Hull, Sand Jannie Marie Bülow, Leeming Diana Julie, Andersen Jeppe Ragnar, Lange Peter, Vestbo Jørgen
Nordic Bioscience Clinical Development, Herlev, Denmark; Nordic Bioscience, Herlev, Denmark.
Nordic Bioscience, Herlev, Denmark.
Chest. 2015 Jul;148(1):16-23. doi: 10.1378/chest.15-0296.
Despite massive investments in the development of novel treatments for heterogeneous diseases such as COPD, the resources spent have only benefited a fraction of the population treated. Personalized health care to guide selection of a suitable patient population already in the clinical development of new compounds could offer a solution. This review discusses past successes and failures in drug development and biomarker research in COPD, describes research in COPD phenotypes and the required characteristics of a suitable biomarker for identifying patients at higher risk of progression, and examines the role of extracellular matrix proteins found to be upregulated in COPD. Novel biomarkers of connective tissue remodeling that may provide added value for a personalized approach by detecting subgroups of patients with active disease suitable for pharmacologic intervention are discussed.
尽管在慢性阻塞性肺疾病（COPD）等异质性疾病的新型治疗方法开发上投入了大量资金，但所花费的资源仅使一小部分接受治疗的人群受益。在新化合物的临床开发中，采用个性化医疗来指导选择合适的患者群体可能会提供一种解决方案。本综述讨论了COPD药物开发和生物标志物研究过去的成功与失败，描述了COPD表型的研究以及用于识别疾病进展风险较高患者的合适生物标志物所需的特征，并研究了在COPD中发现上调的细胞外基质蛋白的作用。还讨论了结缔组织重塑的新型生物标志物，这些生物标志物可能通过检测适合药物干预的活动性疾病患者亚组，为个性化治疗方法提供附加价值。
