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NHLBI 研讨会报告执行摘要:利用当前科学进展理解结节病变异性并改善结局。

Executive Summary of the NHLBI Workshop Report: Leveraging Current Scientific Advancements to Understand Sarcoidosis Variability and Improve Outcomes.

机构信息

1 Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado.

2 Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.

出版信息

Ann Am Thorac Soc. 2017 Dec;14(Supplement_6):S415-S420. doi: 10.1513/AnnalsATS.201707-563OT.

Abstract

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung; it is associated with significant disparities, more commonly impacting those in the prime of their lives (age 20-50 yr, with a second peak after age 60 yr), black individuals, and women. However, the burden of disease, the ability to diagnose and prognose organ involvement and course, as well as specific treatment options, management options, and disease pathogenesis remain poorly understood. As a result, the National Heart, Lung, and Blood Institute undertook a sarcoidosis workshop, "Leveraging Current Scientific Advancements to Understand Sarcoidosis Variability and Improve Outcomes," to help address these issues by defining the scientific and clinical priorities to improve sarcoidosis care. The overarching recommendations from this workshop are outlined in the following summary and detailed in the accompanying articles. The recommendations included establishing collaborations and networks to conduct research based on consensus definitions of disease phenotypes and standards of care, and to provide clinical outreach to areas with a burden of disease to improve care. These collaborative networks would also serve as the hub to conduct clinical trials of devastating phenotypes (e.g., cardiac, neurologic, and fibrotic disease) not only for treatment but to enhance our understanding of the burden of disease. In addition, the networks would be used to leverage state-of-the-art "omics" and systems biology research, as well as other studies to advance understanding of disease pathogenesis, and development of biomarkers and therapeutic targets, with a goal to translate this information to improve care of individuals with sarcoidosis.

摘要

结节病是一种系统性肉芽肿性疾病,主要影响肺部;它与显著的差异相关,更常见于处于生命黄金期(20-50 岁,60 岁后出现第二个高峰)的人群、黑人和女性。然而,疾病负担、诊断和预测器官受累和病程的能力,以及特定的治疗选择、管理选择和疾病发病机制仍然了解甚少。因此,美国国立心肺血液研究所(National Heart, Lung, and Blood Institute)开展了一项结节病研讨会,“利用当前科学进展理解结节病变异性并改善结局”,旨在通过定义改善结节病护理的科学和临床优先事项来解决这些问题。本次研讨会的总体建议在以下总结中概述,并在相关文章中详细说明。这些建议包括建立合作和网络,根据疾病表型和护理标准的共识定义进行研究,并向疾病负担较大的地区提供临床服务,以改善护理。这些合作网络还将作为枢纽,开展破坏性表型(如心脏、神经和纤维化疾病)的临床试验,不仅用于治疗,还用于增强我们对疾病负担的理解。此外,这些网络将用于利用最先进的“组学”和系统生物学研究以及其他研究来推进对疾病发病机制的理解,以及开发生物标志物和治疗靶点,目标是将这些信息转化为改善结节病患者的护理。

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本文引用的文献

1
Disease Burden and Variability in Sarcoidosis.结节病的疾病负担和变异性。
Ann Am Thorac Soc. 2017 Dec;14(Supplement_6):S421-S428. doi: 10.1513/AnnalsATS.201707-564OT.
2
Genetic, Immunologic, and Environmental Basis of Sarcoidosis.结节病的遗传、免疫和环境基础。
Ann Am Thorac Soc. 2017 Dec;14(Supplement_6):S429-S436. doi: 10.1513/AnnalsATS.201707-565OT.
3
High-Risk Sarcoidosis. Current Concepts and Research Imperatives.高风险结节病。当前概念和研究重点。
Ann Am Thorac Soc. 2017 Dec;14(Supplement_6):S437-S444. doi: 10.1513/AnnalsATS.201707-566OT.
4
Application of "Omics" and Systems Biology to Sarcoidosis Research.“组学”和系统生物学在结节病研究中的应用。
Ann Am Thorac Soc. 2017 Dec;14(Supplement_6):S445-S451. doi: 10.1513/AnnalsATS.201707-567OT.
5
Genetics of Sarcoidosis.结节病的遗传学
Clin Chest Med. 2015 Dec;36(4):569-84. doi: 10.1016/j.ccm.2015.08.002. Epub 2015 Oct 1.
8
Etiologies of Sarcoidosis.结节病的病因。
Clin Rev Allergy Immunol. 2015 Aug;49(1):6-18. doi: 10.1007/s12016-015-8481-z.

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