Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana Via di Valcannuta, 247, I-00166 Rome, Italy.
Unit of Thoracic Surgery, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.
Curr Med Chem. 2019;26(10):1721-1733. doi: 10.2174/0929867325666180601100235.
We report a comprehensive overview of current Chronic Obstructive Lung Disease (COPD) therapies and discuss the development of possible new pharmacological approaches based on "new" knowledge. Specifically, sensitivity/resistance to corticosteroids is evaluated with a special focus on the role of gene mutations in drug response.
Critically review the opportunities and the challenges occurring in the treatment of COPD.
Findings from "omics" trials should be used to learn more about biological targeted drugs, and to select more specific drugs matching patient's distinctive molecular profile. Specific markers of inflammation such as the percentage of eosinophils are important in determining sensitivity/resistance to corticosteroids. Specific gene variations (Single nucleotide polymorphisms: SNPs) may influence drug sensitivity or resistance. Clinicians working in a real-world need to have a suitable interpretation of molecular results together with a guideline for the treatment and recommendations. Far more translational research is required before new results from omics techniques can be applied in personalized medicine in realworld settings.
我们报告了目前慢性阻塞性肺疾病（COPD）治疗的全面概述，并讨论了基于“新”知识开发可能的新药理方法的可能性。具体而言，我们评估了皮质类固醇的敏感性/耐药性，特别关注基因突变在药物反应中的作用。
批判性地审查 COPD 治疗中出现的机遇和挑战。
“组学”试验的结果应用于了解更多关于生物靶向药物的信息，并选择更符合患者独特分子特征的更具体的药物。炎症的特定标志物，如嗜酸性粒细胞百分比，对于确定对皮质类固醇的敏感性/耐药性很重要。特定的基因变异（单核苷酸多态性：SNP）可能会影响药物的敏感性或耐药性。在实际环境中应用个体化医学中的组学技术的新结果之前，临床医生需要对分子结果进行适当的解释，并制定治疗和推荐建议。在转化研究方面还需要做更多的工作。
