2nd Respiratory Medicine Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece.
Dept of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund, Sweden; Dept of Clinical Pharmacy & Pharmacology, UMCG, and QPS-NL, Groningen, the Netherlands.
Respir Med. 2018 Sep;142:15-22. doi: 10.1016/j.rmed.2018.07.006. Epub 2018 Jul 17.
Asthma is a common disease, and although its clinical manifestations may be similar among patients, recent research discoveries have shown that it consists of several distinct clinical clusters or phenotypes, each with different underlying molecular pathways yielding different treatment responses. Based on these observations, an alternative approach - known as 'precision medicine' - has been proposed for the management of patients with severe asthma. Precision medicine advocates identification of treatable traits, linking them to therapeutic approaches targeting genetic, immunological, environmental, and/or lifestyle factors in individual patients. The main "goal" of this personalised approach is to enable choosing a treatment which will be more likely to produce a beneficial response in the individual patient rather than a 'one size fits all' approach. The aim of the present review is to discuss different ways of phenotyping asthma and to provide a rationale for treatment algorithms based on principles of precision medicine.
哮喘是一种常见疾病，尽管患者的临床表现可能相似，但最近的研究发现，它由几个不同的临床聚类或表型组成，每个表型都有不同的潜在分子途径，产生不同的治疗反应。基于这些观察结果，提出了一种替代方法——精准医学——来管理重症哮喘患者。精准医学主张确定可治疗的特征，并将其与针对个体患者遗传、免疫、环境和/或生活方式因素的治疗方法联系起来。这种个性化方法的主要“目标”是选择一种更有可能在个体患者中产生有益反应的治疗方法，而不是采用“一刀切”的方法。本综述的目的是讨论不同的哮喘表型方法，并为基于精准医学原则的治疗算法提供依据。
