Khan Malik M Khurram S, Cole Adam G, Mannino David M
University of Kentucky College of Medicine, Lexington, Kentucky, USA.
Curr Opin Pulm Med. 2022 Mar 1;28(2):115-120. doi: 10.1097/MCP.0000000000000837.
In this review, we will discuss the current status and recent developments in precision medicine in chronic obstructive pulmonary disease (COPD) through the lens of treatable traits.
Although the term 'treatable traits' in the treatment of COPD is relatively recent, this concept has been used for many years if one considers interventions such as long-term oxygen therapy or alpha-1 antitrypsin replacement therapy. Recent advances have included expanding the definition of COPD to include a broader population of people with lower respiratory disease but not meeting the strict criteria for obstruction, advances in imaging to aid in the diagnosis and treatment of COPD, advances in understanding symptoms and exacerbations to define severity, using biomarkers to guide therapy and better understanding and addressing polymorbidity and frailty. In addition, there is a concerted effort to use these concepts to identify COPD patients earlier in the disease process wherein disease modification may be possible.
Focusing on subsets of patients with COPD with certain characteristics should lead to better outcomes and fewer adverse effects from treatment.
在本综述中，我们将透过可治疗特征这一视角，探讨慢性阻塞性肺疾病（COPD）精准医学的现状及近期进展。
尽管COPD治疗中“可治疗特征”这一术语相对较新，但如果将长期氧疗或α-1抗胰蛋白酶替代疗法等干预措施考虑在内，这一概念已被使用多年。近期进展包括扩大COPD的定义，将更多患有下呼吸道疾病但未达到严格阻塞标准的人群纳入其中；成像技术的进步有助于COPD的诊断和治疗；在理解症状和急性加重以界定严重程度方面取得进展；利用生物标志物指导治疗；以及更好地理解和应对共病和虚弱。此外，正在齐心协力利用这些概念在疾病进程中更早地识别COPD患者，此时疾病修饰或许是可行的。
关注具有特定特征的COPD患者亚组应能带来更好的治疗效果，并减少治疗的不良反应。
